Clinical features and prognosis in patients examined in medical and social expertise bureaus due to peptic ulcer disease

Abstract

Aim. To study the clinical features, disability degree and expert examination results in patients with peptic ulcer disease. Methods. Acts of expertise of patients with peptic ulcer disease (gastric ulcer - 44 patients, duodenal ulcer - 47 patients) performed in medical and social expertise bureau on internal diseases of Saint-Petersburg, Russia from 2009 to 2011 were examined. Results. The most frequent peptic ulcer disease risk factors found in both of the groups were: predisposing diet and dietary habits (65.9% of patients with gastric ulcer, 78.7% of patients with duodenal ulcer), smoking (53.2 and 63.6% respectively), stress (70.5 и 87.2% respectively). In 10 (22.7%) patients with gastric ulcer and in 38 (80.9%) patients with duodenal ulcer peptic ulcer disease was associated with presence of Helicobacter pylori. There was a combination of predisposing factors in a majority of patients. In most of the cases a moderate activity and a long term of the disease was registered. Complications were diagnosed in 30 (68.2%) patients with gastric ulcer and in 27 (57.4%) patients with duodenal ulcer, most frequently: gastrointestinal bleeding - 19 (43.2%) and 12 (25.5%) patients respectively, gastric outlet obstruction - 10 (22.7%) and 9 (19.2%) patients respectively. According to the medical and social expertise algorithm 19 (43.2%) patients with gastric ulcer and 17 (36.2%) patients with duodenal ulcer were primarily rated as disability degree III, 3 (6.8%) and 2 (4.3%) patients respectively - as disability degree II. Contraindicated jobs and labor conditions, low labor, functional and social status were the reasons of setting up the status of disabled. Conclusion. The preliminary data show that peptic ulcer disease is not only a medical, but a major social problem, requiring novel treatment and prevention methods, as well as personal rehabilitation programs development and improvement.