title: Changing trends in peptic ulcer prevalence in a tertiary care setting in the Philippines: a seven-year study.
abstract: OBJECTIVE
  The declining global prevalence of peptic ulcer disease (PUD) might be because of the decreasing prevalence of Helicobacter pylori (Hp) infection. The aims of the present study were to determine the prevalence of PUD during a 7-year period and to investigate its relationship with the prevalence of Hp infection during the same period.
  
  
  METHODS
  All upper gastrointestinal endoscopies carried out at Santo Tomas Hospital in Manila from January 1996 to December 2002 were evaluated. Endoscopies reporting gastric ulcers (GU) and duodenal ulcers (DU) with Hp status were analyzed.
  
  
  RESULTS
  A total of 15 341 endoscopies were evaluated. Overall, 2600 (16.95%) GU and 1575 (10.27%) DU were identified. There was a decreasing trend in the prevalence of GU (P < 0.0001) and DU (P < 0.0001) during the study period. Overall PUD prevalence declined from 35.87% in 1996 to 18.80% in 2002. This decline was seen for both GU and DU (20.05 vs 14.34%, and 15.83 vs 7.02%, respectively). The prevalence of Hp infection decreased significantly from 1996 to 2002 for both GU and DU (68.13 vs 33.48%, P < 0.0001; and 76.67 vs 36.50%, P < 0.0001, respectively). The decrease in Hp prevalence was significantly related to the decrease in ulcer prevalence (r = 0.97, P = 0.0004 for GU; r = 0.89, P = 0.0079 for DU; and r = 0.92, P = 0.0035 for all PUD). The prevalence of bleeding secondary to PUD remained stable during the 7-year period (P = 0.87).
  
  
  CONCLUSIONS
  During the 7-year period, there was a significant decline in the prevalence of PUD. This decline in PUD prevalence was associated with a corresponding decrease in Hp prevalence.
authors.affiliation: Section of Gastroenterology, University of Santo Tomas, España, Manila, The Philippines. sjganwong@yahoo.com
authors.forename: Stephen N
authors.initials: SN
authors.lastname: Wong
authors.forename: Jose D
authors.initials: JD
authors.lastname: Sollano
authors.forename: Melchor M
authors.initials: MM
authors.lastname: Chan
authors.forename: Ramon E
authors.initials: RE
authors.lastname: Carpio
authors.forename: Celina S
authors.initials: CS
authors.lastname: Tady
authors.forename: Albert E
authors.initials: AE
authors.lastname: Ismael
authors.forename: Estelita A
authors.initials: EA
authors.lastname: Judan-Ruiz
authors.forename: Victorio N
authors.initials: VN
authors.lastname: Ang
authors.forename: Johnny T
authors.initials: JT
authors.lastname: Go
authors.forename: Victoriano Y
authors.initials: VY
authors.lastname: Lim
authors.forename: Jesus Y
authors.initials: JY
authors.lastname: Perez
authors.forename: Sol Z
authors.initials: SZ
authors.lastname: Alvarez
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005260:Female; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000453:epidemiology*; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000453:epidemiology* / Q000382:microbiology; D010679:Philippines / Q000453:epidemiology; D015995:Prevalence