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Proportion of peptic ulcer disease not related to H. pylori or aspirin/NSAID

A study in the latest issue of Alimentary Pharmacology & Therapeutics finds that peptic ulcer disease appears idiopathic in a fifth of cases.

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The proportion 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 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.

The team selected 933 patients during the year 2009.

Age was an independent predictor of peptic ulcer disease
Alimentary Pharmacology & Therapeutics

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.

The team found that 713 patients were classified into 4 groups.

Group 1 included 285 patients who had only H. pylori infection.

Group 2 included 133 patients with only gastrotoxic drugs.

There were 141 patients in Group 3 who had both, and Group 4 included 154 patients with neither H. pylori infection nor gastrotoxic drug intake (‘idiopathic ulcers’).

Patients with idiopathic ulcers differed in many ways both from H. pylori and NSAID/aspirin groups.

Multivariate analysis identified only 3 independent predictors, including age, French metropolitan origin and the presence of comorbidities.

Dr Pariente's team commented, "In a general hospital-based population in France, peptic ulcer disease appears idiopathic in a fifth of cases."

Aliment Pharmacol Ther 2013: 38(8): 946–954
04 October 2013

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