The gastritis associated with chronic gastric ulcer has been studied by means of biopsy specimens taken under vision through a fibreoptic gastroscope from four standard sites in the stomach. Observations have been made in patients with untreated gastric ulcer and also in patients after medical or surgical treatment of the ulcer. The gastritis is usually widespread in chronic peptic ulcer of the body of the stomach, whereas it is commonly more localized in chronic prepyloric ulcer. Superficial or atrophic gastritis has been found to persist or even worsen after healing of the ulcer, whether the treatment was medical or surgical. This finding suggests that gastritis is the basic disease process and that gastric ulceration is a secondary phenomenon.
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