The arthritic ulcer: a retrospective study of peptic ulceration in patients with rheumatoid arthritis.

Four patients with duodenal ulcer (DU) and nine with gastric ulcer (GU) were admitted to a general hospital rheumatology ward over an eighteen month period. Indigestion was the predominant though not invariable presenting symptom. Most ulcers healed with cimetidine over a period of six weeks to eight months, though two patients required surgery. Non-steroidal anti-inflammatory drugs were continued in all patients without major complications. Unanswered questions raised by the study, to which a prospective trial could be directed, include the sensitivity and specificity of indigestion as a presenting feature of peptic ulceration, the effect of non-steroidal anti-inflammatory drugs (NSAID's) other than aspirin on the aetiology and natural history of gastric ulceration, and the rational choice of antirheumatic and anti-ulcer therapy in rheumatoid patient in whom peptic ulceration has occurred.