Unbound MEDLINE

Trends in the prevalence of peptic ulcer disease and Helicobacter pylori infection in family physician-referred uninvestigated dyspeptic patients in Hong Kong.

Abstract

BACKGROUND
Peptic ulcer disease is mainly caused by Helicobacter pylori infection and the use of non-steroidal anti-inflammatory drugs.
AIM
To investigate the trends in the prevalence of peptic ulcer disease, H. pylori infection and non-steroidal anti-inflammatory drug use in uninvestigated dyspeptic patients over recent years in Hong Kong.
METHODS
Data from consecutive patients with uninvestigated dyspeptic symptoms referred by family physicians for open access upper endoscopy during 1997 and 2003 were analysed in relation to peptic ulcer disease, H. pylori infection and non-steroidal anti-inflammatory drug use.
RESULTS
Among 2700 patients included, 405 (15%) had peptic ulcer disease and 14 (0.5%) had gastric cancer. There was a reduced trend from 1997 to 2003 in the prevalence of peptic ulcer disease (17, 20, 14, 16, 13, 14 and 14%, respectively, chi2 = 5.80, P = 0.016) (mainly because of decrease in duodenal ulcers), H. pylori infection (44, 50, 49, 44, 40, 40, 36 and 43%, respectively, chi2 = 13.55, P < 0.001) and non-steroidal anti-inflammatory drug use (13, 5, 5, 6, 3, 4, 4 and 5% respectively, chi2 = 13.61, P < 0.001). The prevalence of peptic ulcer disease, H. pylori infection and non-steroidal anti-inflammatory drug use between 2001 and 2003 were significantly lower than that between 1997 and 2000 (17% vs. 13%, OR = 0.78, 95% CI: 0.63-0.96, P = 0.020 for peptic ulcer disease; 47% vs. 39%, OR =0.72, 95% CI: 0.60-0.86, P < 0.001 for H. pylori infection; and 6% vs. 4%, OR = 0.56, 95% CI: 0.39-0.82, P = 0.002 for non-steroidal anti-inflammatory drug use). H. pylori infection was associated with both duodenal ulcer (OR = 15.87, 95% CI: 10.60-23.76, P < 0.001) and gastric ulcer (OR = 3.12, 95% CI: 2.15-4.53, P < 0.001) whereas non-steroidal anti-inflammatory drug use was only associated with gastric ulcer (OR = 2.97, 95% CI: 1.70-5.20, P < 0.001).
CONCLUSIONS
The prevalence of peptic ulcer disease, mainly duodenal ulcers, was reduced in association with a decreasing trend in the prevalence of H. pylori infection and non-steroidal anti-inflammatory drug use from 1997 to 2003.

Links

  • Publisher Full Text
  • Authors

    Xia B, Xia HH, Ma CW, Wong KW, Fung FM, Hui CK, Chan CK, Chan AO, Lai KC, Yuen MF, Wong BC

    Institution

    Department of Internal Medicine, Research Center of Digestive Diseases of Zhongnan Hospital, Key Laboratory of Allergy and Immune-related Diseases, Wuhan University School of Medicine, China.

    Source

    Alimentary pharmacology & therapeutics 22:3 2005 Aug 1 pg 243-9

    MeSH

    Adolescent
    Adult
    Age Factors
    Aged
    Aged, 80 and over
    Anti-Inflammatory Agents, Non-Steroidal
    Duodenal Ulcer
    Dyspepsia
    Family Practice
    Female
    Helicobacter Infections
    Helicobacter pylori
    Hong Kong
    Humans
    Male
    Middle Aged
    Peptic Ulcer
    Prevalence
    Referral and Consultation
    Sex Factors
    Stomach Neoplasms

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    16091062