The proportion (and even the reality) of peptic ulcer disease (PUD) not related to H. pylori or NSAID/aspirin is debated.
Dr Pariente and colleagues from France analyzed the current epidemiological and clinical characteristics of peptic ulcer disease in French general hospitals.
The research team performed a prospective multicenter study of patients with peptic ulcer disease in 32 French general hospitals over 1 year.
H. pylori status was assessed by histology, and/or serology and/or C13-urea breath test.
NSAID/aspirin intake, and data about concomitant diseases were collected on the day of endoscopy.
|40% had only H. pylori infection|
|Alimentary Pharmacology & Therapeutics|
The researchers selected 933 patients during the year 2009.
After exclusion of 118 patients with only erosive duodenitis, 24 with major missing data, 13 with other causes of ulcer and 65 negative for H. pylori by only one test, 713 patients were classified into 4 groups.
The team found that 40% had only H. pylori infection, 18% only gastrotoxic drugs, 20% had both, and 22% neither H. pylori infection nor gastrotoxic drug intake.
Patients with idiopathic ulcers differed in many ways both from H. pylori and NSAID/aspirin groups.
However, multivariate analysis identified only 3 independent predictors, including age, French metropolitan origin and the presence of comorbidities.
Dr Pariente's team concludes, "In a general hospital-based population in France, peptic ulcer disease appears idiopathic in a fifth of cases."