Trends in prevalence of peptic ulcer disease and Helicobacter pylori infection and frequency of NSAID intake in general practitioner-referred dyspeptic patients over 6 years in Hong Kong

Abstract

Background and aim: Peptic ulcer disease is common in the world, and is strongly associated with Helicobacter pylori infection, and use of non-steroidal anti-inflammatory drugs (NSAIDs). The aim of the present study was to investigate the trends of prevalence of peptic ulcer disease and H. pylori infection and frequency of NSAID intake over the past 6 years in Hong Kong. Methods: Clinical and endoscopic data on patients referred by general practitioners including H. pylori status (as determined by a rapid urease test and histology), NSAIDs use during 1998 and 2003 were retrospectively retrieved in Hong Kong University Queen Mary Hospital. Results: A total 2409 cases of patients who had upper gastrointestinal symptoms and undergone endoscopy were included. Overall, 369 cases of peptic ulcer disease (238 duodenal ulcer, 116 gastric ulcer and 15 both duodenal and gastric ulcer) were identified. There were reduced trends from 1998 to 2003 in the prevalence of peptic ulcer disease (chi square for trend 4.043, P0.044) andH. pylori infection (chi square for trend 10.144, P0.0014), but not in the frequency NSAID intake. Classifying two sets of the data from 1998 to 2000 and from 2001 to 2003, the prevalence of peptic ulcer disease and H. pylori infection during 2001 and 2003 was significantly lower than that during 1998 and 2000 (13.52% vs. 16.55%, chi square9.011, OR1.269, 95%CI: 1.014~1.588, P0.042 for peptic ulcer disease and 29.44% vs. 35.25%, chi square4.120, OR1.304, 95%CI: 1.099~1.548, P0.0027). However, NSAID intake remained unchanged (4.72% vs 3.14%). In addition, both H. pylori infection and NSAID intake were associated with peptic ulcer disease. However, there was no association between H. pylori infection and NSAID intake. Conclusion: There is a decreased trend in the prevalence of peptic ulcer disease from 1998 to 2003 in Hong Kong, which is likely to be associated with the reduced prevalence of H. pylori infection.