How is that a counterpoint? You're just presenting a rare case, like Zollinger-Ellison, or some genetic or physiologic Vagal over-stimulation. 80%+ of ulcers are caused by H. Pylori infection. Next largest group is misuse of NSAIDS (also the most common causes for pediatric ulcers). Why would a doctor not first test and treat the common things, rather than do an invasive procedure?