Changing trends and characteristics of peptic ulcer disease: A multicenter study from 2010 to 2019 in Korea

World J Gastroenterol. 2023 Nov 28;29(44):5882-5893. doi: 10.3748/wjg.v29.i44.5882.

Abstract

Background: The clinical trend and characteristics of peptic ulcer disease (PUD) have not fully been investigated in the past decade.

Aim: To evaluate the changing trends and characteristics of PUD according to age and etiology.

Methods: We analyzed seven hospital databases converted into the Observational Medical Outcomes Partnership-Common Data Model between 2010 and 2019. We classified patients with PUD who underwent rapid urease tests or Helicobacter pylori (H. pylori) serology into three groups: H. pylori-related, drug [nonsteroidal anti-inflammatory drugs (NSAIDs) or aspirin]-related, and idiopathic (H. pylori/NSAID/aspirin-negative) PUD and compared the yearly trends and characteristics among the three groups.

Results: We included 26785 patients in 7 databases, and the proportion of old age (≥ 65 years) was 38.8%. The overall number of PUD exhibited no decrease, whereas PUD in old age revealed an increasing trend (P = 0.01 for trend). Of the 19601 patients, 41.8% had H. pylori-related, 36.1% had drug-related, and 22.1% had idiopathic PUD. H. pylori-related PUD exhibited a decreasing trend after 2014 (P = 0.01), drug-related PUD demonstrated an increasing trend (P = 0.04), and idiopathic PUD showed an increasing trend in the old-age group (P = 0.01) during 10 years. Patients with drug-related PUD had significantly more comorbidities and concomitant ulcerogenic drugs. The idiopathic PUD group had a significantly higher number of patients with chronic liver disease.

Conclusion: With the aging population increase, the effects of concomitant ulcerogenic drugs and preventive strategies should be investigated in drug-induced PUD. Further studies are required to clarify the relationship between idiopathic PUD and chronic liver disease.

Keywords: Characteristics; Drug; Idiopathic; Peptic ulcer disease; Trend.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Aspirin / pharmacology
  • Helicobacter Infections* / complications
  • Helicobacter Infections* / diagnosis
  • Helicobacter Infections* / epidemiology
  • Helicobacter pylori*
  • Humans
  • Liver Diseases* / complications
  • Peptic Ulcer* / epidemiology
  • Peptic Ulcer* / etiology
  • Republic of Korea / epidemiology

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Aspirin