Clin Endosc.  2017 Nov;50(6):578-584. 10.5946/ce.2016.129.

Risk Factors for the Presence of Symptoms in Peptic Ulcer Disease

• Lee SP
• Sung IK
• Kim JH
• Lee SY
• Park HS
• Shim CS

• KMID: 2398309
• DOI: http://doi.org/10.5946/ce.2016.129

Abstract

BACKGROUND/AIMS
Peptic ulcer disease (PUD) is a common condition, but is difficult to detect in asymptomatic individuals. We aimed to investigate the prevalence of symptomatic and asymptomatic PUD during screening endoscopy and to identify risk factors for the presence of symptoms in patients with PUD.
METHODS
We investigated subjects who underwent a health inspection, including endoscopy of the upper gastrointestinal (GI) tract and a serum anti-Helicobacter pylori IgG assay, and who completed a self-report questionnaire about their symptoms.
RESULTS
Of the 12,852 subjects included in the study, 124 (1.0%) had symptomatic PUD and 309 (2.4%) had asymptomatic PUD. Old age, current smoking, and H. pylori infection were independent risk factors for symptomatic and asymptomatic PUD. Use of non-steroidal anti-inflammatory drugs (NSAIDs) was an independent risk factor only for symptomatic PUD (p=0.040). Compared to subjects with asymptomatic PUD, subjects with symptomatic PUD were more likely to have active-stage ulcers (p=0.002) and to drink more heavily (p=0.005).
CONCLUSIONS
Use of NSAIDs is a risk factor for symptomatic PUD, but not for asymptomatic PUD. Excessive alcohol consumption and active-stage ulcers in patients with PUD are related to the presence of gastroduodenal symptoms.

Keyword

Peptic ulcer; Anti-inflammatory agents, non-steroidal; Helicobacter pylori; Heavy drinking

MeSH Terms

Alcohol Drinking
Anti-Inflammatory Agents, Non-Steroidal
Endoscopy
Helicobacter pylori
Humans
Immunoglobulin G
Mass Screening
Peptic Ulcer*
Prevalence
Risk Factors*
Smoke
Smoking
Ulcer
Anti-Inflammatory Agents, Non-Steroidal
Immunoglobulin G
Smoke

Figure

• 

  Fig. 1. Flow chart of inclusion and exclusion of subjects. A total of 16,008 people who underwent a health inspection (gastroscopy, a self-report questionnaire, and a serum Helicobacter pylori IgG antibody test) at our center were investigated. Subjects younger than 17 years of age, subjects who underwent upper gastrointestinal (GI) surgery, subjects with adenoma or carcinoma in the upper GI tract, subjects who did not properly answer the questionnaire, subjects using proton pump inhibitors or histamine-2 receptor antagonists, and subjects previously diagnosed with functional dyspepsia were excluded from the study. If the results of the serum H. pylori IgG antibody test were equivocal and other H. pylori tests were not performed, subjects were excluded, because the presence of H. pylori infection could not be determined. Subjects without peptic ulcer disease (PUD) were categorized into the healthy control group. Among subjects diagnosed with PUD, subjects with ulcers in the scarring stage were excluded. The remaining subjects were categorized into the symptomatic or asymptomatic PUD group according to the presence of symptoms.

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