Gastric and Duodenal Ulcer Healing Under Placebo Treatment

The healing time relation of 30 gastric and 15 duodenal ulcers was assessed by repeated endoscopic measurements of ulcer size on days 1, 21, and 42 of a 6-week period, during which a selected population of patients was being treated as outpatients on an inert placebo. Antacids in small amounts were only given in case of ulcer pain. There was evidence for a linear relationship between the absolute initial ulcer size and its reduction with the time in incompletely healed ulcers of both types. Their percentage reduction from the original size was 71% after 3 weeks in gastric and 83% in duodenal ulcers; 82% after 6 weeks in gastric and 83% in duodenal ulcers. The healing time course for both types of ulcers appeared to follow an exponential function. The calculated half-life was 1.7 weeks for gastric and 1.9 weeks for duodenal ulcers. The number of healed duodenal ulcers observed at the 3-week examination was significantly greater than that of healed gastric ulcers (P = 0.05). It is concluded that repeated measurements of the ulcer size before complete ulcer healing contribute to a optimal characterization of the healing time course. The calculated half-life of less than 2 weeks makes shorter control intervals reasonable for both types of ulcers. The ulcer half-life appears to be a more accurate criterion of the healing process than that of complete healing.