Systematic review: the global incidence and prevalence of peptic ulcer disease

Aliment Pharmacol Ther. 2009 May 1;29(9):938-46. doi: 10.1111/j.1365-2036.2009.03960.x.


Background: Peptic ulcer disease (PUD) is most commonly associated with Helicobacter pylori infection and the use of acetylsalicylic acid (ASA) and nonsteroidal anti-inflammatory drugs (NSAIDs). The management of H. pylori infection has improved radically in recent years; however, the prescription of ASA and NSAIDs has increased over the same period.

Aim: To evaluate the current global incidence and prevalence of PUD by systematic review of the literature published over the last decade.

Methods: Systematic searches of PubMed, EMBASE and the Cochrane library.

Results: The annual incidence rates of PUD were 0.10-0.19% for physician-diagnosed PUD and 0.03-0.17% when based on hospitalization data. The 1-year prevalence based on physician diagnosis was 0.12-1.50% and that based on hospitalization data was 0.10-0.19%. The majority of studies reported a decrease in the incidence or prevalence of PUD over time.

Conclusions: Peptic ulcer disease remains a common condition, although reported incidence and prevalence are decreasing. This decrease may be due to a decrease in H. pylori-associated PUD.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal
  • Anti-Ulcer Agents / therapeutic use*
  • Aspirin / therapeutic use*
  • Female
  • Helicobacter Infections / drug therapy*
  • Helicobacter Infections / epidemiology
  • Helicobacter pylori*
  • Humans
  • Male
  • Peptic Ulcer / drug therapy*
  • Peptic Ulcer / epidemiology
  • Practice Patterns, Physicians'
  • Prevalence


  • Anti-Inflammatory Agents, Non-Steroidal
  • Anti-Ulcer Agents
  • Aspirin