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Duodenal ulcer in the elderly.

E Scapa¹, M Horowitz, M Waron

¹Institute of Gastroenterology, Assaf Harofeh Medical Center, Zerifin, Israel.

Journal of Clinical Gastroenterology

|October 1, 1989

Summary

Older adults with duodenal ulcers (DU) often present atypically, with painless bleeding being more common. Pain may be milder, and concurrent gastric ulcers are more frequent in this demographic.

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Area of Science:

Gastroenterology
Geriatric Medicine
Internal Medicine

Background:

Duodenal ulcer (DU) diagnosis and management can differ in elderly populations.
Understanding atypical presentations in older adults is crucial for timely intervention.

Purpose of the Study:

To compare the clinical characteristics and presentation of duodenal ulcers in elderly patients versus a younger control group.
To identify factors contributing to atypical DU presentation in older individuals.

Main Methods:

Prospective follow-up of 333 duodenal ulcer patients, with 75 identified as elderly (65-93 years).
Endoscopic diagnosis and characterization of ulcers.
Comparison of demographic, clinical, and etiological factors between elderly and younger groups.

Main Results:

Elderly DU patients showed fewer smokers but higher use of steroids and NSAIDs, and more arteriosclerotic heart disease.
Painless upper gastrointestinal bleeding was more common in the elderly, with milder pain when present.
Increased incidence of concurrent gastric and duodenal ulcers was observed in older patients.

Conclusions:

Duodenal ulcers in the elderly frequently present atypically, with pain not being the primary symptom.
Steroid and NSAID use may be linked to bleeding and reduced pain perception in older DU patients.
Diagnostic and therapeutic approaches for DU should be adapted for the elderly, considering atypical presentations.

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