[QOL and the older people with peptic ulcer]

The population older than 65 years old in Japan is now increasing in the recent years. The peptic ulcer, especially complicated peptic ulcers such as bleeding ulcer or perforating ulcer may disturb the quality of life in the older people because of long term hospitalization or death. To evaluate the characteristics of gastric mucosa in the older people, we investigated the mucosal blood volume using reflectance spectrophotometry and measured adenine nucleotides in biopsy samples from gastric mucosa using high-performance liquid chromatography. In the elderly, the mucosal blood volume significantly decreased according to aging and energy metabolism in human gastric mucosa was impaired. This may weaken their defensive mechanism. The combination therapy cimetidine and ecabet sodium compared with cimetidine alone showed a significant higher ulcer healing rate and symptom relief rate. Thus, the combination therapy with mucoprotective agents and acid suppressant accelerates ulcer healing and symptom relief and may maintain QOL in the old people with peptic ulcers. However, in the recent studies, Helicobacter pylori infection may affect these factors in the elderly. Therefore, we should reinvestigate the changes of mucosal defensive factors by aging.