Intractability in terms of the medical treatment of PUD
Intractability is defined as mucosal healing refractory to maximal medical therapy. The following three criteria define a refractory ulcer and are generally indications for operative intervention:
- Ulcer persistence after 2 months of PPI or 3 months of H 2 -antagonist treatment
- Ulcer recurrence within 1 year, despite maintenance medical therapy
- Ulcer disease in which cycles of prolonged activity are interrupted by brief or absent remissions
