Risk Factors for the Presence of Symptoms in Peptic Ulcer Disease
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Background/Aims: Peptic ulcer disease (PUD) is a common condition, but is difficult to detect in asymptomatic individuals. We aimed to investigate the prevalence of symptomatic and asymptomatic PUD during screening endoscopy and to identify risk factors for the presence of symptoms in patients with PUD. Methods: We investigated subjects who underwent a health inspection, including endoscopy of the upper gastrointestinal (GI) tract and a serum anti-Helicobacter pylori IgG assay, and who completed a self-report questionnaire about their symptoms. Results: Of the 12,852 subjects included in the study, 124 (1.0%) had symptomatic PUD and 309 (2.4%) had asymptomatic PUD. Old age, current smoking, and H. pylori infection were independent risk factors for symptomatic and asymptomatic PUD. Use of non-steroidal anti-inflammatory drugs (NSAIDs) was an independent risk factor only for symptomatic PUD (p=0.040). Compared to subjects with asymptomatic PUD, subjects with symptomatic PUD were more likely to have active-stage ulcers (p=0.002) and to drink more heavily (p=0.005). Conclusions: Use of NSAIDs is a risk factor for symptomatic PUD, but not for asymptomatic PUD. Excessive alcohol consumption and active-stage ulcers in patients with PUD are related to the presence of gastroduodenal symptoms.
Abstract
Background/Aims: Peptic ulcer disease (PUD) is a common condition, but is difficult to detect in asymptomatic individuals. We aimed to investigate the prevalence of symptomatic and asymptomatic PUD during screening endoscopy and to identify risk factors for the presence of symptoms in patients with PUD. Methods: We investigated subjects who underwent a health inspection, including endoscopy of the upper gastrointestinal (GI) tract and a serum anti-Helicobacter pylori IgG assay, and who completed a self-report questionnaire about their symptoms. Results: Of the 12,852 subjects included in the study, 124 (1.0%) had symptomatic PUD and 309 (2.4%) had asymptomatic PUD. Old age, current smoking, and H. pylori infection were independent risk factors for symptomatic and asymptomatic PUD. Use of non-steroidal anti-inflammatory drugs (NSAIDs) was an independent risk factor only for symptomatic PUD (p=0.040). Compared to subjects with asymptomatic PUD, subjects with symptomatic PUD were more likely to have active-stage ulcers (p=0.002) and to drink more heavily (p=0.005). Conclusions: Use of NSAIDs is a risk factor for symptomatic PUD, but not for asymptomatic PUD. Excessive alcohol consumption and active-stage ulcers in patients with PUD are related to the presence of gastroduodenal symptoms.
참고문헌 (24)
- Milosavljevic T, "Complications of peptic ulcer disease", Dig Dis, 29, pp.491~493 (2011)
- Al Dhahab H, "State-of-the-art management of acute bleeding peptic ulcer disease", Saudi J Gastroenterol, 19, pp.195~204 (2013)
- Wolfe MM, "Gastrointestinal toxicity of nonsteroidal antiinflammatory drugs", N Engl J Med, 340, pp.1888~1899 (1999)
- Hopkins RJ, "Relationship between Helicobacter pylori eradication and reduced duodenal and gastric ulcer recurrence: a review", Gastroenterology, 110, pp.1244~1252 (1996)
- Atherton JC, "Mosaicism in vacuolating cytotoxin alleles of Helicobacter pylori. Association of specific vacA types with cytotoxin production and peptic ulceration", J Biol Chem, 270, pp.17771~17777 (1995)
- Hunt RH, "Acid-NSAID", aspirin interaction in peptic ulcer disease, 2011, pp.29, 465~468
- Yamaoka Y, "Helicobacter pylori outer membrane proteins and gastroduodenal disease", Gut, 55, pp.775~781 (2006)
- Potamitis GS, "Helicobacter pylori and Nonmalignant Diseases", Helicobacter, 20(Suppl 1), pp.26~29 (2015)
- Thorat MA, "Prophylactic use of aspirin: systematic review of harms and approaches to mitigation in the general population", Eur J Epidemiol, 30, pp.5~18 (2015)
- Sasaki H, "Ten-year trend of the cumulative Helicobacter pylori eradication rate for the ‘Japanese eradication strategy’", Digestion, 88, pp.272~278 (2013)
- Kim JH, "Seroepidemiological study of Helicobacter pylori infection in asymptomatic people in South Korea", J Gastroenterol Hepatol, 16, pp.969~975 (2001)
- Lau JY, "Systematic review of the epidemiology of complicated peptic ulcer disease: incidence, recurrence, risk factors and mortality", Digestion, 84, pp.102~113 (2011)
- Choi HS, "Combining the serum pepsinogen level and Helicobacter pylori antibody test for predicting the histology of gastric neoplasm", J Dig Dis, 15, pp.293~298 (2014)
- Halder SL, "Influence of alcohol consumption on IBS and dyspepsia", Neurogastroenterol Motil, 18, pp.1001~1008 (2006)
- Kim HM, "NSAID is inversely associated with asymptomatic gastric ulcer: local health examination data from the Korean National Health Insurance Corporation", Scand J Gastroenterol, 48, pp.1371~1376 (2013)
- Yap PR, "Non-steroidal anti-inflammatory drugs (NSAIDs)induced dyspepsia", Curr Pharm Des, 21, pp.5073~5081 (2015)
- D’Elios MM, "Inflammation, immunity, and vaccines for Helicobacter pylori", Helicobacter, 14(Suppl 1), pp.21~28 (2009)
- Tahara T, "Association of endoscopic appearances with dyspeptic symptoms", J Gastroenterol, 43, pp.208~215 (2008)
- Li LF, "Cigarette smoking and gastrointestinal diseases:the causal relationship and underlying molecular mechanisms", Int J Mol Med, 34, pp.372~380 (2014)
- 이상표, "The Effect of Emotional Stress and Depression on the Prevalence of Digestive Diseases", Journal of Neurogastroenterology and Motility (JNM), 21(2), pp.273~282 (2015), 대한소화기 기능성질환∙운동학회[DOI]
- Ford AC, "Characteristics of functional bowel disorder patients: a cross-sectional survey using the Rome III criteria", Aliment Pharmacol Ther, 39, pp.312~321 (2014)
- Tadayuki Oshima, "Epidemiology of Functional Gastrointestinal Disorders in Japan and in the World", Journal of Neurogastroenterology and Motility (JNM), 21(3), pp.320~329 (2015), 대한소화기 기능성질환∙운동학회[DOI]
- Bode G, "Dyspeptic symptoms in middle-aged to old adults: the role of Helicobacter pylori infection, and various demographic and lifestyle factors", J Intern Med, 252, pp.41~47 (2002)
- Stone MA, "Lack of correlation between self-reported symptoms of dyspepsia and infection with Helicobacter pylori, in a general population sample", Eur J Gastroenterol Hepatol, 10, pp.301~304 (1998)
