Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Sep;23(9):604-8.
doi: 10.1155/2009/181059.

Incidence of duodenal ulcers and gastric ulcers in a Western population: back to where it started

Marcel J M Groenen  1 , Ernst J Kuipers, Bettina E Hansen, Rob J Th Ouwendijk
Affiliations

Incidence of duodenal ulcers and gastric ulcers in a Western population: back to where it started

Marcel J M Groenen et al. Can J Gastroenterol. 2009 Sep.

Abstract
in English, French

Background/objectives: As recently as 40 years ago, a decline in the incidence of peptic ulcers was observed. The discovery of Helicobacter pylori had a further major impact on the incidence of ulcer disease. Our aim was to evaluate the trends in the incidence and bleeding complications of ulcer disease in the Netherlands.

Methods: From a computerized endoscopy database of a district hospital, the data of all patients who underwent upper gastrointestinal endoscopy from 1996 to 2005 were analyzed. The incidence of duodenal and gastric ulcers, with and without complications, were compared over time.

Results: Overall, 20,006 upper gastrointestinal endoscopies were performed. Duodenal ulcers were diagnosed in 696 (3.5%) cases, with signs of bleeding in 158 (22.7%). Forty-five (6.5%) of these ulcers were classified as Forrest I and 113 (16.2%) as Forrest II. Gastric ulcers were diagnosed in 487 cases (2.4%), with signs of bleeding in 60 (12.3%). A Forrest 1 designation was diagnosed in 19 patients (3.9%) and Forrest 2 in 41 patients (8.4%). The incidence of gastric ulcers was stable over time, while the incidence of duodenal ulcers declined.

Conclusions: The incidence of duodenal ulcer disease in the Dutch population is steadily decreasing over time. Test and treatment regimens for H pylori have possibly contributed to this decline. With a further decline in the prevalence of H pylori, the incidence of gastric ulcers is likely to exceed the incidence of duodenal ulcers in the very near future, revisiting a similar situation that was present at the beginning of the previous century.

HISTORIQUE ET OBJECTIFS :: Il y a à peine 40 ans, on observait un fléchissement du nombre d’ulcères gastroduodénaux. Par ailleurs, la découverte de l’Helicobacter pylori a eu des conséquences importantes sur l’incidence des maladies ulcéreuses. Nous visions à évaluer les tendances dans l’incidence et les complications hémorragiques des maladies ulcéreuses aux Pays-Bas.

MÉTHODOLOGIE :: Les auteurs ont analysé les données de tous les patients qui ont subi une endoscopie œsogastroduodénale entre 1996 et 2005, tirées de la base de données informatisée des endoscopies d’un hôpital de district. Ils ont comparé l’incidence d’ulcères duodénaux et gastriques, avec ou sans complications, au fil du temps.

RÉSULTATS :: Dans l’ensemble, 20 006 endoscopies œsogastroduodénales ont été exécutées. Dans 696 cas (3,5 %), on a diagnostiqué un ulcère duodénal, lesquels comportaient des signes de saignements dans 158 (22,7 %) cas. Quarante-cinq de ces ulcères (6,5 %) étaient classés Forrest I et 113 (16,2 %), Forrest II. On a diagnostiqué des ulcères gastriques dans 487 cas (2,4 %), dont 60 (12,3 %) comportaient des signes de saignement. Dix-neuf patients (3,9 %) avaient une désignation Forrest I et 41 (8,4 %), une désignation Forrest II. L’incidence d’ulcères gastriques est demeurée stable au fil du temps, tandis que celle d’ulcères duodénaux a diminué.

CONCLUSIONS :: L’incidence de maladies ulcéreuses duodénales au sein de la population hollandaise diminue régulièrement au fil du temps. Les tests et les posologies thérapeutiques du H pylori ont peut-être contribué à ce fléchissement. Étant donné le recul de la prévalence de H pylori, l’incidence d’ulcères gastriques est susceptible de dépasser celle des ulcères duodénaux dans un avenir très rapproché, ce qui nous ramènerait à une situation similaire à celle observée au début du siècle dernier.

PubMed Disclaimer

Figures

Figure 1)
Figure 1)
Age-related proportion of patients with ulcer disease
Figure 2)
Figure 2)
Linear regression of mean age of duodenal and gastric ulcer patients in a 10-year period. The mean age of the duodenal ulcer patients increased by 0.992 years per year (95% CI 0.44 to 1.4) (P<0.001) compared with a nonsignificant increase of 0.274 years per year for gastric ulcer patients (95% CI −0.34 to 0.89)
Figure 3)
Figure 3)
Trends in the incidence of duodenal ulcer (DU) and gastric ulcer (GU) disease
Figure 4)
Figure 4)
Trends in the incidence of complicated and uncomplicated ulcers. Left panel: Duodenal ulcers (DU) without complications of bleeding (Forrest 3); DU with complications of bleeding (Forrest 1 and 2). Right panel: Gastric ulcers (GU) without complications of bleeding (Forrest 3); GU with complications of bleeding (Forrest 1 and 2)
See this image and copyright information in PMC

References

    1. Cucino C, Sonnenberg A. The long-term time trends of peptic ulcer and ulcerative colitis are interrelated. Am J Gastroenterol. 2002;97:2657–62. - PubMed
    1. Susser M, Stein Z. Civilisation and peptic ulcer. Lancet. 1962;1:115–9. - PubMed
    1. Sonnenberg A. Temporal trends and geographical variations of peptic ulcer disease. Aliment Pharmacol Ther. 1995;9(Suppl 2):3–12. - PubMed
    1. Sonnenberg A. Time trends of ulcer mortality in Europe. Gastroenterology. 2007;132:2320–7. - PubMed
    1. Kuipers EJ, Pena AS, van Kamp G, et al. Seroconversion for Helicobacter pylori. Lancet. 1993;342:328–31. - PubMed

MeSH terms

LinkOut - more resources