Epidemiology of peptic ulcer disease: endoscopic results of the systematic investigation of gastrointestinal disease in China.
OBJECTIVE
Complications of peptic ulcer disease (PUD) are common in China. Population-based estimates of the prevalence of PUD are needed to quantify and characterize the population at risk of these complications.


METHODS
As part of a large epidemiological study, 3,600 randomly selected residents of Shanghai (aged 18-80 years) were asked to undergo endoscopy and to provide blood samples for Helicobacter pylori serology. All participants also completed a general information questionnaire and Chinese versions of the reflux disease questionnaire (RDQ) and Rome II questionnaire. Associations between PUD and other factors were analyzed using a multiple logistic regression model.


RESULTS
In total, 3,153 individuals (87.6%) completed the survey. All underwent blood tests, and 1,030 patients (32.7%) agreed to undergo endoscopy. Results from 1,022 patients were suitable for analysis. In all, 176 participants (17.2%) had PUD (62 with gastric ulcer; 136 with duodenal ulcer). The prevalence of H. pylori infection was 73.3% in the total population and 92.6% among those with PUD. H. pylori infection was associated with the presence of PUD (odds ratio (OR), 6.77; 95% confidence interval (CI), 2.85-16.10). The majority (72.2%) of individuals with PUD had none of the upper gastrointestinal symptoms assessed by the RDQ. PUD was not significantly associated with symptom-defined gastroesophageal reflux disease (GERD) (OR, 0.80; 95% CI, 0.32-2.03), reflux esophagitis (OR, 1.46; 95% CI, 0.76-2.79) or dyspepsia (OR, 1.69; 95% CI, 0.94-3.04).


CONCLUSIONS
The prevalence of endoscopically confirmed PUD in this Shanghai population (17.2%) is substantially higher than in Western populations (4.1%). The majority of individuals with PUD were asymptomatic.
Li
Zhaoshen
Z
Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Zou
Duowu
D
Ma
Xiuqiang
X
Chen
Jie
J
Shi
Xingang
X
Gong
Yanfang
Y
Man
Xiaohua
X
Gao
Li
L
Zhao
Yanfang
Y
Wang
Rui
R
Yan
Xiaoyan
X
Dent
John
J
Sung
Joseph J
JJ
Wernersson
Börje
B
Johansson
Saga
S
Liu
Wenbin
W
He
Jia
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China / Q000453:epidemiology; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006305:Health Status Indicators; D016481:Helicobacter Infections / Q000453:epidemiology; D016480:Helicobacter pylori; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000453:epidemiology* / Q000382:microbiology; D015995:Prevalence; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires