Time, change and peptic ulcer disease in Rotherham, UK.
OBJECTIVE
We have documented the changing pattern of peptic ulcer disease in our centre in the last quarter of the 20th century and speculate on the reasons thereof.


METHODS
The profile of peptic ulcer disease patients presenting newly to our centre (population 250,000) from 1977 to 2001 was examined. All patients were prospectively followed and detailed records kept. Results are presented in 5-year periods.


RESULTS
Seven thousand five hundred and ninety new peptic ulcer disease patients (5564 duodenal ulcer+2026 gastric ulcer) were seen, peaking in 1982-1986 but declining thereafter, and with a falling male preponderance. Patients with gastric ulcer were older than those with duodenal ulcer; were older than duodenal ulcer, the mean age of both increased over time and the age gap from the general population widened. The numbers presenting with perforation changed little but haemorrhage increased, particularly amongst the elderly. Ulcers refractory to H2 receptor antagonists declined even before proton pump inhibitors were introduced. Elective surgery, already declining before H2 receptor antagonists, had virtually disappeared by 1992-1996.


CONCLUSIONS
Peptic ulcer disease affects an older population, an increasing proportion of whom present with haemorrhage. Refractoriness to H2 receptor antagonists and the need for elective operation was declining even before the emergence of modern treatment. We suggest the changes observed result not only from modern therapy but also substantially from a changing natural history.
Bardhan
K D
KD
Rotherham General Hospitals NHS Trust, Moorgate Road, Rotherham, South Yorkshire S60 2UD, UK. bardhan.sec@rothgen.nhs.uk
Royston
C
C
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004381:Duodenal Ulcer / Q000188:drug therapy / Q000601:surgery; D004636:Emergency Service, Hospital; D005260:Female; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data / Q000639:trends*; D010437:Peptic Ulcer / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery*; D011446:Prospective Studies; D012307:Risk Factors; D013276:Stomach Ulcer / Q000188:drug therapy / Q000601:surgery; D006113:United Kingdom / Q000453:epidemiology
D000897:Anti-Ulcer Agents; D006635:Histamine H2 Antagonists