Peptic Ulcer Disease in the Proton Pump Inhibitor Era in Coastal Odisha
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2017, Vol 5, Issue 8
Abstract
Background and Objective: There is a wide variation in the prevalence of peptic ulcer in India both before and since the use of endoscopy. We studied the risk factors, mode of presentation and treatment outcome in patients with peptic ulcer attending two gastrointestinal (GI) clinics in coastal Odisha, and its relationship with Helicobacter pylori infection. Methods: We investigated patients who underwent a health inspection for upper GI symptoms. Upper GI endoscopy was performed, and biopsy specimens were collected from the stomach of the patients who were found to have peptic ulcer disease (PUD). All patients with peptic ulcer were prospectively followed after H. pylori eradication regimen. After a minimum of 4 weeks repeat, upper GI endoscopy was performed to assess healing of ulcers. Results: Between 2015 and 2017, 3000 patients with peptic ulcer were seen, of whom 1480 (49.33%) had duodenal ulcer, 917 (30.56%) had gastric ulcer, and 603 (20.1%) had both duodenal and gastric ulcer. The mode of presentation was epigastric pain (36%), dyspepsia (26%), GI bleed (24%), and gastric outlet obstructive symptoms (14%). Risk factors were smoking (38%), nonsteroidal anti-inflammatory drugs (NSAID) intake (22%), alcohol intake (13%), and indigenous drug (8%). Among 926 patients, rapid urease test (RUT) could be done. 682 (73.65%) were positive, and 244 (26.35%) were negative for RUT. Among the H. pylori positive subjects duodenal ulcer was most common (49.85%) followed by gastric ulcer (30.8%) and both gastric and duodenal ulcer (19.35%). Treatment with H. pylori eradication regimen resulted in complete healing 75%, partial healing in 15% but non-healing still persisted in 10% patients. Conclusions: PUD is very common in coastal eastern Odisha. Among them, duodenal ulcer is the most common variety. Epigastric pain is the most common type of presentation. Smoking is the most common risk factor followed by NSAID intake. H. pylori association causes mostly duodenal ulcers. Complete healing of ulcers occurs in two-third cases after H. pylori eradication regimen. Further studies required to assess the etiology in remaining partial and non-healing ulcer cases.
Authors and Affiliations
Haribhakti Seba Das, Chitta Ranjan Panda, Sambit Kumar Behera
Keywords
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