Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 28, 2023; 29(44): 5882-5893
Published online Nov 28, 2023. doi: 10.3748/wjg.v29.i44.5882
Changing trends and characteristics of peptic ulcer disease: A multicenter study from 2010 to 2019 in Korea
Yoon Jin Choi, Tae Jun Kim, Chang Seok Bang, Yong Kang Lee, Moon Won Lee, Su Youn Nam, Woon Geon Shin, Seung In Seo
Yoon Jin Choi, Department of Internal Medicine, National Cancer Center, Goyang-si 13620, South Korea
Tae Jun Kim, Department of Internal Medicine, Samsung Medical Center, Seoul 06351, South Korea
Chang Seok Bang, Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Chuncheon 24253, South Korea
Yong Kang Lee, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang-si 10444, South Korea
Moon Won Lee, Department of Internal Medicine, Pusan National University School of Medicine, Busan 50463, South Korea
Su Youn Nam, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kyungpook National University Chilgok Hospital, Daegu 41404, South Korea
Woon Geon Shin, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul 05355, South Korea
Woon Geon Shin, Seung In Seo, Institute for Liver and Digestive Diseases, Hallym University, Chuncheon 24253, South Korea
Seung In Seo, Division of Gastroenterology, Department of Internal Medicine, Kangdong Sacred Heart Hospital, Seoul 05355, South Korea
Author contributions: Choi YJ and Seo SI contributed to the acquisition of data, analysis and interpretation of data, drafting of the manuscript; Kim TJ, Bang CS, Lee YK, and Lee MW participated in the technical or material support of this study; Nam SY and Shin WG contributed to the critical revision of the manuscript for important intellectual content; Seo SI involved in the study concept and design, and study supervision.
Institutional review board statement: This study was approved by the Institutional Review Board (IRB) of Kangdong Sacred Hospital (IRB number: 2021-11-001). The other six hospitals were affiliated with the Research Border Free Zone, which recognizes IRB approval of the research organizing center and waives individual IRB approval.
Informed consent statement: As the study used anonymous and pre-existing data, the requirement for the informed consent from patients was waived.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Dataset available from the corresponding author’s e-mail doctorssi@kdh.or.kr.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Seung In Seo, MD, PhD, Associate Professor, Division of Gastroenterology, Department of Internal Medicine, Kangdong Sacred Heart Hospital, 150, Seongan-ro, Gangdong-gu, Seoul 05355, South Korea. doctorssi@kdh.or.kr
Received: June 5, 2023
Peer-review started: June 5, 2023
First decision: August 26, 2023
Revised: September 30, 2023
Accepted: November 14, 2023
Article in press: November 14, 2023
Published online: November 28, 2023
Processing time: 175 Days and 8.3 Hours
ARTICLE HIGHLIGHTS
Research background

To date, few large-scale studies have comprehensively investigated the recent changing trends and clinical characteristics of peptic ulcer disease (PUD), including the multiple risk factors.

Research motivation

The incidence of idiopathic PUD, has increased in recent years, particularly in Asian countries. The clinical outcomes of idiopathic PUD revealed recurrent ulcer bleeding and higher mortality in previous studies; however, characteristics of idiopathic PUD remain poorly understood and warrant further investigation.

Research objectives

We aimed to evaluate the changing trends and characteristics of PUD according to age and etiology.

Research methods

We analyzed seven hospital databases that were converted to a common data model between 2010 and 2019. We classified PUD patients who underwent rapid urease testing or Helicobacter pylori (H. pylori) serology testing into the following three groups according to etiology: (1) H. pylori-related; (2) drug-related [H. pylori-negative and nonsteroidal anti-inflammatory drugs (NSAIDs)/aspirin-related]; and (3) Idiopathic (H. pylori/NSAID/aspirin-negative) PUD.

Research results

The overall number of PUD exhibited no decrease, whereas PUD in old age revealed an increasing trend. H. pylori-related PUD exhibited a decreasing trend after 2014, drug-related PUD demonstrated an increasing trend, and idiopathic PUD showed an increasing trend in the old-age group during 10 years. The idiopathic PUD group had a significantly higher number of patients with chronic liver disease.

Research conclusions

There was an increase in the incidence of PUD in the older age group during the last decade. There was a decrease in H. pylori-related PUD and an increase in drug-related and idiopathic PUD, especially in the elderly group.

Research perspectives

Further preventive strategies for drug-induced PUD should be developed. Further studies are required to clarify the relationship between idiopathic PUD and chronic liver disease.