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Peptic ulcer in the very old patients
1School of Public health, University of Tampere, Tampere, Finland. lauri.seinela@uta.fi
Objective:
To describe the clinical features of peptic ulcer in patients aged 80 years or over.
Design:
The patient files of 73 ulcer patients were retrospectively analyzed.
Results:
Peptic ulcer was found in 17% of the gastroscopies made on patients aged 80 years or over. Epigastric pain was the most common symptom (74%). Vomiting and nausea were also common symptoms. 48% of the ulcers were duodenal and 52% gastric. The majority (65%) of ulcers were Helicobacter pylori negative. H.-pylori-positive patients used acetylsalicylic acid more frequently than the H.-pylori-negative (57 vs. 43%) ones. Complications occured in 69% of the patients. Aspirin and nonsteroidal anti-inflammatory drug (NSAID) users had more often complications than the others.
Conclusions:
Peptic ulcer is a common clinical finding of gastroscopy in patients aged 80 years or over. Most ulcers are H.-pylori-negative and almost evenly divided between duodenal and gastric ulcers. Most of the elderly patients suffer from epigastric pain. Complications are frequent among the patients, especially in aspirin and NSAIDs users. H.-pylori-infected aspirin users are at increased risk of ulcer disease. Before starting long-term aspirin treatment in elderly patients, eradication of H. -pylori is recommended.