The ulcer disease: an updated classification system.

Abstract

The study included 736 probands with ulcer disease and 110 healthy subjects as well as all their relatives up to a third-degree of relation (n = 21889). All subjects underwent a thorough genealogical analysis, blood group, PTC and dermatoglyphic studies were performed on the whole contingent. Using extensive genealogical, genetico-mathematical and multifactorial analysis we studied the manifestations of anticipation, the influence of hereditary predisposition on gastric secretion and acidity under conditions of maximum pentagastrin stimulation as well as the disease inheritance pattern. The results of our comprehensive studies suggest that type I gastric ulcer according to H. Johnson, unlike type II and type III, is not genetically determined. On the other hand, type II and type III gastric ulcer do not differ substantially from duodenal ulcer and should therefore be categorised as belonging to this form of the disease. On this basis we propose a new classification system which accepts the existence of two ulcer diseases: gastric ulcer disease, and ulcer disease of the pyloroduodenal region.