Gastric Ulcer 2030: Insights from yesterday, today and future trends

Despite significant strides in the diagnosis and treatment of gastrointestinal disease, gastric ulcer has become a common condition that still carries a significant burden of morbidity worldwide. It is caused by an imbalance of aggressive factors like gastric acid, pepsin, Helicobacter pylori infection, NSAIDs, oxidative stress and inflammatory mediators and defensive factors like mucus secretion, bicarbonate production, prostaglandin synthesis and mucosal blood flow. Overt recognition of microbial, molecular and environmental contributors in gastric ulcer pathogenesis has evolved from a previous focus on stress and acid hypersecretion. The identification of H. pylori transformed the management of ulcers and brought about a significant drop in rates of recurrence with the use of eradication therapy. Modern therapies involve the use of proton-pump inhibitors, histamine H2 receptor antagonists, cytoprotective agents and combination antimicrobial therapies. But resistance to antibiotics and side effects of treatment, as well as recurrence of the illness are still big problems. By 2030, emerging innovations such as nanotechnology drug delivery systems, artificial intelligence diagnostics, microbiome modulation and regenerative medicine and personalized therapeutics are anticipated to change the face of gastric ulcer management. This review aims to present a summary of the evolution, pathogenesis, diagnosis therapy and future prospects in gastric ulcer disease.