Clinical characteristics of elderly Korean patients with peptic ulcer

Yu, Ki Dong; Kim, Nayoung; Park, Young Soo; Hwang, Jin Hyeok; Kim, Jin Wook; Lee, Dong Ho; Jeong, Sook Hyang; Lee, Kwang Hyuck; Lee, Hyung Suk; Kwack, Kyung Keun; Kim, Kwang Il; Kim, Cheol Ho

Abstract

BACKGROUND: The incidence of peptic ulcer has decreased in the general population, but it has increased for the geriatric patients worldwide. The aim of the study is to determine the age-related characteristics of peptic ulcer patients.
METHODS
A total of 277 patients (195 men and 82 women), who were diagnosed with peptic ulcer from May 2003 to Dec 2004, were analyzed retrospectively. The clinical characteristics of peptic ulcer were compared between the two groups, that is, 138 elderly (= 65 yrs) and 139 non-elderly (= 50 yrs) patients.
RESULTS
Peptic ulcer in the elderly were located more atypically (high body and the greater curvature side of the mid and low body), the lesions were large and healed slowly. In the elderly group, 50.7% of the ulcers were gastric and 36.2% were duodenal. On the other hand, in the non-elderly group, 30.2% and 57.6% of the ulcers were gastric and duodenal, respectively. There was no difference of the main symptoms between the two groups. For endoscopically bleeding ulcer, the use of NSAID was statistically significant (p=0.006) only for the elderly group. The presence of Helicobacter pylori was less common in the elderly group than in the non-elderly (57.7% vs 77%, respectively, p=0.001). In the case of gastric ulcer, the rate of H. pylori infection was similar between the two groups (62.9% vs 73.8%, respectively, p=0.233). In contrast, in the case of duodenal ulcer, H. pylori infection was less common for the elderly patients than in the non-elderly patients (51% vs 77.5%, respectively, p=0.002).
CONCLUSIONS
For the elderly patients with peptic ulcer in Korea, the role of H. pylori was relatively less important that it was for the non-eldery group. On the contrary, NSAID, aspirin and combined chronic illness seem to contribute to ulcer. Bleeding peptic ulcer was discovered in both groups with no significant difference in the occurrence rate.