Clinical characteristics of Helicobacter pylori-negative duodenal ulcer disease.
OBJECTIVE
Previous data on H. pylori-negative duodenal ulcer (DU) are limited due to different exclusion criteria adopted. In this study we attempted to clarify the characteristics of H. pylori-negative DU disease from patients referred for endoscopy.


METHODS
We recruited patients with DU disease and without H. pylori infection as confirmed by biopsy urease and 13C-urea breath tests. With each patient we carried out a structured personal interview including basic demographic and clinical data, personal habits, use of NSAIDs/aspirin, antibiotics, proton pump inhibitors (PPI) and anti-Hp therapy. If patients used antibiotics or PPI, a urea breath test was performed four or two weeks after discontinuation, respectively.


RESULTS
The mean age of patients with H. pylori-negative DU was 60.3 years (20-87). Among the 66 H. pylori-negative DU patients, 34 (51.5%) had reported use of NSAID/aspirin, 24 (36.4%) had a history of previous eradication therapy. Among the 32 non-H. pylori and non-NSAID DU cases, five (15.6%) had psychophysical stress, four (12.6%) had co-morbid illnesses, and two (6.3%) were alcoholics.


CONCLUSIONS
NSAID/aspirin use is the most common cause of H. pylori-negative DU disease. Psychophysical stress, co-morbid illnesses, and alcohol abuse appear to be associated with the development of non-H. pylori and non-NSAID DU disease.
Chen
Tseng-Shing
TS
Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, NO. 201, Sec. 2, Shih-Pai Road Taipei, Taiwan, 11217, R.O.C. tschen@vghtpe.gov.tw
Chang
Full-Young
FY
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D004381:Duodenal Ulcer / Q000209:etiology* / Q000382:microbiology; D000431:Ethanol / Q000009:adverse effects; D005260:Female; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000009:adverse effects; D013315:Stress, Psychological / Q000150:complications
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000431:Ethanol