ENDOSCOPIC ULTRASONOGRAPHIC EVALUATION OF GASTRIC-ULCER HEALING ON TREATMENT WITH PROTON PUMP INHIBITORS VERSUS H-2-RECEPTOR ANTAGONISTS

Background: It has been reported that time to peptic ulcer healing is shorter with proton pump inhibitors (PPI) than with H-2-receptor antag onists (H-2-RA). This study was designed to examine the difference in the healing process between gastric ulcers treated with PPI and those treated with H-2-RA. Methods: The healing of deep gastric ulcers treat ed with PPI (n = 11) or H-2-RA (n = 13) was evaluated with endoscopic ultrasonography (EUS). Every 2 weeks during treatment EUS variables su ch as the width and the depth of the ulcer crater, the thickness and s ize of the low echoic area of the ulcer base, and the distance of the disrupted muscularis propria were measured. The contraction rates of E US variables, the ratios of the contraction rate of the depth to that of the width of the ulcer crater (D/W ratio) and the contraction rate of the distance of the disrupted muscularis propria layer to that of t he width of the ulcer crater (Dm/W ratio) were calculated. Results: On ly at week 2 were the D/W ratio and Dm/W ratio significantly higher in the group receiving PPI (D/W ratio, 1.79 +/- 0.701; Dm/W ratio, 0.938 +/- 0.207) than in the group receiving HI-RA (D/W ratio, 1.10 +/- 0.5 59; Dm/W ratio, 0.641 +/- 0.166). Conclusion: This study demonstrated that PPI therapy is associated with more rapid and stronger healing th an obtained with H-2-RA during the early treatment period.