Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 7 (2), 175-81

High Recurrence Rate of Idiopathic Peptic Ulcers in Long-Term Follow-up

Affiliations

High Recurrence Rate of Idiopathic Peptic Ulcers in Long-Term Follow-up

Hyuk Yoon et al. Gut Liver.

Abstract

Background/aims: Our aim was to compare the long-term clinical outcomes of idiopathic peptic ulcer disease (IPUD) with those of Helicobacter pylori-positive and nonsteroidal anti-inflammatory drug (NSAID)-induced peptic ulcer disease (PUD).

Methods: Patients with endoscopically diagnosed PUD were retrospectively reviewed. According to their H. pylori-infection status and history of NSAIDs use, patients were categorized into three groups: H. pylori-positive PUD, NSAID-induced PUD, and IPUD. Clinical outcomes were analyzed, and the recurrence rate of PUD was compared among the three groups.

Results: A total of 238 patients were enrolled. Those with IPUD, NSAID-induced PUD, and H. pylori-positive PUD comprised of 56, 60, and 122 patients, respectively. The 5-year cumulative incidences of recurrent ulcers were 24.3% (95% confidence interval [CI], 11.6% to 37.0%) in IPUD, 10.9% (95% CI, 2.6% to 19.2%) in NSAID-induced PUD, and 3.8% (95% CI, 0.1% to 7.5%) in H. pylori-positive PUD (IPUD vs NSAID-induced PUD/H. pylori-positive PUD, p=0.43/p<0.001 by log-rank test). In the Cox-proportional hazards model, only IPUD remained as an independent risk factor associated with recurrent ulcers (hazard ratio, 5.97; 95% CI, 1.94 to 18.34; p=0.002).

Conclusions: IPUD exhibited a higher recurrence rate than H. pylori-positive and NSAID-induced PUD in long-term follow-up and was an independent risk factor for ulcer recurrence.

Keywords: Helicobacter pylori; Idiopathic peptic ulcer; Nonsteroidal anti-inflammatory drug; Recurrence.

Conflict of interest statement

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1
The end status of the three peptic ulcer disease (PUD) groups at the point of censoring. NSAID, nonsteroidal anti-inflammatory drug.
Fig. 2
Fig. 2
Kaplan-Meier estimates of 5-year cumulative probabilities of recurrent peptic ulcer in the three peptic ulcers disease (PUD) groups. CI, confidence interval; NSAID, nonsteroidal anti-inflammatory drug.
Fig. 3
Fig. 3
Kaplan-Meier estimates of 5-year cumulative probabilities of recurrent peptic ulcers after excluding recurrent ulcers associated with nonsteroidal anti-inflammatory drug (NSAID) use or Helicobacter pylori infection in the three peptic ulcer disease (PUD) groups. CI, confidence interval.

Similar articles

See all similar articles

Cited by 9 PubMed Central articles

See all "Cited by" articles

References

    1. Hopkins RJ, Girardi LS, Turney EA. Relationship between Helicobacter pylori eradication and reduced duodenal and gastric ulcer recurrence: a review. Gastroenterology. 1996;110:1244–1252. - PubMed
    1. Nishikawa K, Sugiyama T, Kato M, et al. Non-Helicobacter pylori and non-NSAID peptic ulcer disease in the Japanese population. Eur J Gastroenterol Hepatol. 2000;12:635–640. - PubMed
    1. Ciociola AA, McSorley DJ, Turner K, Sykes D, Palmer JB. Helicobacter pylori infection rates in duodenal ulcer patients in the United States may be lower than previously estimated. Am J Gastroenterol. 1999;94:1834–1840. - PubMed
    1. Jang HJ, Choi MH, Shin WG, et al. Has peptic ulcer disease changed during the past ten years in Korea? A prospective multi-center study. Dig Dis Sci. 2008;53:1527–1531. - PubMed
    1. Yim JY, Kim N, Choi SH, et al. Seroprevalence of Helicobacter pylori in South Korea. Helicobacter. 2007;12:333–340. - PubMed

LinkOut - more resources

Feedback