title: Prevalence of non-Helicobacter pylori duodenal ulcer in Karachi, Pakistan.
abstract: OBJECTIVE
  To determine the prevalence of non-Helicobacter pylori (H pylori)-related duodenal ulcer in patients with acid-peptic diseases.
  
  
  METHODS
  Medical records of patients who attended the Gastroenterology Department at Aga Khan University Hospital from 1999 to 2001 and had endoscopic diagnosis of duodenal ulcers were reviewed. Duodenal ulcer associated with H pylori was diagnosed on the basis of endoscopy, rapid urease test and histopathology whereas histories of aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs) related duodenal ulcers. Non-H pylori, non-NSAID duodenal ulcers were those without H pylori infection and history of NSAID intake. Co-morbid conditions associated were noted.
  
  
  RESULTS
  Of 2 260 patients, 10% (217/2 260) had duodenal ulcer. Duodenal ulcer related to H pylori infection accounted for 53% (116/217), NSAID-related 10% (22/217), non-H pylori non-NSAID 29% (62/217), and 8% (17/217) had both H pylori infection and histories of NSAID intake. Fifteen percent (18/116) patients had past histories of peptic ulcer disease in H pylori infection, while 8% (5/62) in non-H pylori non-NSAID ulcer. Co-morbid conditions in H pylori infection were seen in 23% (27/116) and 34% (21/62) in non-H pylori non-NSAID ulcer.
  
  
  CONCLUSIONS
  Incidence of H pylori infection related with duodenal ulcer is common. In the presence of co-morbids, non-H pylori and non-NSAID duodenal ulcer is likely to be present.
authors.affiliation: Section of Gastroenterology, Department of Medicine, Aga Khan University Hospital, Stadium Road, Karachi, Pakistan. yakoobjaved@hotmail.com
authors.forename: Javed
authors.initials: J
authors.lastname: Yakoob
authors.forename: Wasim
authors.initials: W
authors.lastname: Jafri
authors.forename: Nadim
authors.initials: N
authors.lastname: Jafri
authors.forename: Muhammad
authors.initials: M
authors.lastname: Islam
authors.forename: Shahab
authors.initials: S
authors.lastname: Abid
authors.forename: Saeed
authors.initials: S
authors.lastname: Hamid
authors.forename: Hasnain
authors.initials: H
authors.lastname: AliShah
authors.forename: Hizbullah
authors.initials: H
authors.lastname: Shaikh
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D004381:Duodenal Ulcer / Q000453:epidemiology* / Q000209:etiology / Q000382:microbiology; D005260:Female; D016481:Helicobacter Infections / Q000453:epidemiology; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D015995:Prevalence
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal