The marked drop in the frequency of Helicobacter pylori infection resulting from the use of antibiotics and potent anti-acid medications has substantially lowered the prevalence of peptic ulcer disease in recent decades.

Management of this condition, however, is challenging because of the escalating perils of antibiotic resistance and the abuse of anti-inflammatory drugs. For example, the increased prevalence of cholangiocarcinomas may associate with this peptic ulcer disease management including the prolonged use of proton pump inhibitors. Cholangiocarcinoma is one of the most lethal cancers and accounts for almost 15% of all hepatic malignancies. This review provides a concise summary of the latest findings in the pathogenetic mechanisms of cholangiocarcinoma, essentially focusing on peptic ulcer disease and its associated therapies.

We also suggest interventions that may reduce Helicobacter pylori infection and peptic ulcers with the bacteriostatic agent, melatonin. Melatonin treatment may reduce the incidence of this devastating cancer or improve the outcome of individuals that develop this disease.