Peptic ulcers in the elderly: unique features and management.
Contrary to the general trend, peptic ulcers are on the rise in the elderly in terms of frequency, complications, and mortality, possibly due to the use of and complications from nonsteroidal anti-inflammatory drugs (NSAIDs). Unfortunately, the infrequency of abdominal pain and the frequent presence of serious concomitant diseases complicate both the diagnosis and management of peptic ulcers in the elderly. Ulcers heal equally when treated with H2-receptor antagonists, antacids, or sucralfate. Patients with a history of silent, complicated ulcers and patients with serious concomitant diseases require low-dose maintenance H2-blockers to prevent ulcer recurrence. The frequency of NSAID-related ulcers may be reduced in selected patients with misoprostol in the case of gastric ulcers, or misoprostol or H2-blockers in the case of duodenal ulcers. NSAID-related ulcers heal when treated with H2-blockers.
Freston
M S
MS
Clinical Research Center, University of Connecticut Health Center, Farmington.
Freston
J W
JW
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D000897:Anti-Ulcer Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D006801:Humans; D010437:Peptic Ulcer / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control; D012008:Recurrence
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000897:Anti-Ulcer Agents