Occurrence of peptic ulcer disease in connective tissue disease patients associated with xerostomia.
BACKGROUND
Saliva plays a role in mucosal protection and ulcer healing.


OBJECTIVE
: To study whether decreased salivary production leads to peptic ulcer disease in connective tissue disease patients associated with xerostomia.


METHODS
Two hundred and two connective tissue disease patients (90 with xerostomia and 112 without xerostomia) were enrolled. Their demographic data and use of medications were recorded. Peptic ulcer disease was confirmed by endoscopy. The stimulated salivary output and secretory epidermal growth factor level were measured.


RESULTS
Compared with non-xerostomic counterparts, xerostomic patients manifested a higher occurrence of peptic ulcer disease (31% vs. 12%, P = 0.001), lower stimulated salivary output (9.3 +/- 4.1 vs. 22.9 +/- 5.9 mL/15 min, P < 0.001) and lower stimulated salivary epidermal growth factor output (1.40 +/- 0.77 vs. 3.00 +/- 0.96 ng/min, P < 0.001). Multivariate analysis disclosed that an older age (> or = 60 years) (odds ratio, 4.71; P < 0.001), xerostomia with stimulated salivary output of < or =1 mL/min (odds ratio, 7.54; P = 0.014) and the use of non-steroidal anti-inflammatory drugs (odds ratio, 5.76; P = 0.031) were the risk factors leading to peptic ulcer disease. In addition, xerostomic connective tissue disease patients receiving non-steroidal anti-inflammatory drugs manifested an extremely high risk of development of peptic ulcer disease (odds ratio, 19.78; P < 0.001).


CONCLUSIONS
Ageing, the use of non-steroidal anti-inflammatory drugs and poor salivary function are potential risk factors for the development of peptic ulcer disease in patients with connective tissue disease. If these xerostomic subjects consume non-steroidal anti-inflammatory drugs, they will encounter an extremely high peptic ulcer disease risk.
Luo
J-C
JC
Division of Gastroenterology, Taipei Veterans General Hospital and National Yang-Ming University, Taiwan.
Lin
H-Y
HY
Chang
F-Y
FY
Lu
R-H
RH
Lu
C-L
CL
Chen
C-Y
CY
Lee
S-D
SD
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D016022:Case-Control Studies; D003240:Connective Tissue Diseases / Q000150:complications*; D004415:Dyspepsia / Q000209:etiology; D004815:Epidermal Growth Factor / Q000097:blood; D005260:Female; D016481:Helicobacter Infections / Q000150:complications; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000209:etiology*; D012044:Regression Analysis; D012307:Risk Factors; D014987:Xerostomia / Q000150:complications*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D004815:Epidermal Growth Factor