Peptic Ulcer Disease in the Elderly

Gilinsky, Norman H.

doi:10.3109/00365528809099146

Cited by 24 publications

(11 citation statements)

References 54 publications

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“…The rate of perforated peptic ulcers has tended to decrease [4,6,8,9]. Concomitantly, a gradual relative increase in elderly persons sustaining a perforation has been observed [4,6,8,9].…”

Section: Discussionmentioning

confidence: 99%

Perforated Peptic Ulcer: Long‐term Results after Simple Closure in the Elderly

Blomgren

1997

World j. surg.

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The relative incidence of peptic ulcer perforation in the elderly is rising, and the optimal surgical treatment has yet to be defined. To evaluate the long-term result after simple closure a follow-up study was initiated at a Swedish community hospital. During 1983-1992 a total of 151 patients were admitted with perforated peptic ulcer; 92 were elderly (i.e., 70 years or older), 63 of whom were operated with simple closure. Mortality at 30 days was 27% (17/63) and the total in-hospital mortality 30% (19/63). After a mean follow-up of 79 months, 14 of the 44 survivors are still alive. So far only three of the survivors have required additional hospitalization for complications of peptic ulcer disease. Because the rate of serious recurrences is low (14%, 6/44), it is concluded that simple closure is an adequate surgical treatment for peptic ulcer perforation in the elderly.

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“…The rate of perforated peptic ulcers has tended to decrease [4,6,8,9]. Concomitantly, a gradual relative increase in elderly persons sustaining a perforation has been observed [4,6,8,9].…”

Section: Discussionmentioning

confidence: 99%

Perforated Peptic Ulcer: Long‐term Results after Simple Closure in the Elderly

Blomgren

1997

World j. surg.

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“…These pathophys iological considerations are indirectly con firmed by the excellent clinical results [11,[26][27][28] obtained in the elderly with antisecretory drugs. 258 Pilotto/Viancllo/Di Mario/Plebani/ Farinati/Azzini…”

Section: Discussionmentioning

confidence: 99%

“…These findings suggest an increased susceptibility of the gastric mucosa to damage in the elderly. However, it is also interesting to consider gastroduodenal secretory capacity in peptic ulcer patients in relation to advanc ing age; in fact, it is important to know wheth er there is a different acid and/or pepsin out put corresponding to the epidemiological and clinical differences in ulcer disease in the elderly, who suffer a higher morbidity and mortality [11]. The aim of this retrospective study was therefore to evaluate the influence of age on gastric acid and pepsin secretion in a large sample of GU and DU patients.…”

Section: Introductionmentioning

confidence: 99%

Effect of Age on Gastric Acid, Pepsin, Pepsinogen Group A and Gastrin Secretion in Peptic Ulcer Patients

et al. 1994

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To verify the effect of age on gastric secretions in gastric (GU) and duodenal ulcer (DU) patients, we carried out a retrospective study evaluating basal and stimulated gastric acid secretion in 427 peptic ulcer subjects aged between 12 and 73 years (GU = 74, DU = 353) in addition to studying gastric juice pepsin, serum pepsinogen group A (PGA) and gastrin in 175 patients (GU = 28, DU = 147). All subjects were then divided into groups according to their sex and age ( < 30, 30–39, 40–49, 50–59 and > 60 years). Basal, maximal and peak acid outputs (BAO, MAO, PAO) were unchanged in the various age groups, though MAO and PAO were higher in males than females and in DU than in those with GU, even in the elderly ( > 60 years). Pepsin and gastrin levels were unchanged at the various ages in GU and DU, while PGA was higher in males with DU aged 50 or over. This demonstrates that acid, pepsin and gastrin secretions do not change with age in ulcer patients. Acid secretion retains its typical distribution according to pathology (DU > GU) and sex (males > females), and also appears to have a fundamental pathogenetic role in peptic ulcer in the elderly.

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“…bleeding and perforation, are more frequent in the elderly [2,3]. Recently, studies have demonstrated that the recurrence of both GU and DU is markedly decreased after the cure of HP infection [4][5][6][7][8]; however, until now, no data has been published regarding the clinical outcome of HP-associated GU and DU in elderly people treated for HP infection.…”

Section: Introductionmentioning

confidence: 90%

The Long-Term Clinical Outcome of Elderly Patients with Helicobacter pylori-Associated Peptic Ulcer Disease

et al. 1998

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The objective of this study was to evaluate the long-term efficacy of Helicobacter pylori (HP) eradication treatment in elderly patients with HP-associated peptic ulcer. A total of 56 subjects, 25 affected with gastric ulcer (GU, 9 males, 16 females, mean age 77.8 years, range 67–93) and 31 with duodenal ulcer (DU, 19 males, 12 females, mean age 76.5 years, range 65–87) were confirmed to be HP-positive by gastric histology and the rapid urease test. All patients were then consecutively treated with omeprazole for 4 weeks plus one or two antibiotics for 1 week as anti-HP treatment. Clinical checkups were then performed every 3 months for 1 year for the evaluation of symptoms and clinical recurrences. Endoscopy with gastric biopsies was repeated after 1, 3 and 12 months for the evaluation of ulcer healing, HP infection and chronic gastritis activity. Statistical analysis was performed by means of the Student t test for unpaired data, the Fisher exact test (two-tailed), and the McNemar χ² test. After 4 weeks of treatment, endoscopy confirmed healing of the ulcer in all patients, regardless of the treatment used to cure HP infection. Two months after the end of therapy, a total of 44 patients were HP-negative and 12 patients were still HP-positive. During the 1-year follow-up period 1/44 (2.2%) of the HP-eradicated patients and 5/12 (41.6%) of the still HP-positive patients suffered relapses (p = 0.001): the difference between the two groups remained statistically significant when patients were divided into the subgroups, GU (p = 0.01) and DU (p = 0.04). Two months after the end of therapy, there was still a significant reduction of symptoms both in HP-eradicated (p < 0.0000) and in HP-positive (p = 0.002) patients. After 1 year, however, there was a significantly decreased symptomatology only in HP-eradicated subjects (p < 0.0000) and not in patients still HP-positive. After both 2 months and 1 year of follow-up, chronic gastritis activity demonstrated a significant improvement only in HP-eradicated patients (p = 0.0000). In conclusion, the eradication of HP infection significantly improved the long-term clinical outcome of peptic ulcer disease in the elderly, reducing the recurrences of GU and DU, the patient’s symptomatology and the histological signs of chronic gastritis activity. The cure of HP infection is, therefore, strongly recommended in elderly patients with HP-associated peptic ulcer disease.

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Peptic Ulcer Disease in the Elderly

Cited by 24 publications

References 54 publications

Perforated Peptic Ulcer: Long‐term Results after Simple Closure in the Elderly

Perforated Peptic Ulcer: Long‐term Results after Simple Closure in the Elderly

Effect of Age on Gastric Acid, Pepsin, Pepsinogen Group A and Gastrin Secretion in Peptic Ulcer Patients

The Long-Term Clinical Outcome of Elderly Patients with Helicobacter pylori-Associated Peptic Ulcer Disease

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