[Changes in surgical treatment of peptic ulcer in the elderly by H2-blockers].
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.
Takahashi
T
T
Department of Surgery, Tokyo Metropolitan Geriatric Hospital.
Yamashiro
M
M
Hashimoto
H
H
Noro
T
T
Hino
Y
Y
Hirashima
T
T
Kuroiwa
K
K
Kino
K
K
D000368:Aged; D005743:Gastrectomy; D005773:Gastroscopy; D006635:Histamine H2 Antagonists / Q000627:therapeutic use*; D006801:Humans; D010437:Peptic Ulcer / Q000175:diagnosis / Q000628:therapy*
D006635:Histamine H2 Antagonists