Korean J Gastroenterol.  2010 Oct;56(4):220-228. 10.4166/kjg.2010.56.4.220.

Risk Factors for Development and Recurrence of Peptic Ulcer Disease

• Kim JJ
• Kim N
• Lee BH
• Kang JM
• Seo P
• Lim MK
• Kwon JH
• Song BJ
• Lee JW
• Lee SH
• Park YS
• Hwang JH
• Kim JW
• Jeong SH
• Lee DH
• Jung HC
• Song IS

• KMID: 1718357
• DOI: http://doi.org/10.4166/kjg.2010.56.4.220

Abstract

BACKGROUND/AIMS
Peptic ulcer disease (PUD) is one of the common gastrointestinal diseases, and its medical management has been developed so much that the incidence of its serious complications, such as bleeding and perforation, are declining significantly. Its prevalence in Korea is not definitely decreased, probably due to increasing proportion of elderly patients and their rising usage of non-steroidal anti-inflammatory drugs (NSAIDs) and aspirins. This study was conducted to identify the risk factors for development and recurrence of peptic ulcer disease in Korea.
METHODS
From 2003 to 2008, upper gastrointestinal endoscopy and detailed personal questionnaires were performed for patients who visited Department of Gastroenterology at Seoul National University Bundang Hospital. In total, 475 PUD patients and 335 non-ulcer dyspepsia patients were included. The results of questionnaires and repeated upper gastrointestinal endoscopy at initial diagnosis time and follow-up periods were analyzed.
RESULTS
Multivariable analysis showed that male, H. pylori infection, NSAIDs use and smoking were risk factors for the development of PUD. The use of proton pump inhibitors (PPIs) and H2 receptor antagonists has significantly reduced the risk of PUD in patients who had taken NSAIDs and/or aspirins. H. pylori infection was found as the only risk factor for the recurrence of PUD.
CONCLUSIONS
For the old patients who are taking drugs, such as NSAIDs and aspirins, concomitant use of PPIs or H2 receptor antagonists should be considered to protect from the development of PUD. H. pylori eradication has been confirmed again to be essential for the treatment of PUD patients infected with H. pylori.

Keyword

Peptic ulcer; Risk factors; Helicobacter pylori; NSAIDs; PPIs

MeSH Terms

Adult
Aged
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
Aspirin/therapeutic use
Endoscopy, Gastrointestinal
Female
Helicobacter Infections/complications/drug therapy
Helicobacter pylori
Histamine H2 Antagonists/therapeutic use
Humans
Male
Middle Aged
Peptic Ulcer/drug therapy/*etiology
Proton Pump Inhibitors/therapeutic use
Questionnaires
Recurrence
Risk Factors
Sex Factors
Smoking
Stomach Ulcer/etiology

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