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Trends in ulcer diagnosis with high prevalence of H pylori

In an area with a high prevalence of H. pylori infection, the incidence of peptic ulcer is declining rapidly due to a reduction of H. pylori infection in the young and widespread use of proton-pump inhibitors, reports January's Alimentary Pharmacology and Therapeutics.

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It is unknown whether the incidence of peptic ulcer changes in areas with a high prevalence of Helicobacter pylori infection.

Dr Lanas and colleagues from Spain undertook a study in order to determine trends in peptic ulcer complications in a community with a high prevalence of Helicobacter pylori infection.

The researchers obtained new endoscopic diagnoses of peptic ulcers and their complications from 1985 to 2000.

The research team also evaluated H. pylori infection in the adult population, the number of prescriptions for anti-secretory drugs and non-steroidal anti-inflammatory drugs.

Although the global prevalence of H. pylori infection remains high, in this population (>60%), the researchers found a 41% to 25% decrease in the incidence of peptic ulcers and ulcer complications.

Decreased incidence was associated with a 3.5-fold increase in the number of prescriptions of proton-pump inhibitors
Alimentary Pharmacology and Therapeutics

The research team noted that this was associated with a decrease in the prevalence of H. pylori infection in people under 65 years of age.

In addition, the decreased incidence was associated with a 3.5-fold increase in the number of prescriptions of proton-pump inhibitors and an increase in the number of prescriptions of non-steroidal anti-inflammatory drugs, especially coxibs.

Dr Lanas concluded, "In an area with a high prevalence of H. pylori infection, the incidence of peptic ulcer and associated complications is declining rapidly."

"This was associated with a reduction of the prevalence of H. pylori infection in the young and a widespread use of proton-pump inhibitors."

"The increase in the use of non-steroidal anti-inflammatory drugs, especially coxibs, has not changed the tendency."

Alimentary Pharmacology & Therapeutics; 2005: 21 (1): 65
14 January 2005

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