Medical management of chronic gastric ulcer.

The results of medical treatment in 113 patients with chronic ulceration of the angulus and vertical part of the stomach are reported. The ulcers failed to heal in 38% and healed but recurred in 22%. The ulcers healed and, except for minor recurrences in a few, remained healed for five years in 40%. The prognosis for patients with ulcers with long histories and large ulcers was poor, and this is true of other series reported in the literature. If such cases had been excluded from the present series the success rate would have risen to 64%. Patients with ulcers in these two categories should be referred for surgery. It is suggested that a trial of medical treatment is justifiable in most other cases, surgery being reserved for its failures.