Hospital based analytic study of peptic ulcer disease in patients with dyspeptic symptoms

Background: Peptic ulcer disease is one of the most common diseases prevalent in developing country like Nepal and with availability of endoscopy there have been increase in diagnosis and therapeutic use of endoscopy. Objective: The aim of this study is to investigate the prevalence of peptic ulcer disease in patient who came for upper gastrointestinal endoscopy in Kathmandu Medical College Teaching Hospital. Materials and methods: All patients who were referred to department of endoscopy from outpatient department (OPD) and inpatient department with symptoms like dyspepsia, upper GI bleeding were included from August 2004 to August 2008. Results: A total of 2761 patient were evaluated, with mean age group of 40.57 years (range 8- 95 years) and with sex distribution of male 1353 (49%) and female 1408 (51%) and racial difference into Aryan 2050 (74.2%) and Mongoloid 771 (25.8%). There were 983 patients (35.60%) with peptic disease which includes erosive gastritis, non erosive gastritis, duodenitis and gastroduodenitis without obvious ulcer. The prevalence of peptic disease with or without ulcer was more common in age group of 20- 49 years (n= 764, 27.67 %) with 70 patient with gastric ulcer (2.5%) and 50 patient with duodenal ulcer (1.8%). There was no significant racial difference among incidence of peptic ulcer (P value= 0.527). Conclusions: Peptic ulcer disease is a significant cause of morbidity in urban population of Nepal with more prevalent of erosive diseases in productive age group (20-49 years). However both male and female have equal incidence of peptic ulcer disease and there was no significant racial difference in its incidence. Key words: Peptic ulcer diseases; Oesophago-gastroduodenoscopy; H. pylori DOI: 10.3126/kumj.v7i2.2706 Kathmandu University Medical Journal (2009) Vol.7, No.2 Issue 26, 135-138

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Pre-operative serum albumin and body mass index as predictors of post-operative morbidity and mortality in perforation peritonitis secondary to peptic ulcer disease

International Surgery Journal ◽

10.18203/2349-2902.isj20210369 ◽

2021 ◽

Vol 8 (2) ◽

pp. 589

Author(s):

Bhanu Prakash K. R. ◽

Manasa Mohan ◽

Subhas Patil

Keyword(s):

Body Mass Index ◽

Peptic Ulcer ◽

Serum Albumin ◽

Peptic Ulcer Disease ◽

Body Mass ◽

Gastrointestinal Disease ◽

Morbidity And Mortality ◽

P Value ◽

Ulcer Disease ◽

Perforation Peritonitis

Background: Peptic ulcer disease (PUD) affects 4 million people worldwide annually. Perforated peptic ulcer is a serious complication of PUD and patients often present with acute abdomen that carries high risk for morbidity and mortality. This is worsened in patients who are malnourished. The incidence of malnutrition is around 30% in patients with gastrointestinal disease and is frequently unrecognized. Albumin or prealbumin levels may help identify these patients. Obesity is also another cause for morbidity and has deleterious effects on wound healing. Therefore this study was carried out to assess if preoperative serum albumin and body mass index can be used as predictors of morbidity and mortality in patients with perforated peptic ulcers.Methods: 70 patients with peptic perforation peritonitis presented to the hospitals attached to Bangalore Medical College and Research Institute from November 2018 to May 2020 and were included in the study. Pre-operative Serum Albumin and BMI was noted and the patients were followed up for 30 days.Results: Mean albumin level in our study was 3.01. The patients with Serum Albumin <3.5 g/dl have more complications compared to patients with >3.5 g/dl. Morbidity and mortality increases with severity of hypoalbuminemia. This study was statistically significant with a p value <0.05. In our study, we also found that patients with abnormal BMI have more complications than patients with normal BMI but it is statistically insignificant with a p value >0.05.Conclusions: Serum albumin is a good indicator for predicting postoperative morbidity and mortality in peritonitis secondary to peptic ulcer disease.

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Factors affecting morbidity and mortality in peptic ulcer perforation

International Surgery Journal ◽

10.18203/2349-2902.isj20181105 ◽

2018 ◽

Vol 5 (4) ◽

pp. 1335

Author(s):

Kadasiddeshwara G. Byakodi ◽

Harini B. S. ◽

Vasant Teggimani ◽

Narayan Kabade ◽

Abhijit Hiregoudar ◽

...

Keyword(s):

Peptic Ulcer ◽

Peptic Ulcer Disease ◽

Female Gender ◽

Morbidity And Mortality ◽

P Value ◽

High Morbidity ◽

Peptic Ulcer Perforation ◽

Female Population ◽

Ulcer Disease ◽

Ulcer Perforation

Background: Peptic ulcer disease is very common disease in developing countries and so are its complications. With the introduction of H2 receptor antagonists and proton pump inhibitors, the incidence of elective surgery for peptic ulcer (PU) disease has decreased dramatically, although complications of peptic ulcer disease such as perforation and bleeding have remained fairly constant.Methods: A prospective study was conducted on43 patients presenting to KIMS Hospital, Hubli with features suggestive of hollow viscus perforation and intraoperative findings suggestive of peptic ulcer perforation from January 2015 to June 2016.Results: In this study, there were 43 cases of peptic ulcer perforation. Peptic ulcer perforation was common in third decade of life(n=12) with the mean age(SD) 39.88 years. Perforation is more common in males as compared to the female population 7.6:1. Post-operative morbidity is seen in 31 (72.1%) of patients and mortality in 4 (9.3%). Smoking, Alcohol beverage consumption, regular ingestion of NSAIDs were commonly seen in patients with peptic ulcer perforation but these factors were not significant risk factors for postoperative mortality and morbidity. Age ≥60 years (p-value 0.051), Female gender (p-value 0.012), Presence of co-morbid conditions (p-value 0.055), Shock on admission (p-value 0.029, perforation-surgery interval >24 hours (p-value 0.001), preoperative higher-grade ASA, purulent intraperitoneal collection (p-value 0.002) were statistically significant predictors of mortality.Conclusions: Perforated peptic ulcer (PPU) is a life-threatening disease with historically reported high morbidity and mortality rates. Age ≥60 years, female gender, presence of co-morbidities, preoperative shock, higher ASA grade, perforation-surgery interval >24 hours, Purulent intraperitoneal collection are inter-related statistically significant predictors of mortality. Therefore, proper resuscitation from shock, improving ASA grade and decreasing delay in surgery is needed to improve overall results.

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Pulmonary tuberculosis and peptic ulcer disease association in geriatric patients

Journal of Lung Pulmonary & Respiratory Research ◽

10.15406/jlprr.2019.06.00200 ◽

2019 ◽

Vol 6 (2) ◽

pp. 23-24

Author(s):

GRAÇA MARIA CASTRO VIANA

Keyword(s):

Peptic Ulcer ◽

Pulmonary Tuberculosis ◽

Peptic Ulcer Disease ◽

Clinical Manifestations ◽

Age Group ◽

Geriatric Population ◽

Ulcer Disease ◽

Loss Of Weight ◽

Severe Clinical Picture ◽

Exogenous Factors

The geriatric population is predisposed to the development of pulmonary tuberculosis (PT), both by endogenous and exogenous factors. Regarding for peptic ulcer disease (PUD) in this same age group, the clinical manifestations are related to the loss of weight and to the depreciation of the general state; a situation that provokes reactivation of PT, causing a more severe clinical picture, not only due to the association of the two pathologies, but also by the age group itself. In this case report, we present a 97-year-old woman with an unexpected association of pulmonary tuberculosis and DUP.

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Obesity and Risk of Peptic Ulcer Disease: A Large-Scale Health Check-Up Cohort Study

Nutrients ◽

10.3390/nu11061288 ◽

2019 ◽

Vol 11 (6) ◽

pp. 1288

Author(s):

Jeung Hui Pyo ◽

Hyuk Lee ◽

Jee Eun Kim ◽

Yoon Ho Choi ◽

Tae Jun Kim ◽

...

Keyword(s):

Peptic Ulcer ◽

Cohort Study ◽

Peptic Ulcer Disease ◽

Cumulative Incidence ◽

Large Scale ◽

Obese Group ◽

P Value ◽

Ulcer Disease ◽

Obese Subjects ◽

Metabolically Healthy

The association between obesity and peptic ulcer disease (PUD) is inconclusive. To evaluate the association of obesity and metabolically healthy obesity (MHO) with PUD risk, we performed a retrospective cohort study of 32,472 subjects without PUD at baseline who underwent repeated health examinations. Participants were stratified by body mass index (BMI) and metabolically healthy state. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazard modelling. During the follow-up period, 1940 PUD cases occurred. PUD, particularly gastric ulcer (GU), had significantly higher cumulative incidence in obese subjects compared to non-obese subjects (p value < 0.001). The HR for developing GU was 1.32 (95% CI, 1.16–1.49; p value <0.001); after adjusting for confounding factors (lifestyle, metabolic, and Helicobacter pylori status), the association was no more significant (p value = 0.789). For duodenal ulcer (DU), cumulative incidence between obese and non-obese groups was not significantly different (p value = 0.464). The risk of developing DU in the obese group was not significantly different from the non-obese group (HR 0.95; 95% CI, 0.83–1.09; p value = 0.469) and consistently showed no association after adjusting for metabolic parameters (p value = 0.199). Furthermore, MHO subjects had no increase in GU or DU risks. In this large cohort study, PUD risk was not associated with obesity or MHO.

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CLINICAL PROFILE AND OUTCOME OF PATIENTS PRESENTING WITH ACUTE UPPER GI BLEEDING IN A TERTIARY CARE CENTRE OF WESTERN NEPAL

Journal of Universal College of Medical Sciences ◽

10.3126/jucms.v6i1.21656 ◽

2018 ◽

Vol 6 (1) ◽

pp. 3-7

Author(s):

Shatdal Chaudhary ◽

Smriti Shakya ◽

Niraj Kumar Jaiswal ◽

Aakash Shahi ◽

Pushpa Raj Dhakal ◽

...

Keyword(s):

Peptic Ulcer ◽

Mortality Rate ◽

Peptic Ulcer Disease ◽

Esophageal Varices ◽

Tertiary Care ◽

Age Group ◽

Care Centre ◽

Inclusion Criteria ◽

Tertiary Care Centre ◽

Ulcer Disease

Introduction: Acute upper gastrointestinal (UGI) bleeding is a common medical emergency which is associated with significant morbidity and mortality. The annual incidence of UGI bleeding varies from 48 to 160 cases per 100,000 populations in the United States of America (USA), with a mortality rate of 7% to 10%. The aetiology and outcome of UGI bleeding varies significantly in different geographic regions depending on the demographic and socioeconomic characteristics of the local population. This study was done to evaluate the clinical profile and outcome of patients presenting with acute UGI bleeding at a tertiary care centre in Lumbini zone of Nepal.Material and Methods: This was a hospital based prospective observational study. All the patients who presented with acute UGI bleeding and fulfilled the inclusion criteria from 1st August 2013 to 31st July 2014 were included in the study. The study was cleared by the ethical review committee of the institute and written informed consent was taken from all the patients.Results: During the study period, 70 patients fulfilled the inclusion criteria and were subjected to statistical analysis. The mean age of patients in the present study was 55.11 ± 19.93 years. The majority of patients (30, 43%) were elder, belonging to the age group of more than 60 years. There were 55 (79%) male and 15 (21 %) female. The patients were mostly farmers by occupation accounting 29 (41 %) cases. Ethnically, 26 (3 7%) patients of UGI bleeding were from janajati group where majority of them had esophageal varices. Overall, the peptic ulcer disease was the leading cause of UGI bleeding seen in 26 (37%) patients followed by esophageal varices seen in 23 (33%) patients. 0 positive was the commonest blood group which was found in 28 (40%) of our patients. In our study 44 (63%) patients were alcohol consumers and 37 (53%) had coexisting comorbidities that added for the UGI bleeding related complications. During admission, 7 patients expired causing 10% mortality.Conclusion: Acute UGI bleeding was commonly seen in older age group patients with male preponderance. Peptic ulcer disease was the leading cause of the UGI bleeding. The mortality rate was found to be 10%. The mortality also increased with increasing age and patients with pre-existing co morbidities. Journal of Universal College of Medical ScienceVol. 6, No. 1, 2018, Page: 3-7

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Peptic Disease in Elderly Patients

Canadian Journal of Gastroenterology ◽

10.1155/2000/697943 ◽

2000 ◽

Vol 14 (11) ◽

pp. 922-928 ◽

Cited By ~ 6

Author(s):

Neda Khaghan ◽

Peter R Holt

Keyword(s):

Peptic Ulcer ◽

Elderly Patients ◽

Peptic Ulcer Disease ◽

Elderly People ◽

Ulcer Disease ◽

Treatment Regimens ◽

Atypical Symptoms ◽

Peptic Disease ◽

Gastrointestinal Problems ◽

H Pylori

The increase in life expectancy demands that more attention be given to gastrointestinal problems, such as peptic ulcer disease, in elderly people. This review summarizes many of the physiological changes that have a role in peptic ulcer disease in elderly patients. HowHelicobacter pyloriinfection modifies the course of peptic disease is also reviewed. The clinical presentation of peptic diseases often differs in elderly people, and atypical symptoms are common. Accurate diagnosis requires aggressive endoscopic evaluation. Treatment regimens using H2receptor antagonists, proton pump inhibitors and regimens to eradicateH pylorimay also need to be altered in elderly patients.

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PREVALENCE OF H. PYLORI

The Professional Medical Journal ◽

10.29309/tpmj/2010.17.03.2536 ◽

2010 ◽

Vol 17 (03) ◽

pp. 431-439

Author(s):

MASOOD JAVED ◽

KHALID AMIN ◽

DILSHAD MUHAMMAD ◽

Aamir Husain ◽

Nasir Mahmood

Keyword(s):

Duodenal Ulcer ◽

Peptic Ulcer ◽

Gastric Ulcer ◽

Peptic Ulcer Disease ◽

Protective Mechanism ◽

Skilled Workers ◽

Ulcer Disease ◽

Peptic Disease ◽

Number Of Patients ◽

H Pylori

Background: Acid peptic disease is a world wide problem among all the age groups and both sexes. Duodenal ulcer is common as compared to gastric ulcer. Its prevalence being 4:1 in USA & UK and 5:1 in Pakistan1,2,3. Etiology of peptic ulcer is almost certainly multi-factorial. Basic paradigm for ulcer disease is the imbalance between the digestive activity of acid and pepsin and the protective mechanism in place toresist mucosal digestion. Over the past few years a new line of thought has been evolved after isolating spiral campylobacter like organism from antral biopsy specimens. H pylori is now considered to be an important if not the only causative agent of gastritis and peptic ulcer disease. The dictum; No acid – No ulcer summarized the pathogenesis of peptic ulcer disease but new dictum seems to be; No H.pylori -No ulcer4,5, as over90% of Duodenal ulcer and 70% of Gastric ulcer patients are infected byH.Pylori6. Aim of the study was to evaluate the prevalence of H.pylori among Duodenal ulcer patients at Faisalabad District and its suburbs. Study Design: Descriptive Study. Period: From Mar 2008 to Oct 2008. Materials and Methods: 50 patients (40 Males, 10 Females) belonging to Faisalabad District and surrounding areas with upper gastrointestinal symptoms of acid peptic disease and endoscopy proved duodenal ulcer were subjected to gastric antral mucosal biopsies for evaluation of the H.Pylori status with the help of unease test and histological examination of biopsy specimen. Results: Epigastric pain was the most frequent symptom 90%. (46 out of 50 patients). 92% showed evidence of H. pylori infection. Maximum incidence of H. pylori was recordedin age group IV (46—55 years). Maximum number of patients was skilled workers (35 out of 50) 70%. 80 % of the patients belonged to lower and middle class. Percentage of H.pylori positivity was 89.1 % and 84.34 %. Conclusions: Acceptance of contributory role and high prevalence rate of H.pylori instigates us for addition of antimicrobial treatment to the conventional treatment with H2 Blockers and PPIs which is cost effectiveand alter the course of the disease.

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Prevalence of Peptic Ulcer Disease and Associated Factors Among Dyspeptic Patients At Endoscopy Unit, University of Gondar Hospital, Northwest Ethiopia

10.21203/rs.3.rs-1152130/v1 ◽

2021 ◽

Author(s):

Belete Assefa ◽

Abilo Tadesse ◽

Zinahebizu Abay ◽

Alula Abebe ◽

Tsebaot Tesfaye ◽

...

Keyword(s):

Peptic Ulcer ◽

Peptic Ulcer Disease ◽

Associated Factors ◽

Northwest Ethiopia ◽

P Value ◽

Upper Gastrointestinal Endoscopy ◽

Ulcer Disease ◽

Endoscopy Unit ◽

H Pylori ◽

Upper Gastrointestinal

Abstract Background: Dyspepsia is a common complaint in upper gastrointestinal disorders. It is described as predominant epigastric pain lasting for at least one month. Peptic Ulcer Disease (PUD) occurs in 5-15% of patients with dyspepsia. Helicobacter pylori (H.pylori) infection and non-steroidal anti-inflammatory drugs (NSAIDs)/aspirin (ASA) use are widely known risk factors for PUD. This research article aimed to determine the prevalence of PUD and associated factors among dyspeptic patients at the endoscopy unit, University of Gondar hospital, Northwest Ethiopia.Methods: A hospital-based cross-sectional study was conducted at University of Gondar hospital. A sample of 218 adults who presented with the complaint of dyspepsia, and underwent endoscopic evaluation were interviewed from June 1 to November 30, 2020. A consecutive sampling method was used to recruit the study subjects. Relevant clinical history was obtained from patients’ medical records. Upper gastrointestinal endoscopy was used to confirm the presence of peptic ulcer disease. The Data were entered into EpiData version 4.6.0.2 and exported to SPSS version 20 for analysis. Logistic regression analysis was used to identify associated factors with the occurrence of PUD among dyspeptic patients. P-value <0.05 was used to declare a statistically significant association.Results: A total of 218 dyspeptic patients who underwent upper gastrointestinal endoscopic evaluations were included in the study. The PUD was diagnosed in one-third of patients with dyspepsia. Dyspeptic patients with active H. pylori infection (AOR=6.3, 95%CI: 2.96-13.38) and NSAIDs/ASA use (AOR=6.2, 95%CI: 2.93-13.36) were at higher risk of developing PUD.Conclusion: The magnitude of active H. pylori infection among symptomatic PUD patients was high. So then, a “test-and-treat” strategy is advised. Cautious use of NSAIDs/ASA is required as it is readily available over-the-counter.

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Peptic ulcer disease: a cross-sectional study of symptoms and risk factors among students at Jimma University, Ethiopia

Gastrointestinal Nursing ◽

10.12968/gasn.2021.19.2.36 ◽

2021 ◽

Vol 19 (2) ◽

pp. 36-40

Author(s):

Melkamu Gelan ◽

Abdisa Eba ◽

Desalegn Nigatu ◽

Bonsa Amsalu

Keyword(s):

Risk Factors ◽

Peptic Ulcer ◽

Peptic Ulcer Disease ◽

Statistical Significance ◽

Cross Sectional Study ◽

P Value ◽

Sectional Study ◽

Cross Sectional ◽

Ulcer Disease ◽

Jimma University

Background: Peptic ulcer disease (PUD), which includes gastric and duodenal ulcers, is a common condition with symptoms including epigastric or abdominal pain. It is multifactorial, with physiological, demographic and environmental risk factors, some of which make it more prevalent in developing countries. Aims: This study aims to assess the symptoms of and risk factors for PUD among students at Jimma University, Jimma, Ethiopia. Methods: This institutional based cross-sectional study design used a self-administered questionnaire to collect data for analysis. This included logistic regression analysis, in which a p-value of <0.05 at 95% CI indicated statistical significance. Findings: Of the 240 respondents, 41.3% had symptoms indicative of PUD. Most students developed symptoms after enrolling at university and primarily managed them with medication. PUD-like symptoms were found to be associated with year of study, frequent Non-steroidal anti-inflammatory drugs(NSAIDs use, smoking, prolonged fasting and anxiety. Conclusions: PUD is highly prevalent in this setting. Therefore, the university may wish to raise awareness of PUD and aim to reduce anxiety among students.

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