Two Cases of Proton Pump Inhibitor (PPI)-resistant Gastric Ulcers Caused by Gastric Empting Disturbance

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  • NISHINO Yuki
    Department of Internal Medicine I. and Molecular Science & Applied Medicine, Yamaguchi University School of Medicine
  • NISHIKAWA Jun
    Department of Internal Medicine I. and Molecular Science & Applied Medicine, Yamaguchi University School of Medicine
  • SATAKE Masaaki
    Department of Internal Medicine I. and Molecular Science & Applied Medicine, Yamaguchi University School of Medicine
  • MATSUMOTO Toshihiko
    Department of Internal Medicine I. and Molecular Science & Applied Medicine, Yamaguchi University School of Medicine
  • AKASHI Keiko
    Department of Internal Medicine I. and Molecular Science & Applied Medicine, Yamaguchi University School of Medicine
  • KITOU Tomoko
    Department of Internal Medicine I. and Molecular Science & Applied Medicine, Yamaguchi University School of Medicine
  • NAKAMURA Hiroki
    Department of Internal Medicine I. and Molecular Science & Applied Medicine, Yamaguchi University School of Medicine
  • OKITA Kiwamu
    Department of Internal Medicine I. and Molecular Science & Applied Medicine, Yamaguchi University School of Medicine

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Other Title
  • 胃排出能低下を伴ったプロトポンプ阻害薬（ＰＰＩ）抵抗性胃潰ようの２例
  • イ ハイシュツノウ テイカ オ トモナッタ プロトポンプ ソガイヤク PPI テイコウセイ イカイヨウ ノ 2レイ
  • 胃排出能低下を伴ったプロトポンプ阻害薬(PPI)抵抗性胃潰瘍の2例

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Proton pump inhibitors (PPIs) are known to be the most potent anti-ulcer agents, because of stronger inhibitory action of gastric acid secretion in comparison with H2-receptor antagonists (H2-RAs). PPIs have been used in the treatment of H2-RA-resistant ulcers. However, in accordance of accumulation of these cases, it is also known that some peptic ulcers are resistant even to PPIs as well as H2-RAs. Two patients who suffered from hemorrhagic gastric ulcers were admitted to our institution. The hemostasis was verified by endoscopy after intravenous administrations of H2-RAs. Rebleeding from ulcers occurred after change of intravenous injection of H2-RAs to oral administrations of PPIs. H2-RAs was given again instead of PPIs, and gastric ulcers were healed. It is not clear why some gastric ulcers are resistant to PPIs. We considered that disturbance of gastric emptying was one of the important factors to develop PPI-resistant ulcers.

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