title: Prevalence of lesions detected at upper endoscopy: an Italian survey.
abstract: BACKGROUND
  Prevalence of gastroduodenal lesions is changing in the last decades. Prevalence of Helicobacter pylori infection, non-steroidal anti-inflammatory drugs (NSAIDs), and proton pump inhibitor (PPI) therapy may be involved in such a phenomenon. We assessed gastroduodenal lesions prevalence in a nationwide study.
  
  
  METHODS
  Consecutive patients who underwent upper endoscopy for the first time in 24 Italian centres between January 2012 and 31 March 2012 were enrolled. Prevalence of gastric ulcer (GU), duodenal ulcer (DU), gastric erosions (GE), duodenal erosions (DE), gastric polyp (GP), Barrett's oesophagus (BE), and neoplasia was assessed.
  
  
  RESULTS
  Overall, 1054 (M/F: 388/666; Mean age: 57.5 ± 5 years) patients were enrolled. H. pylori infection was detected in 356 (33.9%) patients, 358 (34%) were taking NSAIDs, and 532 (50.5%) PPIs. PPI therapy was associated with a significantly lower H. pylori detection rate (27.8% vs 39.8%; OR: 0.6, 95% CI 0.45-0.77; P<0.001). GU, DU, GE, DE, GP and BE were detected in 17 (1.6%), 13 (1.2%), 150 (14.2%), 50 (4.7%), 51 (4.8%) and 17 (1.6%), respectively. Moreover, 3 (0.3%) distal gastric cancers were observed. H. pylori infection remained the most prevalent factor for all gastroduodenal lesions, but gastric polyp. One third of patients with GU and GE were taking only NSAIDs therapy.
  
  
  CONCLUSIONS
  The prevalence of peptic ulcer was very low (<3%), with a similar rate between DU and GU. As many as half patients were on ongoing PPI therapy. Such a therapy could affect both the detection rate of H. pylori infection and the real prevalence of gastroduodenal lesions.
authors.affiliation: Gastroenterology and Digestive Endoscopy, 'Nuovo Regina Margherita' Hospital, Rome, Italy. Electronic address: angelozullo66@yahoo.it.
authors.forename: Angelo
authors.initials: A
authors.lastname: Zullo
authors.affiliation: Department of Digestive and Liver Disease, Sant'Andrea Hospital, University Sapienza of Rome, Rome, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Esposito
authors.affiliation: Gastroenterology and Digestive Endoscopy, 'Nuovo Regina Margherita' Hospital, Rome, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Ridola
authors.affiliation: Gastroenterology and Digestive Endoscopy, 'Nuovo Regina Margherita' Hospital, Rome, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Hassan
authors.affiliation: Department of Digestive and Liver Disease, Sant'Andrea Hospital, University Sapienza of Rome, Rome, Italy.
authors.forename: Edith
authors.initials: E
authors.lastname: Lahner
authors.affiliation: Department of Gastroenterology and Digestive Endoscopy, "Casa Sollievo della Sofferenza" Hospital, IRCCS, San Giovanni Rotondo, Foggia, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Perri
authors.affiliation: Gastroenterology, Maresca Hospital, Torre del Greco, Naples, Italy.
authors.forename: Maria Antonietta
authors.initials: MA
authors.lastname: Bianco
authors.affiliation: Gastroenterology Unit 'Riuniti' Hospital, Foggia, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: De Francesco
authors.affiliation: Department of Gastroenterology, HHT Center, Maggiore Hospital, Crema, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Buscarini
authors.affiliation: Department of Digestive and Liver Disease, Sant'Andrea Hospital, University Sapienza of Rome, Rome, Italy.
authors.forename: Emilio
authors.initials: E
authors.lastname: Di Giulio
authors.affiliation: Department of Digestive and Liver Disease, Sant'Andrea Hospital, University Sapienza of Rome, Rome, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Annibale
mesh_terms: D000328:Adult; D004381:Duodenal Ulcer / Q000453:epidemiology; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology*; D016481:Helicobacter Infections / Q000453:epidemiology; D016480:Helicobacter pylori; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D013276:Stomach Ulcer / Q000453:epidemiology
keywords: Erosions; Peptic ulcer; Polyp; Proton pump inhibitor therapy; Upper endoscopy