The relative contribution of NSAIDs and Helicobacter pylori to the aetiology of endoscopically-diagnosed peptic ulcer disease: observations from a tertiary referral hospital in the UK between 2005 and 2010
Alimentary Pharmacology and Therapeutics,  Clinical Article

Musumba C et al. – The non–steroidal anti–inflammatory drug (NSAID), particularly low–dose aspirin (LDA), were most commonly associated with peptic ulcer disease (PUD) in this cohort. The findings are compatible with the decline in the prevalence of H. pylori–positive PUD and increase in non–NSAID, non–H. pylori PUD previously reported.

Methods
  • Patients diagnosed with PUD following endoscopy were categorised as non-steroidal anti-inflammatory drug (NSAID)-users or non-users, and their H. pylori status determined.
  • Comparisons between NSAID-users and non-users, and between non-aspirin NSAID-users and LDA-users were summarised using counts and corresponding percentages (for categorical variables) and means and standard deviations (for continuous variables).

Results
  • Overall, 386 patients were enrolled; 57% used NSAIDs (51% LDA only) and 43% were non-users.
  • 57% of the whole cohort was H. pylori-positive (including 66% with duodenal ulcers and 47% with gastric ulcers).
  • Compared with non-users, NSAID-users were older (mean age 68 vs. 61 years) and fewer were H. pylori-positive (52% vs. 63%).
  • LDA-users were older (mean age 71 vs. 62 years) and more likely to be H. pylori-positive (61% vs. 41%) than those using non-aspirin NSAIDs.
  • Twelve per cent of the patients were neither using NSAIDs nor were H. pylori-positive.

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