Clinical Presentation of Peptic Ulcer in the Elderly

Abstract

The aim of this study was to determine the age-related characteristics of peptic-ulcer patients. A total of 125 consecutive patients (63 men and 62 women) with peptic ulcer were studied prospectively. The ulcers were diagnosed at endoscopy. The mean age of patients was 62 years (57 years in men and 68 in women). Patients were asked about their use of nonsteroidal anti-inflammatory drugs (NSAIDs). The main symptom, the duration of symptoms, the ulcer location and size, and the presence of Helicobacter pylori (HP) from the histologic specimen were recorded. Ulcer complications such as bleeding or perforation were also noted. These parameters were compared in two age groups: 65 years or under (n = 65) and over 65 years (n = 60). In the older age group, duodenal ulcer was less common (42 vs. 66%, p = 0.008) and typical epigastric pain was rare (35 vs. 91 %, p < 0.001). Ulcer bleeding was present more commonly in the older age group (50 vs. 14%, p < 0.001). The duration of symptoms was shortest in patients who used NSAIDs, especially among older patients. Elderly patients also had an atypical location more often (39 vs. 15%, p = 0.003). After adjustment for use of NSAIDs, these characteristics remained among the elderly. The presence of HP was less common in the older age group (56 vs. 92%, p < 0.001). Furthermore, in the group of elderly patients who did not use NSAIDs, 35% were HP-negative. In conclusion, the presentation of peptic ulcer in the elderly has distinct characteristics, which are not entirely related to the use of NSAIDs.

Lack of association between Helicobacter pylori infection and extracardiac atherosclerosis in dyspeptic elderly subjects

“…Our results show that elderly patients with HP infection had, as expected, a higher prevalence of peptic ulcer disease and higher titres of IgG anti-HP antibodies. These findings were in agreement with recent studies demonstrating that, in elderly subjects, HP infection is associated with clinically important gastroduodenal pathologies [24,25]. HP eradication reduces both short-and long-term symptomatology, gastritis activity and ulcer recurrences [26,27].…”

Nuclear Factor-κB Regulates Cyclooxygenase-2 Expression and Cell Proliferation in Human Gastric Cancer Cells

“…Histopathologic and epidemiologic studies showed that gastric cancer may be associated with hyperproliferation of gastric cells (Kemppainen et al, 1997;Persing and Prendergast, 1999) and this hypothesis was proven in studies on Helicobacter pylori infection (Correa, 1997;Guarner et al, 1993;Lynch and Axon, 1995;Moss, 1999). Increased proliferation of gastric cells by Helicobacter pylori was inhibited by supplementation of antioxidants and NF-B inhibitors (Bukin et al, 1993;Sharma et al, 1995).…”

Changing prevalence of upper gastrointestinal disease in 28 893 Koreans from 1995 to 2005

“…That is, the prevalence of H. pylori-negative peptic ulcers in the USA and Australia is relatively high, at 27-43%, and relatively low in Europe and Japan, at 2.7-8.0% [31][32][33][34][35][36]. This could be explained from the fact that the infection rate of H. pylori fell more rapidly in the USA and Australia.…”