The Association ofHelicobacter pyloriInfection and Nonsteroidal Anti-Inflammatory Drugs in Peptic Ulcer Disease

Abstract

BACKGROUND AND AIM: Peptic ulcer disease (PUD) affects 10% of the world population.Helicobacter pyloriinfection and the use of a nonsteroidal anti-inflammatory drug (NSAID) are the principal factors associated with PUD. The aim of the present study was to evaluate a cohort of patients with PUD and determine the association betweenH pyloriinfection and NSAID use.PATIENTS AND METHODS: The medical charts of patients with endoscopic diagnosis of PUD were retrospectively reviewed from September 2002 to August 2003. Patients were divided into three groups according to ulcer etiology:H pyloriinfection (group 1); NSAID use (group 2); and combinedH pyloriinfection and NSAID use (group 3).RESULTS: One hundred two patients were evaluated: 36 men (35.3%) and 66 women (64.7%). Forty patients hadH pyloriinfection, 43 had used NSAIDs and 15 had combinedH pyloriinfection and NSAID use; four patients with ulcers secondary to malignancy were excluded. The frequency of women was significantly higher in group 2 (P=0.01). The mean age of patients in group 1 was significantly lower than in the other two groups (P=0.003). PUD developed earlier in group 3 than in group 2 (5.0±4.7 months versus 1.4±2.1 months, respectively, P=0.018). Thirty-two patients (32.7%) had bleeding peptic ulcer. Group 2 had a higher risk of bleeding peptic ulcer than the other two groups (P=0.001).CONCLUSIONS: The development of PUD was observed earlier in the combinedH pyloriand NSAID group than in patients with only NSAID use. This suggests a synergic effect between the two risks factors in the development of PUD.