Published online Nov 28, 2023. doi: 10.3748/wjg.v29.i44.5882
Peer-review started: June 5, 2023
First decision: August 26, 2023
Revised: September 30, 2023
Accepted: November 14, 2023
Article in press: November 14, 2023
Published online: November 28, 2023
Processing time: 175 Days and 8.3 Hours
To date, few large-scale studies have comprehensively investigated the recent changing trends and clinical characteristics of peptic ulcer disease (PUD), including the multiple risk factors.
The incidence of idiopathic PUD, has increased in recent years, particularly in Asian countries. The clinical outcomes of idiopathic PUD revealed recurrent ulcer bleeding and higher mortality in previous studies; however, characteristics of idiopathic PUD remain poorly understood and warrant further investigation.
We aimed to evaluate the changing trends and characteristics of PUD according to age and etiology.
We analyzed seven hospital databases that were converted to a common data model between 2010 and 2019. We classified PUD patients who underwent rapid urease testing or Helicobacter pylori (H. pylori) serology testing into the following three groups according to etiology: (1) H. pylori-related; (2) drug-related [H. pylori-negative and nonsteroidal anti-inflammatory drugs (NSAIDs)/aspirin-related]; and (3) Idiopathic (H. pylori/NSAID/aspirin-negative) PUD.
The overall number of PUD exhibited no decrease, whereas PUD in old age revealed an increasing trend. H. pylori-related PUD exhibited a decreasing trend after 2014, drug-related PUD demonstrated an increasing trend, and idiopathic PUD showed an increasing trend in the old-age group during 10 years. The idiopathic PUD group had a significantly higher number of patients with chronic liver disease.
There was an increase in the incidence of PUD in the older age group during the last decade. There was a decrease in H. pylori-related PUD and an increase in drug-related and idiopathic PUD, especially in the elderly group.
Further preventive strategies for drug-induced PUD should be developed. Further studies are required to clarify the relationship between idiopathic PUD and chronic liver disease.