Drug-induced gastropathy in elderly Taiwanese

Drug-induced gastropathy was common in developing countries in which drug consumption was heavy. The aim of this study is to evaluate the difference in the distribution of clinical features and endoscopic findings between elderly and non-elderly and to determine the risk factors of drug-induced gastrointestinal mucosal damage in elderly.

Four hundred and fifty patients with gastrointestinal mucosal damages were recruited from the outpatient clinic or emergency room. All patients were confirmed by endoscopic examination with Olympus Videoscope QX-200 or GIF-p20. Patient's clinical symptoms, endoscopic findings and risk factors were collected. Data was analyzed by chi 2 test and expressed as Odds ratio.

The age distribution of gastropathy was predominant at 60-69 years old, and the case number gradually declined as age increased or decreased, respectively. The clinical presentation of asymptomatic bleeding was significantly higher in the elderly than in the non-elderly, while epigastric pain combined with dyspepsia or bleeding was not different between elderly and non-elderly groups. The endoscopic findings of gastric ulcer and erosions were significantly predominant in the elderly group, while no difference was found for duodenal ulcer between these 2 groups. Non-steroidal anti-inflammatory drugs were the popular drug which lead to gastropathy in both elderly and non-elderly groups. Drugs, especially steroids, history of arthritis or peptic ulcer, and alcohol consumption were found to be the risk factors associated with increased risk of gastropathy in the elderly. Stress was also significantly associated with increased risk of gastropathy in the non-elderly. There was no significant difference in smoking habit and use of other drugs between these 2 groups.

The clinical features of symptoms, endoscopic findings and risk factors of gastropathy varied significantly between the elderly and the non-elderly. Drug-induced gastropathy, especially steroid treatment for arthritis, was a significant risk factor in the elderly. Program for assessment and management of these elderly patients under treatment is important.