Methods/Aims-During 1993-1994 an audit of the outcomes of a consecutiv
e series of peptic ulcer patients, first diagnosed endoscopically betw
een 1972-1983, was carried out. Three hundred and thirty six patients
fitting the entry criteria were identified, 46 had died in the interva
l, and 44 were lost to follow up, leaving 246 available for evaluation
. All patients completed questionnaires on their current symptomatic s
tate, drug treatment, and details of any operations they had undergone
since their original diagnosis. In addition they were asked to indica
te, on an analogue scale, their overall assessment of how their ulcer
problem was affecting them at the time of the review. Where available
hospital records were obtained and analysed for any further admissions
and the results of any further endoscopies. Results-Of the 246 patien
ts, 158 were men and 88 female. Duodenal ulcers (DU) were present in 2
04 and gastric ulcers (GU) in 51 (nine had both a DU and GU). Since th
e diagnosis 65 patients had undergone surgical treatment: 44 for poor
ulcer control, nine for pyloric stenosis, nine for a perforation, one
for a major gastrointestinal bleed, and two for a gastric carcinoma de
veloping within two years of the diagnosis of a GU. The overall incide
nce of ulcer complications during this follow up period (excluding the
carcinomas) was 7 . 7%. Initial medical treatment was with histamine
H-2 blockade in 234 patients - 87 . 4% cimetidine (C) and 11% ranitidi
ne (R) - with other agents in the remainder. At follow up 176 patients
were still receiving medical treatment (C, 71%: R, 22%, other, 7%) in
cluding 30 who had previously undergone a definitive surgical procedur
e. Dyspeptic symptoms were recorded in 50 . 4% of the patients, abdomi
nal pain being the commonest complaint. There was a significant relati
on between abdominal pain and the analogue scores provided by the pati
ents with significantly more (p = 0 . 02) of those who bad undergone s
urgical treatment recording this as a continuing problem (44 . 6% v 36
%). Conclusion-There is no evidence provided by this study that, in th
ese patients, their ulcer disease is undergoing spontaneous remission
with time.