Peptic Ulcer Diseases in Korea

Abstract

Peptic ulcer disease (PUD) is one of the most commonly encountered gastroenterologic diseases in Korea. The trend in diagnosis and treatment of PUD in Korea has changed in the past decade with the introduction of endoscopy and potent acid suppressants such as proton pump inhibitors. The discovery of Helicobacter pylori has opened a new era for the understanding of pathogenesis and management of PUD. In this review, we tried to look back at the history of PUD in Korea and the changes of epidemiologic features and treatment of PUD in Korea. INTRODUCTIONPeptic ulcer disease (PUD) is one of the most commonly encountered gastroenterologic diseases. It is defined as a break in the lining of the mucosa, with appreciable depth at endoscopy or histologic evidence of involvement of the submucosa. EPIDEMIOLOGIC DATABefore 1980's, experts in gastroenterology described PUD several times and analyzed them into complicated and un-complicated ones in patients who underwent surgical treatment.However, epidemiological studies for PUD was first described in 1984 and 8 epidemiological studies were published so far. 2-9Two studies included data of 1970's, 6 studies included data of 1980's, 3 studies included data of 1990's, and one study included data of 2000's.We have been performed a series of surveys for PUD in the 8 institutes of the Catholic University of Korea over two decades. These serial surveys included over 1,000 patients each time, with questionnaires on general life style, medical histories, and endoscopic findings of PUD patients. The first survey was performed between 1988 and 1989, second one between 1996 and 1997, and now third one is under way which contains over 250 enrolled patients so far. Considering the previous epidemiological data, while the ratio of GU, DU, and combined GU and DU has not been changed much from 1970's to 2000's, it is likely that the ratio of GU is increasing compared to DU in our serial data. Incidence and prevalenceIn-Sik Chung, Byung-Wook Kim：Peptic Ulcer Diseases in Korea 21 Age and sexThe mean ages of patients with GU and DU tend to increase both in the previous epidemiological data and in our serial data.Peak ages of PUD also have been increased for the past two decades, i.e., peak age of GU changed from 40's to 50's, peak age of DU changed from 30's to 50's, and peak age of combined GU and DU changed from 40's to 50's.Male over female ratio is declining in GU but not in DU in the previous epidemiologic studies and in our serial data. It is plausible that the increasing consumption of aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) both in male and female elderly patients is associated with this tendency. ComplicationsThe incidence and prevalence of complicated PUD such as bleeding and perforation have been reported in various ranges in previous epidemiologic studies. Bleeding was reported in 3.9∼10.4% of GU, 6.2∼12.4% of DU, and 0∼14.4% in combined GU and DU groups. Perforation was reported in 0.1∼0.7% of GU, 0.1∼2.7% of DU, and 0% in combined GU and DU groups. Obstructio...

Women Who Sleep More Have Reduced Risk of Peptic Ulcer Disease; Korean National Health and Nutrition Examination Survey (2008–2009)

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Racial Differences in Bleeding Risk: An Ecological Epidemiological Study Comparing Korea and United Kingdom Subjects

“…25 The widespread implementation of eradication therapy for H. pylori infection, particularly the reduced infection rates in younger generations, has led to a decrease in the incidence of peptic ulcer disease over time. 26 Additionally, the exclusion of individuals taking medications that could promote bleeding from the gastrointestinal system, and the fact that major lower gastrointestinal bleed causes, such as diverticulosis, are more common in Western populations, may partially explain the lower incidence in East Asians. 5 Studies reporting racial differences in bleeding rates at the anatomical site other than ICH and bleeding from the gastrointestinal system are limited.…”

Pharmacological Therapy of Peptic Ulcer

“…국내 자료에 의하면, 소화성 궤양은 1995년에 18.0%, 2000 년에 19.1%, 2005년에 20.2%로 증가 추세이다. 1 과거에 비해 Helicobacter pylori 관련 위궤양은 감소하는 추세이지만, 2 아 스피린과 non-steroidal anti-inflammatory drugs를 많이 복 용하기 때문에 소화성 궤양은 임상에서 여전히 쉽게 만나는 문 제이다. 3…”