title: [Changes in surgical treatment of peptic ulcer in the elderly by H2-blockers].
abstract: It has common knowledge that the advent of H2-blockers has radically changed the treatment of peptic ulcer. We reviewed 26,667 endoscopic examinations, 5,800 consecutive autopsies and 134 consecutive patients operated for peptic ulcer over an 18-year period to evaluate the effects of H2-blockers on the treatment of peptic ulcer in the elderly (> or = 60 years of age). The number of operations for peptic ulcer in the elderly markedly declined after H2-blocker therapy was introduced. This is mainly due to decreased operative indications for gastric bleeding as a result of conservative treatment. However, the incidence of perforating ulcers has hardly changed even after the introduction of H2-blockers. More than 90% of these cases were non-diagnosed or non-treated ulcers and 50% of them were NSAID- or steroid-treated, which is characteristic in the elderly. We conclude that patients to be treated by anti-inflammatory drugs should be screened by endoscopy, and should be given anti-ulcer drugs prophylactically if necessary.
authors.affiliation: Department of Surgery, Tokyo Metropolitan Geriatric Hospital.
authors.forename: T
authors.initials: T
authors.lastname: Takahashi
authors.forename: M
authors.initials: M
authors.lastname: Yamashiro
authors.forename: H
authors.initials: H
authors.lastname: Hashimoto
authors.forename: T
authors.initials: T
authors.lastname: Noro
authors.forename: Y
authors.initials: Y
authors.lastname: Hino
authors.forename: T
authors.initials: T
authors.lastname: Hirashima
authors.forename: K
authors.initials: K
authors.lastname: Kuroiwa
authors.forename: K
authors.initials: K
authors.lastname: Kino
mesh_terms: D000368:Aged; D005743:Gastrectomy; D005773:Gastroscopy; D006635:Histamine H2 Antagonists / Q000627:therapeutic use*; D006801:Humans; D010437:Peptic Ulcer / Q000175:diagnosis / Q000628:therapy*
chemical_list: D006635:Histamine H2 Antagonists