Title: Clinical Profile and Risk factor of Peptic ulcer disease in coastal eastern India
Authors: Manas Kumar Panigrahi, Ayaskanta Singh, Kanishka Uthansingh, Debasis Misra, Debasmita Behera, Mitali Rath, Mahesh Chandra Sahu, Manoj Kumar Sahu
DOI: https://dx.doi.org/10.18535/jmscr/v6i7.108
Abstract
Background: Peptic ulcer patients increased day by day in eastern Odisha. Here we assessed the impact of multiple risk factors, including Helicobacter pylori infection, on the incidence of peptic ulcer disease (PUD).
Aims: The aim of the study was to access the clinical profile, complications involvement, risk factors and possible associations with in peptic ulcer diseases of respective patients.
Material and Method: It was an observational study done for a period of 1 year. Consecutive patients having peptic ulcer diagnosed during upper gastrointestinal (UGI) endoscopy were enrolled. The ulcer particulars, Forrest class, clinical presentation, complications, therapy and possible dietary and environmental risk factors were noted in pre designed questionnaire. Rapid urease test (RUT) was done to detect H. pylori infection.
Results: Among 1015 patients 633 (55%) had duodenal ulcer while 437 (38%) had gastric ulcer and 81 (7%) had both. Three fourths (75%) of the patients with peptic ulcer disease were males. The mean age of presentation was around 47 years. The most common presentation was pain abdomen (69%) and gastro intestinal bleed (31%). The ulcers of 903 patients (88%) were classified as Forrest III. Endotherapy was done in 28 patients (2.7%), those with Forrest I and Forrest IIa, IIb ulcers. H. Pylori infection was positive in 49% with PUD; while 18% of the patients gave history of NSAIDS consumption. There is a high proportion of non-NSAID, non-H.pylori peptic ulcer disease (~41%). Diabetes, hypertension, and chronic kidney disease were present in 7%, 12% and 2% respectively. It was seen that male gender (OR-1.5) and addiction to alcohol (OR-1.7); smoking (OR- 5.6) and Pan Masala (OR-1.5) were significantly associated with peptic ulcer disease as compared to controls.
Conclusion: The prevalence of peptic ulcer in endoscopy data remains high (8.2%) in coastal eastern India. Duodenal ulcer is commoner than gastric ulcer although the proportion has reached similar level (1.3:1). Not all patients present with pain abdomen. H. pylori infection and NSAIDS intake history is strongly associated with PUD. The proportion of idiopathic peptic ulcer (Non NSAIDS, Non H. Pylori) is around 41%.
Keywords: Clinical profile, risk factors, peptic ulcer disease, H. pylori.
