scholarly journals Peptic Ulcer at the End of the 20th Century: Biological and Psychological Risk Factors

1999 ◽  
Vol 13 (9) ◽  
pp. 753-759 ◽  
Author(s):  
Susan Levenstein
Keyword(s):  
Risk Factors ◽  
Peptic Ulcer ◽  
Psychosocial Factors ◽  
Low Socioeconomic Status ◽  
Heavy Drinking ◽  
Clinical Importance ◽  
Subjective Distress ◽  
Anti Inflammatory ◽  
The Rich ◽  
H Pylori

The prevailing concept of peptic ulcer etiology has swung over entirely in just a few years from the psychological to the infectious, yet the rich literature documenting an association between psychosocial factors and ulcer is not invalidated by the discovery ofHelicobacter pylori. Physical and psychological stressors interact to induce ulcers in animal models, concrete life difficulties and subjective distress predict the development of ulcers in prospective cohorts, shared catastrophes such as war and earthquakes lead to surges in hospitalizations for complicated ulcers, and stress or anxiety can worsen ulcer course. Many known ulcer risk factors, including smoking, nonsteroidal anti-inflammatory drug use, heavy drinking, loss of sleep and skipping breakfast, can increase under stress; the association of low socioeconomic status with ulcer is also accounted for in part by psychosocial factors. Among possible physiological mechanisms, stress may induce gastric hypersecretion, reduce acid buffering in the stomach and the duodenum, impair gastroduodenal blood flow, and affect healing or inflammation through psychoneuroimmunological mechanisms. Psychosocial factors seem to be particularly prominent among idiopathic or complicated ulcers, but they are probably operative in run of the millH pyloridisease as well, either through additive effects or by facilitating the spread of the organism across the pylorus, while gastrointestinal damage by nonsteroidal anti-inflammatory drugs can also be potentiated by stress. Although the clinical importance of peptic ulcer is fading along with the millenium, due to secular trends and new therapies, it remains worthy of study as a splendid example of the biopsychosocial model.

scholarly journals CLINICAL PROFILE AND RISK FACTORS FOR BENIGN PEPTIC ULCER DISEASE IN A TERTIARY CARE CENTRE IN THE SUBHIMALAYAN RANGES OF NORTH INDIA

2020 ◽  
pp. 1-3
Author(s):  
Vishal Bodh ◽  
Rajesh Sharma ◽  
Brij Sharma
Keyword(s):  
Risk Factors ◽  
Duodenal Ulcer ◽  
Peptic Ulcer ◽  
Gastric Ulcer ◽  
Peptic Ulcer Disease ◽  
Low Socioeconomic Status ◽  
Low Socioeconomic ◽  
Ulcer Disease ◽  
H Pylori ◽  
Upper Gastrointestinal

Background: To study the clinical profile and risk factors for benign peptic ulcer disease. Material and Methods: A total of 200 patients of peptic ulcer disease (PUD) diagnosed on upper gastrointestinal endoscopy were included. The socio-demographic profile, risk factors, clinical and endoscopic findings were recorded. Results: A total of 200 patients of peptic ulcer disease were included, out of which 168(84%) were males, while 32 (16%) were females. Most of the patients (61%) were between age 31-60 years with mean age of 47 years. Most of patients were farmers from rural areas and belonged to low socioeconomic status. History of smoking and alcohol intake was present in 106(53%) and 70( 35 %) patients respectively.Most common presenting complaints were epigastric pain and/or burning in 72 (36%) , followed by upper abdomen discomfort 70(35%) and upper gastrointestinal bleed 58(29%). Duodenal ulcer (DU) was present in 152 (76%), gastric ulcer(GU) in 30 (15%) while 18 (9%) had both DU and GU. Most of the patients had Forrest III ulcer 167 (83.5%) followed by Forrest IIc ulcer 13 (6.5%). H. pylori was detected by rapid urease test on endoscopic biopsy specimen in 156 (78 % ) of the total 200 patients of peptic ulcer disease. H. pylori was detected in 78.94 % case of DU, 60% case of GU and 100% cases of both DU and GU. Conclusion: PUD is a multifactorial health problem affecting almost all populations worldwide. . The major risk factors associated with PUD included tobacco and alcohol consumption besides low socioeconomic status, rural background and occupation of farming. Our findings indicate the substantial role of H. pylori and painkiller ingestion in the pathogenesis of PUD. Duodenal ulcer is most common type followed by gastric ulcer. Most had Forrest III ulcer followed by Forrest IIc.

scholarly journals Association of Helicobacter Pylori with Peptic Ulcer Perforation

2019 ◽  
Vol 2 (1) ◽  
pp. 4-10
Author(s):  
Sunit Agrawal ◽  
D Thakur ◽  
P Kafle ◽  
A Koirala ◽  
R K Sanjana ◽  
...  
Keyword(s):  
Risk Factors ◽  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Perforated Peptic Ulcer ◽  
Patch Repair ◽  
Peptic Ulcer Perforation ◽  
Ulcer Disease ◽  
Ulcer Perforation ◽  
H Pylori

Background: Helicobacter pylori is found in more than 90% cases of peptic ulcer. This study examines the possibility of association of Helicobacter pylori in perforated peptic ulcer disease and its relation to persisting ulcer as well as the influence of other risk factors; namely: smoking, alcohol, current non-steroidal anti inflammatory drugs (NSAIDs) and steroid use. Materials and Methods: In this prospective study, total of 50 cases of peptic ulcer perforation admitted in College of Medical Sciences and Teaching Hospital, Bharatpur, Nepal were selected on the basis of the non-probability (purposive) sampling method. All patients who presented with suspected peptic ulcer perforation were included in the study and the perforations were repaired by Modified Graham’s Patch and were given triple therapy postoperatively. The age, sex, incidence, mode of presentation, precipitating factors, association with the risk factors and postoperative complications were all evaluated and compared. Results: Of 50 patients studied, the age ranged from 17 to 75 years, mean age being 40.1 years with the peak incidence in the 3rd and 5th decades of life showing a male dominance (92%). H. pylori was seen in ulcer edge biopsy in 29 patients (58%). Most common clinical presentation was pain abdomen, the most common signs of perforation were tenderness, rebound tenderness and absent bowel sounds. The mean duration of stay in hospital in H. pylori positive patients was 12.07±8.15 days as compared with 11.1±5.12 days in H. pylori negative patients. The incidence of peptic ulcer perforation was higher in the patients consuming alcohol (64%) than smokers (48%), followed by NSAIDs user(22%). 20% of the patients with delayed presentation developed complications postoperatively. Perforated peptic ulcer was repaired by Modified Graham’s Patch Repair, followed by anti H. pylori therapy in all of them. Conclusion: Peptic ulcer perforation is quite common among the patients with peptic ulcer disease with history of chronic smoking, alcoholism and analgesic intake, more commonly in males. There is association of H. pylori in 58% of patients with peptic ulcer perforation.

scholarly journals ETIOPATHOGENESIS OF PEPTIC ULCER: back to the past?

2014 ◽  
Vol 51 (2) ◽  
pp. 155-161 ◽  
Author(s):  
Mariana Barbosa ARAÚJO ◽  
Paulo BORINI ◽  
Romeu Cardoso GUIMARÃES
Keyword(s):  
Peptic Ulcer ◽  
General Population ◽  
Peptic Ulcers ◽  
Data Bases ◽  
Duodenal Ulcers ◽  
The Past ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
H Pylori ◽  
Made In

ObjectivesTo review some aspects of the etiopathogenesis of peptic ulcerous disease especially on the basis of studies on its correlation withHelicobacter pylori (H. pylori).MethodsA search was made in the data bases MEDLINE, LILACS and PubMed, and in Brazilian and foreign books, referring to the incidence and prevalence of infection by H. pylori and of peptic ulcerous disease in various populations of different countries.ResultsIt was observed that the prevalence of H. pyloriinfection is similar in individuals with peptic ulcerous disease and the general population. There are differences between countries with respect to the prevalence of infection and of gastric or duodenal peptic ulcers. In many countries the prevalence of infection by H. pylorishows stability while the prevalence of peptic ulcerous disease is declining. The prevalence of peptic ulcerous disease without H. pylori infection varies between 20% and 56% in occidental countries.DiscussionThe observations might be suggestive of H. pyloribeing only one more factor to be summed together with other aggressive components in the genesis of peptic ulcerous disease. We would therewith be returning to the classic concept that peptic gastric and duodenal ulcers have multifactorial etiology and would result from imbalance between aggressive and defensive factors. The focus of studies should be enriched with the identification of the defensive factors and of other aggressive factors besides the well known H. pylori and non-steroidal anti-inflammatory drugs, since these two aggressors do not exhaust the full causal spectrum.

Psychosocial Factors Associated with Peptic Ulcer in Aged Persons

1999 ◽  
Vol 85 (3) ◽  
pp. 761-769 ◽  
Author(s):  
Midori Furuse ◽  
Kazuhiro Yoshiuchi ◽  
Hiroaki Kumano ◽  
Yuichi Yamauchi
Keyword(s):  
Risk Factors ◽  
Peptic Ulcer ◽  
Elderly People ◽  
Psychosocial Factors ◽  
Elderly Women ◽  
Statistical Significance ◽  
Physical Risk ◽  
Physical Risk Factors ◽  
Clinical Records ◽  
The Relationship

The relationship between psychosocial factors and the occurrence and aggravation of peptic ulcer was studied in elderly people Thirty nine (14 male) ulcer patients and 79 (30 male) elderly people aged 65 years and over and living in the community were tested. Information on health status, medication, lifestyle, and psychosocial status was obtained by means of interviews using a questionnaire and from the clinical records of the ulcer patients. The same questionnaire was distributed to the residents. Logistic regression analysis adjusting for age disclosed that peptic ulcer was significantly associated with having an occupation and low exercise practice in men. However, the relationship weakened below statistical significance after adjusting for some physical risk factors besides age. Low education was significant but low instrumental support fell short of statistical significance with peptic ulcer in women even after adjustment for several physical risk factors besides age. Thus, the specific psychosocial factors might be independently associated with the occurrence and aggravation of peptic ulcer in at least elderly women.

scholarly journals Prevalence and risk factors of Helicobacter pylori infections in the patients suffering from acid-peptic disease at tertiary care center, Gujarat, India

2018 ◽  
Vol 5 (5) ◽  
pp. 1250
Author(s):  
Anjali K. Kukreja ◽  
Himani B. Pandya ◽  
Santosh Kumar
Keyword(s):  
Risk Factors ◽  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Abdominal Pain ◽  
Prevalence Rate ◽  
Tertiary Care ◽  
Chili Pepper ◽  
Care Hospital ◽  
Spicy Food ◽  
H Pylori

Background: Helicobacter pylori (H. pylori) infection is a medical encumber especially in the developing countries, ranging from acute inflammation to malignancy. The study is intended to explore the prevalence of H. pylori infection and also to compute its associated risk factors.Methods: Sixty two (n=62) symptomatic patients attending the tertiary care hospital, were included in the study. Two antral biopsies collected from each patient were subjected to rapid urease test and Gram staining. IgG antibodies were detected by rapid test based on the principle of Immunochromatography. To evaluate the risk factors, various determinants were asked to each patient in the form of questionnaire. Statistical analysis was done using Fisher exact test. P value < 0.05 was considered significant.Results: Prevalence rate of H. pylori infection was 24.19 % (15/62). More than half (53%) of the infected patients had complained of persistent burning abdominal pain. Prevalence rate was found highest in the patients suffering from peptic ulcer disease (66.6%, P=0.0237). Consumption of unfiltered water (P=0.007, Odd Ratio (OR)-1.06), eating spicy food, meat, fish and chili pepper (P=0.052, OR-1.01) was found the major risk factors. Addictive habits of either smoking/alcohol/tobacco (P=0.904) were not associated with infection.Conclusions: Prevalence of H. pylori infection was found low comparatively and was mainly associated with symptom of persistent burning abdominal pain and peptic ulcer. Use of unfiltered water, spicy food, chili pepper and meat undoubtedly increase the risk of acquiring H. pylori infection. Addictive habits were not significantly associated with infection.

scholarly journals Risk Factors For Recurrence of Peptic Ulcer Disease: A Retrospective Study In Tertiary Care Referral Center

2022 ◽  
Author(s):  
Yaser Alsinnari ◽  
Mohammed S. Alqarni ◽  
Meshari Attar ◽  
Ziad M. Bukhari ◽  
Faisal Baabbad ◽  
...  
Keyword(s):  
Risk Factors ◽  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Recurrence Rate ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Ulcer Disease ◽  
Significant Difference ◽  
Risk Factors For Recurrence ◽  
H Pylori

Abstract Backgrounds: Peptic ulcer disease (PUD) is a common gastrointestinal tract disease characterized by mucosal damage secondary to pepsin and gastric acid secretion. The aim of this study was to evaluate the five-year recurrence rate for treated patients with PUD and risk factors contributing to PUD relapses.Methods: From 2016 through 2021, all patients with endoscopy-proved PUD were identified by reviewing medical records (Best-Care system). Possible risk factors including smoking, non-steroidal anti-inflammatory drugs (NSAIDs), aspirin, alcohol, caffeine, and steroid were analyzed by univariate analysis. Treatment outcomes, 5-year recurrence rate, and mortality rate were assessed.Results: Among 223 patients, there were 187 (83.8%), who diagnosed endoscopy-proved PUD and 36 (16.2%), who diagnosed clinical PUD. Among them, 126 (56.5%) patients were males and the mean age was 62±2 years. The five years recurrence rate of PUD was 30.9%. There was no significant difference in the recurrence rate between the duodenal ulcer (33.3%) and the gastric ulcer (28.8%). By univariate analysis, the use of steroid and NSAID and H. pylori infection were potential risk factors for PUD (P < 0.005). The common complication of PUD was gastrointestinal bleeding (34.1%). Patients who had a complicated PUD were associated with a higher rate of recurrence (45.9%) compared to the uncomplicated PUD (19.2%) (P > 0.05). Conclusion: Our findings demonstrated that the five years recurrence rate of PUD was 30.9%. The use of steroid and NSAID and H. pylori infection were risk factors for recurrence of PUD. PUD places a significant burden on health care systems. Therefore, a multicenter prospective study is needed for effective management to prevent recurrence and complications of PUD.

scholarly journals PEPTIC ULCER FREQUENCY DIFFERENCES RELATED TO H. PYLORI OR AINES

2015 ◽  
Vol 52 (1) ◽  
pp. 46-49 ◽  
Author(s):  
Diego Michelon de CARLI ◽  
Rafael Cardoso PIRES ◽  
Sofia Laura ROHDE ◽  
Caroline Mayara KAVALCO ◽  
Renato Borges FAGUNDES
Keyword(s):  
Duodenal Ulcer ◽  
Peptic Ulcer ◽  
Gastric Ulcer ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
H Pylori ◽  
Second Period

Background Peptic ulcer etiology has been changing because of H. pylori decline. Objectives To estimate peptic ulcer prevalence in 10 years-interval and compare the association with H. pylori and use of non-steroidal anti-inflammatory drugs. Methods Records assessment in two periods: A (1997-2000) and B (2007-2010), searching for peptic ulcer, H. pylori infection and non-steroidal anti-inflammatory drugs use. Results Peptic ulcer occurred in 30.35% in A and in 20.19% in B. H. pylori infection occurred in 73.3% cases in A and in 46.4% in B. Non-steroidal anti-inflammatory drugs use was 3.5% in A and 13.3% in B. Neither condition occurred in 10.4% and 20.5% in A and B respectively. Comparing both periods, we observed reduction of peptic ulcer associated to H. pylori (P=0.000), increase of peptic ulcer related to non-steroidal anti-inflammatory drugs (P=0.000) and idiopathic peptic ulcer (P=0.002). The concurrent association of H. pylori and non-steroidal anti-inflammatory drugs was also higher in B (P=0.002). Rates of gastric ulcer were higher and duodenal ulcer lower in the second period. Conclusions After 10 years, the prevalence of peptic ulcer decreased, as well as ulcers related to H. pylori whereas ulcers associated to non-steroidal anti-inflammatory drugs increased. There was an inversion in the pattern of gastric and duodenal ulcer and a rise of idiopathic peptic ulcer.

scholarly journals ROLE OF HELICOBACTER PYLORI INFECTION AND LIFESTYLE HABITS IN THE DEVELOPMENT OF GASTRODUODENAL DISEASES IN A POPULATION FROM THE BRAZILIAN AMAZON

2013 ◽  
Vol 50 (3) ◽  
pp. 170-174 ◽  
Author(s):  
Ruth Maria Dias Ferreira VINAGRE ◽  
Adenielson VILAR-e-SILVA ◽  
Amanda Alves FECURY ◽  
Luisa Caricio MARTINS
Keyword(s):  
Risk Factors ◽  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Alcohol Consumption ◽  
Eating Habits ◽  
Severe Disease ◽  
Lifestyle Habits ◽  
Excessive Alcohol Consumption ◽  
Excessive Alcohol ◽  
H Pylori

Context Although more than half of the world's population is colonized with Helicobacter pylori, it remains unknown why this organism is able to produce severe disease in some hosts and be innocuous in others. The clinical outcome of infection is determined by several factors, including differences in the host response to bacterial stimulation, specific virulence factors of the organism and environmental influences, or a combination of these factors. Objectives This study compared the prevalence of H. pylori infection and risk factors (infection with CagA+ strains, excessive alcohol consumption, smoking, and inadequate eating habits) between patients with different gastrointestinal disorders and associated these risk factors with the histopathological findings. Methods In a prospective study, samples were collected from 442 patients and a standardized questionnaire regarding lifestyle habits (excessive alcohol consumption, smoking, and eating habits) was applied. The presence of H. pylori and of the cagA gene was investigated by polymerase chain reaction (PCR). Gastric biopsies were obtained for histological assessment. Results The frequency of alcohol consumption, smoking, inadequate diet and infection with CagA+ H. pylori was higher among patients with peptic ulcer and adenocarcinoma when compared to those with gastritis. Gastric inflammation was more pronounced in patients infected with CagA+ strains. Conclusion We conclude that infection with CagA+ H. pylori strains, excessive alcohol consumption, smoking and inadequate eating habits increase the risk of developing peptic ulcer and gastric carcinoma.

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