Clinical trends in ulcer diagnosis in a population with high prevalence of Helicobacter pylori infection.
BACKGROUND
It is unknown whether the incidence of peptic ulcer changes in areas with a high prevalence of Helicobacter pylori infection.


OBJECTIVE
To determine trends in peptic ulcer complications in a community with a high prevalence of H. pylori infection.


METHODS
New endoscopic diagnoses of peptic ulcers and their complications from 1985 to 2000 were obtained. H. pylori infection in the adult population, the number of prescriptions for anti-secretory drugs and non-steroidal anti-inflammatory drugs were also evaluated.


RESULTS
Although the global prevalence of H. pylori infection remains high in this population (>60%), a 41.4 to 25.4% decrease in the incidence of peptic ulcers and ulcer complications was observed. This was associated with a decrease in the prevalence of H. pylori infection in people under 65 years of age, a 3.5-fold increase in the number of prescriptions of proton-pump inhibitors and an increase in the number of prescriptions of non-steroidal anti-inflammatory drugs, especially coxibs.


CONCLUSIONS
In an area with a high prevalence of H. pylori infection, the incidence of peptic ulcer and associated complications is declining rapidly. This was associated with a reduction of the prevalence of H. pylori infection in the young and a widespread use of proton-pump inhibitors. The increase in the use of non-steroidal anti-inflammatory drugs, especially coxibs, has not changed the tendency.
Pérez-Aisa
M A
MA
Service of Digestive Diseases, University Hospital, Zaragoza, Spain.
Del Pino
D
D
Siles
M
M
Lanas
A
A
D000328:Adult; D000367:Age Factors; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D016481:Helicobacter Infections / Q000150:complications / Q000453:epidemiology*; D016480:Helicobacter pylori; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010437:Peptic Ulcer / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D013030:Spain / Q000453:epidemiology
D000894:Anti-Inflammatory Agents, Non-Steroidal; D016861:Cyclooxygenase Inhibitors