Trends in peptic ulcer morbidity and mortality in Iceland

Clinical trends in ulcer diagnosis in a population with high prevalence of Helicobacter pylori infection

“…Furthermore, peptic ulceration and complication has increasingly become a disease of the elderly as the decline was more rapid in younger people. This study agrees with previous reports that suggest that the prevalence of peptic ulcer disease has decreased significantly over the last decade in western countries such as Iceland, 12 Australia 13 or England 14 and Finland. 15 Accordingly, ulcer complications such as bleeding have also declined significantly.…”

“…Some studies 17, 18 on ulcer mortality and ulcer perforation show a cohort pattern, which means that these ulcer manifestations are particularly common in certain high-risk generations. Although a recent trial 12 has demonstrated that ulcer complications, ulcer deaths and uncomplicated ulcers were particularly common in specific generations carrying a high-risk of peptic ulcer throughout their lives, these were the generations with the highest prevalence of H. pylori antibodies, the subjects born after the turn of the century (the very old people) and with an increased consumption of NSAIDs among the elderly people. Another aspect of interest of our study is the overwhelming increase in PPI prescription over the last 5 years of observation, which also correlates with the declining trends in the incidence of peptic ulcer.…”

Changes in the Localization of Perforated Peptic Ulcer and its Relation to Gender and Age of the Patients throughout the Last 45 Years

“…Those studies confirmed the highest risk of perforation in the group of people born during the first and the second decades of the twentieth century. In Iceland those generations had the highest prevalence of H. pylori antibodies [37]. …”

Fiberoptic Endoscopy: The Singular Transformative Event of Our Time

“…Endoscopic ablative technologies including laser or radiofrequency ablation can remove high-grade dysplasia or early cancer that was at one time only amenable to surgical treatment [18,19]. Endosocpically deployed stents for obstructing upper and lower GI cancers achieve good palliation while avoiding the potential mortality of surgical bypass.…”

“…Basil Hirschowitz) endoscopic ultrasonography (EUS), and imaging of the small bowel with both capsule and subsequently single and double balloon endoscopy. Although endoscopic retrograde cholangiopancreatography (ERCP) was first performed in the early 1970s [18], the technique acquired therapeutic potential over the ensuing three decades. For example, endoscopic stone extraction obviated the need for surgical common bile duct exploration with its associated morbidity.…”