Complications of peptic ulcer disease

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Tomica Milosavljevic1, Mirjana Kostić-Milosavljević, Ivan Jovanović

  • 1Clinical Center of Serbia, Gastroenterology and Hepatology Clinic, University of Belgrade, Faculty of Medicine, Belgrade, Serbia. tommilos@hotmail.com

Digestive Diseases (Basel, Switzerland)
|November 19, 2011
PubMed

Insights

Peptic ulcer disease (PUD) complications like bleeding are rising in older adults due to increased NSAID use, while declining in younger individuals. Therapeutic endoscopy and arterial embolization are key treatments for bleeding ulcers.

Area of Science:

  • Gastroenterology
  • Internal Medicine
  • Clinical Epidemiology

Background:

  • Peptic ulcer disease (PUD) presents with four major complications: bleeding, perforation, penetration, and obstruction.
  • Conflicting data exists regarding the incidence of life-threatening PUD complications despite medical advancements.
  • Key trends include declining Helicobacter pylori prevalence and increased nonsteroidal anti-inflammatory drug (NSAID) use, particularly in the elderly.

Purpose of the Study:

  • To analyze the time trends and changing epidemiology of peptic ulcer disease complications.
  • To investigate the impact of H. pylori and NSAID use on PUD complication rates across different age groups.
  • To review current treatment strategies for major PUD complications, focusing on bleeding ulcers.

Main Methods:

  • Review of epidemiological data and clinical trends related to peptic ulcer disease.
  • Analysis of the influence of H. pylori infection and NSAID consumption on ulcer complication incidence.
  • Evaluation of therapeutic endoscopy and angiographic embolization for managing bleeding peptic ulcers.

Main Results:

  • Ulcer complications are increasing in the elderly population, primarily linked to NSAID use.
  • Hemorrhage is the most frequent PUD complication, with an increasing incidence compared to perforation and stenosis.
  • Therapeutic endoscopy is effective for bleeding ulcers, reducing surgical necessity to 10-20%.

Conclusions:

  • Shifting trends in PUD complications necessitate tailored management strategies, especially for elderly patients on NSAIDs.
  • Hemorrhage remains a critical PUD complication, with endoscopic and angiographic interventions proving effective.
  • Transcatheter arterial embolization is a safe and effective option for managing recurrent bleeding after initial endoscopic or surgical treatment.

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