Gastric ulcer in the elderly

Our experience shows that neither basal nor pentagastrin-stimulated acid, pepsin, pepsinogen group A and gastrin secretion significantly change across the age spectrum in subjects with peptic ulcer, even though the typical secretory patterns of patients with GU remain well-defined compared to those with duodenal ulcer (DU), even in the later decades of life. Very little is currently known about age-related changes in the various components of the gastric mucosal barrier; however, a significant reduction of the prostaglandin levels in the gastric mucosa of elderly subjects was recently reported. In elderly GU patients, the concentration of neutral glycoproteins and N-acetylneuraminic acid (NANA) was significantly higher than in young adult GU patients perhaps resulting from the migration of the border between the mucosa of the corpus and the antrum that occurs in the aged stomach. Other factors of pathogenetic importance in GU, such as Helicobacter pylori infection, gastroduodenal motility, gastrointestinal hormones, immune disorders and psychological and social characteristics of the elderly should certainly be further investigated. To date, the published data on the treatment of acute GU in the elderly patients concern studies with H2 blockers: famotidine, ranitidine and nizatidine with healing rates ranging from 67.6% to 90.9% after 6 weeks and 83.8% to 96.0% after 12 weeks of treatment. t present the data available on long-term maintenance treatment of GU disease in the elderly are few: a recent randomized, double-blind study conducted on 61 elderly GU patients with nizatidine vs ranitidine both at the dosage of 150 mg/day showed a relapse rate of 8.29% after 6 months and 34.4% after 12 months.(ABSTRACT TRUNCATED AT 250 WORDS)