Clinical characteristics of peptic ulcer in the aged in Korea

Background : The proportion of the aged (>60 years old) population is increasing in South Korea and it is expected to reach 30.8% in 2030. The aim of this study was to analyze the clinical characteristics of peptic ulcer disease in the aged population in South Korea. Methods : A total of 134 patients (89 men and 45 woman) with peptic ulcers were investigated. The ulcers were diagnosed using esophagogastroduodenoscopy. The main symptom, the duration of the symptoms, the location of the ulcer, the presence of Helicobacter pylori as well as the history of Anti-Inflammatory Agents, Non-Steroidal (NSAID) use were analyzed. The parameters between the two age groups: under 60 years (n=73) and over 60 years (n=61), were compared. Results : In the aged, the frequency of a Helicobacter pylori infection was lower. In a gastric ulcer (GU) in aged patients, the rate of Helicobacter pylori infection was less common than in younger GU patients. In aged duodenal ulcer (DU) patients, the rate of a Helicobacter pylori infection was similar to that of younger DU patients. Bleeding peptic ulcers were more common in NSAID-users than in nonusers. DU was less common in the aged group (29.5% vs. 47.9%, p=0.030) and the incidence of typical epigastric pain in the aged and young groups were similar (33.3% vs. 40.0%, p=0.439). The frequency of ulcer bleeding was not different (22.8% vs. 17.1%, p=0.425) between aged and young groups. However in the aged group, the NSAID users experienced more frequent ulcer bleeding than nonusers. The Helicobacter pylori (+) NSAID users are believed to have a higher tendency to bleed than the Helicobacter pylori (-) NSAID users but without statistical significance. Among the aged, 40% of the NSAID-nonusing peptic ulcer patients was Helicobacter pylori (-). The duration of symptoms was shorter in the aged. An atypical location of the aged and younger groups was similar (13.2% vs. 7.0%, p=0.352). Conclusion : In the aged gastric ulcer patients, factors other than NSAID and Helicobacter pylori are believed to play roles in the development of gastric uclers. However, in the aged duodenal ulcer patients, the role of Helicobacter pylori in the development of a duodenal ulcer was similar to that in the younger group. NSAID is believed to be an important risk factor in the bleeding of ulcers in aged patients. In addition, the Helicobacter pylori (+) NSAID users had more frequent bleeding than the Helicobacter pylori (-) NSAID users but without statistical significance.