[Prognostic factors of the speed of cicatrization in duodenal ulcer. Controlled trial of omeprazole versus ranitidine].

OBJECTIVES

The treatment of duodenal ulcers has changed greatly since the introduction of anti-H2 drugs and sodium pump inhibitors. However the effect of several factors influencing prognosis and the rate of healing remain to be elucidated.

METHODS

Five hundred forty five patients with a fibroscopically proven duodenal ulcer were included in a randomized controlled trial and were treated for one month with omeprazole (20 mg) or ranitidine (300 mg). Twenty epidemiological, clinical and fibroscopic factors of prognosis were recorded when the patients entered in the study and were analyzed after the treatment period.

RESULTS

Endoscopic healing was obtained in 90% of the omeprazole treated patients and in 78% of the ranitidine group (p < 0.001). Multifactorial analysis of the 20 prognostic factors showed that, excepting the treatment factor, only the size of the ulcer (less than 11 mm), its shape (round), its localisation (not on the posterior side) and a moderate pain were factors of good prognosis. Paradoxically, in our study, male patients and alcohol consumption were also positive factors of prognosis.

CONCLUSION

The probability of healing is best for round, small duodenal ulcers located on the anterior side of the bulb.