Peptic ulcer disease in the elderly in Singapore

Of 460 patients with peptic ulcer disease seen over a 30‐month period, there were 174 elderly patients (defined as ? 60 years old), constituting 38%. In this group of elderly, gastric ulcers (GU) were observed more frequently than duodenal ulcers (DU) with a ratio of 1.6: 1 and the male to female ratio was 1.7: 1. In patients < 60 years old, there were more DU than GU with a ratio of 2.7: 1, and a higher male to female ratio of 3.7: 1. Seventy‐two per cent of the elderly had at least one other medical condition with 20% having three or more medical problems. Hypertension and ischaemic heart disease were the most frequently encountered illnesses. Half the elderly presented with upper abdominal pain and one‐third had an atypical presentation. Analgesic ingestion in the preceding 4 weeks was present in 29% of the elderly. In the elderly, bleeding was the most frequent complication occurring in 50%; perforation occurred in 2%. In those with bleeding ulcers, 44% had history of analgesic usage. The mortality of bleeding peptic ulcer in the elderly, was 11% and this was largely due to concurrent medical conditions. Only two deaths occurred due to bleeding ulcer.

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