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- Title
The relative contribution of NSAIDs and H elicobacter pylori to the aetiology of endoscopically-diagnosed peptic ulcer disease: observations from a tertiary referral hospital in the UK between 2005 and 2010.
- Authors
Musumba, C.; Jorgensen, A.; Sutton, L.; Eker, D.; Moorcroft, J.; Hopkins, M.; Pritchard, D. M.; Pirmohamed, M.
- Abstract
Background Recent data from Western countries indicate that the aetiology of peptic ulcer disease ( PUD) is changing as the prevalence of H elicobacter pylori is decreasing while the use of low-dose aspirin ( LDA, ≤325 mg/day) is increasing. Aim To investigate the changing aetiology and demographics of PUD in a well-characterised patient cohort at a large tertiary hospital in the UK between July 2005 and June 2010. Methods Patients diagnosed with PUD following endoscopy were categorised as non-steroidal anti-inflammatory drug (NSAID)-users or non-users, and their H . pylori status determined. Comparisons between NSAID-users and non-users, and between non-aspirin NSAID-users and LDA-users were summarised using counts and corresponding percentages (for categorical variables) and means and standard deviations (for continuous variables). Results Overall, 386 patients were enrolled; 57% used NSAIDs (51% LDA only) and 43% were non-users. 57% of the whole cohort was H . pylori-positive (including 66% with duodenal ulcers and 47% with gastric ulcers). Compared with non-users, NSAID-users were older (mean age 68 vs. 61 years) and fewer were H . pylori-positive (52% vs. 63%). LDA-users were older (mean age 71 vs. 62 years) and more likely to be H . pylori-positive (61% vs. 41%) than those using non-aspirin NSAIDs. Twelve per cent of the patients were neither using NSAIDs nor were H. pylori-positive. Conclusions The NSAIDs, particularly LDA, were most commonly associated with PUD in this cohort. Our findings are compatible with the decline in the prevalence of H . pylori-positive PUD and increase in non- NSAID, non- H . pylori PUD previously reported.
- Subjects
UNITED Kingdom; ETIOLOGY of peptic ulcers; ASPIRIN; HELICOBACTER pylori infections; ETIOLOGY of diseases; ENDOSCOPY
- Publication
Alimentary Pharmacology & Therapeutics, 2012, Vol 36, Issue 1, p48
- ISSN
0269-2813
- Publication type
Article
- DOI
10.1111/j.1365-2036.2012.05118.x