About pyloro-duodenitis

If 3-4 years ago a patient came to us with complaints of late pains after eating, of hunger and night pains, if he had an increased content of free HCI in the gastric juice, blood in the gastric contents or in the feces, and if finally we probed his hypertrophied and painful pylorus, we probably would not hesitate to diagnose a stomach ulcer or duodenal ulcer. Now with such categoricalness and certainty we cannot and should not make such diagnosis. Because now we know, especially due to wide use of gastroscopy (mainly in Germany) and also due to wide spread of gastrointestinal surgery, that the whole symptom complex, which we considered almost pathognomonic for stomach or duodenal ulcer, can be present in diseases of the stomach, where there is no ulcer and never was. We now know of the existence of "ulcer disease without ulcers"-Ulcuskrankheit ohne Ulcus!