Preferential location of idiopathic peptic ulcers

Katsunori Iijima, Takeshi Kanno, Yasuhiko Abe, Makoto Yagi, Sho Asonuma, Motoki Ohyauchi, Hirotaka Ito, Tomoyuki Koike, Tooru Shimosegawa

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)


Abstract: Objective:Helicobacter pylori infection-negative, nonsteroidal antiinflammatory drugs (NSAIDs)-negative peptic ulcers, which are termed idiopathic peptic ulcers (IPUs), have been increasing worldwide. In this study, we investigated the preferential locations of gastric ulcers according to their cause (e.g., H. pylori and NSAIDs), with special attention to IPUs. Material and methods: A total of 361 patients consecutively diagnosed with a peptic ulcer over a period of one year were classified into four groups according to H. pylori-infection status and NSAIDs usage. The ulcer location was divided into the antrum, angularis, and body, and was compared among the four ulcer groups. Results: The ulcers of 43 patients were classified as IPUs. Compared with simple H. pylori ulcers, IPUs more preferentially located in the antrum (14% vs. 52%, p < 0.01). The difference was more pronounced in the analysis of IPUs in which patients with a history of H. pylori eradication or those with severe atrophic gastritis were excluded, and 79% of these IPUs were located in the antrum. With duodenal ulcers taken together, the vast majority of (86%) these IPUs occurred in the duodenal bulb or the antrum. The proportion of antral ulcers in NSAISs users also differed depending on the presence of concomitant H. pylori infection (positive: 22% vs. negative: 62%, p < 0.01). Conclusion: There was a striking difference in the ulcer location within the stomach depending on the cause of the ulcer, and IPUs predominantly occurred in the antrum. This information on the preferential locations of ulceration should provide endoscopists with some hints concerning the etiology of ulcers.

Original languageEnglish
Pages (from-to)782-787
Number of pages6
JournalScandinavian Journal of Gastroenterology
Issue number7
Publication statusPublished - 2016 Jul 2


  • Gastric atrophy
  • H. pylori
  • idiopathic peptic ulcers
  • nonsteroidal antiinflammatory drugs
  • preferential location


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