Digestive disorders

IV/4.2: Epidemiology

Peptic ulcer is a widespread disease. Nowadays there is an approx. 10% chance for temporary or persistent carrying of an ulcer during one’s lifetime. In Hungary the ratio of ulcer carriers is 1.5 to 1.8% of the adult population. Peptic ulcer was a rare disease before the 19th century. The occurrence of gastric ulcer was first reported in young women in the 1830s. 20 to 30 years later the incidence of duodenal ulcer showed a sudden rise, particularly in males. The prevalence of both ulcers kept increasing during the 19th century, and then it reached an epidemic level in the first half of the 20th century; thereafter the incidence and prevalence of both gastric and duodenal ulcers decreased.

Mortality due to peptic ulcer increased in the second half of the 19th century and then it decreased in most age groups after the turn of the century; at the same time mortality due to the complications of ulcer (bleeding, perforation) increased among the elderly women. In the USA yearly 500 000 new patients with peptic ulcer have been reported. Its yearly incidence is 0.1 to 0.3%; its prevalence increases with the age. 70% of patients are between 25 and 64 years of age.

As a result of the decreasing prevalence of H. pylori infection and due to the eradication, the occurrence of peptic ulcer has abated in the younger age groups. At the same time the incidence of peptic ulcer as a complication has increased among the elderly due to the platelet aggregation-inhibiting therapy used for the prevention of cardiovascular diseases, as well as anticoagulation and thrombolysis. In spite of the successes achieved in the recognition and treatment of peptic ulcer, hemorrhage and perforation of the ulcer are significant factors of morbidity and mortality in this age group also nowadays. Peptic ulcer is revealed often when one of its complications is observed.