Epidemiology of peptic ulcer disease

  • A. Sonnenberg
  • A. Sengupta
  • P. Bauerfeind


The epidemiology of both gastric and duodenal ulcer is characterized by marked geographic and temporal variations. The incidence, prevalence and mortality of gastric and duodenal ulcer vary four- to ten-fold among different European countries1. During the past 20–30 years the number of patients who died from peptic ulcer disease2-5, who have been operated upon5, 6, who saw physicians7, 8 or were hospitalized for peptic ulcer disease9-11 have decreased by more than 100 per cent. These changes occurred within so short a period that a genetic basis can be ruled out. Thus, it seems likely that they stem from changes in environmental risk factors. The geographic variability of ulcer prevalence among populations of similar ethnicity and comparable medical standards also hints at environmental influences. Judging from their effect, it appears that environmental factors are of sufficient magnitude to constitute a fertile ground for inquiry because such information would engender the development of potent measures for prevention and treatment of gastric and duodenal ulcer disease. In addition, knowledge of environmental risk factors could provide new insights and methods to study the pathophysiology of peptic ulcer.


Peptic Ulcer Duodenal Ulcer Peptic Ulcer Disease Disability Pension Salt Consumption 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Sonnenberg, A. (1985). Geographic and temporal variations in the occurrence of peptic ulcer disease. Scand. J. Gastroenterol., 20, (Suppl. 110), 11–24Google Scholar
  2. 2.
    Elashoff, J.D. and Grossman, M.I. (1975). Trends in hospital admissions and death rates for peptic ulcer in the United States from 1970 to 1978. Gastroenterology, 68, 280–5Google Scholar
  3. 3.
    Hoogendoorn, D. (1984). Interesting changes of the epidemiological pattern of peptic ulcer. Ned. Tijschr. Geneeskd., 128, 484–91Google Scholar
  4. 4.
    Kurata, J.H. and Haile, B.M. (1982). Racial differences in peptic ulcer disease: fact or myth? Gastroenterology, 83, 162–72Google Scholar
  5. 5.
    Fineberg, H.V. and Pearlman, L.A. (1981). Surgical treatment of peptic ulcer in the United States. Trends before and after the introduction of cimetidine. Lancet, i, 1305–7Google Scholar
  6. 6.
    Smith, M.P. (1977). Decline in duodenal ulcer surgery. J. Am. Med. Assoc., 237, 987–8Google Scholar
  7. 7.
    Vogt, T.M. and Johnson, R.E. (1980). Recent changes in the incidence of duodenal and gastric ulcer. Am. J. Epidemiol, 111, 713–20PubMedGoogle Scholar
  8. 8.
    Sonnenberg, A. (1987). Changes in physician visits for gastric and duodenal ulcer in the United States during 1958–1984 as shown by the National Disease and Therapeutic Index (NDTI). Dig. Dis. Sci., 32, 1–7PubMedGoogle Scholar
  9. 9.
    Coggon, D., Lambert, P, and Langman, M.J.S. (1981). 20 years of hospital admissions for peptic ulcer in England and Wales. Lancet, i, 1302–4Google Scholar
  10. 10.
    Wylie, C.M. (1981). The complex wane of peptic ulcer. I. Recent national trends in deaths and hospital care in the United States. J. Clin. Gastroenterol, 3, 327–32PubMedGoogle Scholar
  11. 11.
    Kurata, J.H., Elashoff, J.D., Haile, B.M. and Honda, G.D. (1983). A reappraisal of time trends in ulcer disease: Factors related to changes in ulcer hospitalization and mortality rates. Am. J. Publ. Health, 79, 1066–72Google Scholar
  12. 12.
    Ishimori, A. and Kawamura, T. (1979). Epidemiology of peptic ulcer disease in Japan. In Fisher, RS (ed.) Peptic Ulcer Disease: An Update, pp. 153–64. (New York: Biomedical Information Corporation Publications)Google Scholar
  13. 13.
    Kurata, J.H., Honda, G.D. and Frankl, H. (1985). The incidence of duodenal and gastric ulcers in a large health maintenance organization. Am. J. Publ Health, 75, 625–9Google Scholar
  14. 14.
    Litton, A. and Murdoch, W.R. (1963). Peptic ulcer in south-west Scotland. Gut, 4, 360–6PubMedGoogle Scholar
  15. 15.
    Dunlop, J.M. (1968). Peptic ulcer in central Scotland. Scott. Med. J., 13, 192–201PubMedGoogle Scholar
  16. 16.
    Sonnenberg, A., Arnold, R. and Fritsch, A. (1982). Epidemiologie und Genetik der Ulcuskrankheit. In Blum, A.L. and Siewert, J.R. (eds) Ulcus-Therapie, pp. 3–22. (Berlin, Heidelberg, New York: Springer)Google Scholar
  17. 17.
    Tovey, F. (1975). Duodenal ulcer in Black populations in Africa south of the Sahara. Gut, 16, 564–76PubMedGoogle Scholar
  18. 18.
    Tovey, F. (1979). Peptic ulcer in India and Bangladesh. Gut, 20, 239–47Google Scholar
  19. 19.
    Sonnenberg, A. (1987). Causative factors in the etiology of peptic ulcer disease become effective before the age of 15 years. J. Chronic Dis., 40, 193–202PubMedGoogle Scholar
  20. 20.
    Langman, M.J.S. (1979). The Epidemiology of Chronic Digestive Disease. (London: Edward Arnold Publishers)Google Scholar
  21. 21.
    Kahn, H.A. (1983). An Introduction to Epidemiologic Methods, pp. 63–78. (New York: Oxford University Press)Google Scholar
  22. 22.
    Jennings, D. (1940). Perforated peptic ulcer. Changes in age-incidence and sex-distribution during the last 150 years (parts 1 and 2). Lancet, i, 395–8 and 444–7Google Scholar
  23. 23.
    Susser, M. and Stein, Z. (1962). Civilization and peptic ulcer. Lancet, i, 115–19Google Scholar
  24. 24.
    Susser, M. (1982). Period effects, generation effects and age effects in peptic ulcer mortality.J. Chronic Dis., 35, 29–40PubMedGoogle Scholar
  25. 25.
    Sonnenberg, A. (1984). The occurrence of a cohort phenomenon in peptic ulcer mortality from Switzerland. Gastroenterology, 86, 398–401PubMedGoogle Scholar
  26. 26.
    Sonnenberg, AvMüller, H. and Pace, F. (1985). Birth-cohort analysis of peptic ulcer mortality in Europe. J. Chronic Dis., 38, 309–17PubMedGoogle Scholar
  27. 27.
    Sonnenberg, A. and Müller, H. (1984). Cohort and period effects in peptic ulcer mortality from Japan. J. Chronic Dis., 37, 699–704PubMedGoogle Scholar
  28. 28.
    Monson, R.R. and MacMahon, B. (1969). Peptic ulcer in Massachusetts physicians. N. Engl. J. Med., 281, 11–15PubMedGoogle Scholar
  29. 29.
    Sonnenberg, A. and Fritsch, A. (1983). Changing mortality of peptic ulcer disease in Germany. Gastroenterology, 84, 1553–7PubMedGoogle Scholar
  30. 30.
    Bonnevie, O. (1975). The incidence of gastric ulcer in Copenhagen County. Scand. J. Gastroenterol, 10, 231–9PubMedGoogle Scholar
  31. 31.
    Bonnevie, O. (1975). The incidence of gastric ulcer in Copenhagen County. Scand. J. Gastroenterol, 10, 385–93PubMedGoogle Scholar
  32. 32.
    Sonnenberg, A. (1985). Disability pensions due to peptic ulcer in Germany between 1953 and 1983. Am. J. Epidemiol, 122, 106–11PubMedGoogle Scholar
  33. 33.
    Richardson, T.C. (1985). Pathogenetic factors in peptic ulcer disease. Am. J. Med., 75, Suppl. 2C, 1–7Google Scholar
  34. 34.
    MacMahon, B. and Pugh, T.F. (1970). Epidemiology — Principles and Methods, pp. 184–98. (Boston: Little, Brown & Co.)Google Scholar
  35. 35.
    Passmore, R. and Draper, M.H. (1965). Energy metabolism. In Albanese, AA (ed.) Newer Methods of Nutritional Biochemistry, pp. 41–83. (New York: Academic Press)Google Scholar
  36. 36.
    Kuczynski, J. (1971). Die Geschichte der Lage der Arbeiter unter dem Kapitalismus. Teil I. Die Geschichte der Lage der Arbeiter in Deutschland von 1789 bis zur Gegenwart, Vols.1–4. (Berlin, East Germany: Akademie Verlag)Google Scholar
  37. 37.
    Thomson, D. (1983). England in the Nineteenth Century 1815–1914. (Harmondsworth, England: Penguin Books Ltd.)Google Scholar
  38. 38.
    Sonnenberg, A., Sonnenberg, G.S. and Wirths, W. (1987). Historie changes of occupational workload and mortality from peptic ulcer in Germany. J. Occup. Med., 28, 756–61Google Scholar
  39. 39.
    Wirths, W. (1965). Veränderungen der Arbeitsbedingungen aus arbeits- und ernährungsphysiologischer Sicht. Ernährungs-Umschau, 12, 29–35Google Scholar
  40. 40.
    Wirths, W., Keller, W. and Kraut, H. (1966). Work and food. Nutr. Dieta., 8, 168–78Google Scholar
  41. 41.
    Kraut, H., Kofranyi, E., Mohr, E. and Wirths, W. (1981). Der Nahrungsbedarf des Menschen. Vol. 1. pp. 68–117. (Darmstadt, West Germany: Dr Dietrich Steinkopf Verlag)Google Scholar
  42. 42.
    Nasiry, R. and Piper, D.W. (1983). Social aspects of chronic duodenal ulcer. A case control study. Digestion, 27, 196–202PubMedGoogle Scholar
  43. 43.
    Würsch, T.G., Hess, H., Walser, R., et al (1978). Die Epidemiologie des Ulcus duodeni. Untersuchungen an 1105 Patienten in Zürich. Dtsch. Med. Wschr., 103, 613–19PubMedGoogle Scholar
  44. 44.
    Horn, J. and Herfarth, C. (1978). Das Gastarbeiterulkus. Med. Klin., 173, 1417–21Google Scholar
  45. 45.
    Quaquish, I., Burkhardt, H.U. and Heilmann, K.L. (1979). Magenerkrankungen bei ausländischen Arbeitnehmern in der Bundesrepublick Deutschland. Münch. Med. Wschr., 121, 1563–5Google Scholar
  46. 46.
    Schmid, E., Vollmer, K., Allmendinger, G., Blaich, E. and Hofgärtner, F. (1984). Epidemiologische Resultate der endoskopischen Untersuchungen beim Ulcus ventriculi und duodeni.Med. Welt, 35, 281–5Google Scholar
  47. 47.
    Lewis, J.H. (1942). The Biology of the Negro, 307. (Chicago: University of Chicago Press)Google Scholar
  48. 48.
    Jennison, J. (1938). Observations made on a group of employees with duodenal ulcer. Am. J. Med. Sci., 196, 654–62Google Scholar
  49. 49.
    Duesberg, R. (1938). Ulcus ad pylorum und Arbeitspause — Statistische Erhebungen. Med. Welt, 12, 595–7Google Scholar
  50. 50.
    Schellong, I. (1937). Die Häufigkeit der Magengeschwürserkrankung bei den (ostpr.) Bauarbeitern und ihre soziale Bedeutung. Z. Ärztl. Fortb., 34, 245–51Google Scholar
  51. 51.
    Sallström, T. (1945). Regarding occupational factors in gastric ulcer and duodenal ulcer. Acta Med. Scand., 120, 340–8Google Scholar
  52. 52.
    Rietschel, E. (1978). Magen-Zwölffingerdarmgeschwüre und Arbeits welt (Felduntersuchung in einem Großbetrieb). Arbeitsmed. Präventivmed. Sozialmed., 13, 197–201Google Scholar
  53. 53.
    Ihre, J.E. and Müller, R. (1943). Gastric and duodenal ulcer. Study of 1193 cases collected during 1930 to 1940 in Stockholm. Acta Med. Scand., 116, 33–57Google Scholar
  54. 54.
    Doll, R., Avery Jones, F. and Buckatzsch, M.M. (1951). Occupational Factors in the Etiology of Gastric and Duodenal Ulcers with an Estimate of their Incidence in the General Population, pp. 1–96. (London: HMSO)Google Scholar
  55. 55.
    Pulvertaft, C.N. (1968). Comments on the incidence and natural history of gastric and duodenal ulcers. Postgrad. Med. J., 44, 597–602PubMedGoogle Scholar
  56. 56.
    Emery, Jr, E.S. and Monroe, R.T. (1935). Peptic ulcer. Nature and treatment based on a study of one thousand, four hundred and thirty-five cases. Arch. Int. Med., 55, 271–92Google Scholar
  57. 57.
    Sonnenberg, A. and Sonnenberg, G.S. (1986). Occupational factors in disability pensions for gastric and duodenal ulcer.J. Occup. Med., 28, 87–90PubMedGoogle Scholar
  58. 58.
    Sonnenberg, A. and Sonnenberg, G.S. (1986). Occupational mortality from gastric and duodenal ulcer. Br. J. Ind. Med., 43, 50–5PubMedGoogle Scholar
  59. 59.
    Sonnenberg, A. and Haas, J. (1986). The joint effect of occupation and nationality on the prevalence of peptic ulcer in German workers. Br. J. Ind. Med., 43, 490–3PubMedGoogle Scholar
  60. 60.
    Markiewicz, K., Cholewa, M. and Lukin, M. (1979). Gastric basal secretion during exercise and restitution in patients with chronic duodenal ulcer. Hepato-Gastroenterol, 26, 160–5Google Scholar
  61. 61.
    Markiewicz, K., Cholewa, M., Gorski, L. and Chmura, J. (1977). Effect of physical exercise on gastric basal secretion in healthy men. Hepato-Gastroenterol, 24, 377–80Google Scholar
  62. 62.
    Oktedalen, O., Guldvog, I., Opstad, P.K., Berstad, A., Gedde-Dahl, E. and Jorde, R. (1984). The effect of physical stress on gastric secretion and pancreatic polypeptide levels in man. Scand. J. Gastroenterol, 19, 770–8PubMedGoogle Scholar
  63. 63.
    Seidel, H. and Woller, R. (1980). Das Geschenk der Erde. Vom Salz zur modernen Chemie, pp. 71–6. (Düsseldorf, West Germany: Econ Verlag)Google Scholar
  64. 64.
    Denton, D. (1982). The Hunger for Salt, pp. 76–90. (New York: Springer-Verlag)Google Scholar
  65. 65.
    Stemmermann, G., Haenszel, W. and Locke, F. (1977). Epidemiologie pathology of gastric ulcer and gastric carcinoma among Japanese in Hawaii. J. Natl Cancer Inst., 58, 13–19PubMedGoogle Scholar
  66. 66.
    Sato, T., Fukuyama, T., Suzuki, T., Takayanagi, J., Murakami, T., Shiotsuki, N., Tanaka, R. and Tsuji, R. (1959). Studies of the causation of gastric cancer. 2. The relation between gastric cancer mortality rate and salted food intake in several places in Japan. Bull Inst. Publ. Health, 8, 187–98Google Scholar
  67. 67.
    Joossens, J.V. (1980). Stroke, stomach cancer and salt. In Kesteloot, H. and Joossens, J.V.(eds) Epidemiology of Arterial Blood Pressure, pp. 489–508. (The Hague: Martinus Nijhoff Publishers)Google Scholar
  68. 68.
    Whelton, P.K. and Goldblatt, P. (1982). An investigation of the relationship between stomach cancer and cerebrovascular disease. Am. J. Epidemiol., 115, 418–27PubMedGoogle Scholar
  69. 69.
    Joossens, J.V. and Geboers, J. (1981). Nutrition and gastric cancer. Nutr. Cancer; 2, 250–61PubMedGoogle Scholar
  70. 70.
    Joossens, J.V. (1980). Dietary salt restriction — The case in favour. In Robertson, J.I.S., Pickering, G.W. and Caldwell, A.D.S. (eds) The Therapeutics of Hypertension, Royal Society of Medicine Series No. 26. pp. 243–50. (London: Academic Press)Google Scholar
  71. 71.
    Tuomilehto, J., Geboers, J., Joossens, J.V., Salonen, J.T. and Tanskanen, T. (1984). Trends in stomach cancer and stroke in Finland. Comparison to northwest Europe and USA. Stroke, 15, 823–8PubMedGoogle Scholar
  72. 72.
    Segi, M., Fujisaku, S. and Kurihara, M. (1959). Mortality for gastric and duodenal ulcer in countries and its geographical correlation to mortality for gastric and intestinal cancer. Schweiz. Z. Path. Bakt., 22, 777–84Google Scholar
  73. 73.
    Sonnenberg, A. (1986). Dietary salt and gastric ulcer. Gut, 27, 1138–42PubMedGoogle Scholar
  74. 74.
    Sonnenberg, A. (1987). Gastric cancer, gastric ulcer, and hypertensive diseases — A common epidemiologic risk factor? (Abstr.) Gastroenterology, 92, 1649Google Scholar
  75. 75.
    Kang, J.Y., Canalese, J., Ellard, K., Ng, J. and Piper, D.W. (1980). Urinary salt excretion in peptic ulcer patients. Aust. N.Z. J. Med., 10, 682PubMedGoogle Scholar
  76. 76.
    Svanes, K., Ito, S., Takeushi, K. and Silen, W. (1982). Restitution of the surface epithelium of the in vitro frog gastric mucosa after damage with hyperosmolar sodium chloride. Gastroenterology, 82, 1409–26PubMedGoogle Scholar
  77. 77.
    Haenszel, W., Kurihara, M., Segi, M. and Lee, R.K.C (1972). Stomach cancer among Japanese in Hawaii. J. Natl. Cancer Inst., 49, 969–88PubMedGoogle Scholar
  78. 78.
    Du Plessis, D.J. (1965). Pathogenesis of gastric ulceration. Lancet, i, 974–8Google Scholar
  79. 79.
    Oi, M., Ito, Y., Kumagai, F., Yoshida, K., Tanaka, Y., Yoshikawa, K., Miho, O. and Kijima, M. (1969). A possible dual control mechanism in the origin of peptic ulcer. A study on ulcer location as affected by mucosa and musculature. Gastroenterology, 57, 280–3PubMedGoogle Scholar
  80. 80.
    Gear, M.W.L., Truelove, S.C. and Whitehead, R. (1971). Gastric ulcer and gastritis. Gut, 12, 639–45PubMedGoogle Scholar
  81. 81.
    Stadelmann, O., Elster, K., Stolte, M., Miederer, S.E., Deyhle, P., Demling, L. and Siegenthaler, W. (1971). The peptic gastric ulcer — histotopography and functional investigations. Scand. J. Gastroenterol, 4, 613–21Google Scholar
  82. 82.
    Tatsuta, M. and Okuda, S. (1975). Location, healing, and recurrence of gastric ulcers in relation to fundal gastritis. Gastroenterology, 69, 897–902PubMedGoogle Scholar
  83. 83.
    Tatsuta, M., Iishi, H. and Okuda, S. (1986). Location of peptic ulcers in relation to antral and fundic gastritis by chromoendoscopic follow-up examinations. Dig. Dis. Sci., 31, 7–11PubMedGoogle Scholar
  84. 84.
    Marshall, B.J. and Warren, J.R. (1984). Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet, i, 1311–14Google Scholar
  85. 85.
    Editorial (1984). Campylobacters in Ottawa. Lancet, ii, 135Google Scholar
  86. 86.
    Rudell, W.S.J., Bone, E.S., Hill, M.J. and Walters, C.L. (1978). Pathogenesis of gastric cancer in pernicious anemia. Lancet, i, 521–3Google Scholar
  87. 87.
    Friedman, G.D., Siegelaub, A.B. and Seltzer, C.C. (1974). Cigarettes, alcohol, coffee and peptic ulcer. N. Engl J. Med., 290, 469–73PubMedGoogle Scholar
  88. 88.
    Piper, D.W., Nasiry, R., Mcintosh, J., Shy, C.M., Pierce, J. and Byth, K. (1984). Smoking, alcohol, analgesics, and chronic duodenal ulcer. Scand. J. Gastroenterol, 19, 1015–21PubMedGoogle Scholar
  89. 89.
    Korman, M.G., Shaw, R.G., Hansky, J., Schmidt, G.T. and Stern, A.I. (1981). Influence of smoking on healing rate of duodenal ulcer in response to cimetidine or high-dose antacid. Gastroenterology, 8O, 1451–3PubMedGoogle Scholar
  90. 90.
    Sonnenberg, A., Müller-Lissner, S.A., Vogel, E., Schmid, E., Gonvers, J.J., Peter, P., Strohmeyer, G. and Blum, A.L. (1981). Predictors of duodenal ulcer healing and relapse. Gastroenterology, 81, 1061–7PubMedGoogle Scholar
  91. 91.
    Sontag, S., Graham, D.Y., Belsito, A., el al (1984). Cimetidine, cigarette smoking, and recurrence of duodenal ulcer. N. Engl. J. Med., 311, 689–93PubMedGoogle Scholar
  92. 92.
    Heuman, R., Larsson, J. and Norrby, S. (1983). Perforated duodenal ulcer — long-term results of following simple closure. Acta Chir. Scand., 149, 77–81PubMedGoogle Scholar
  93. 93.
    McLean Ross, A.G., Smith, M.A., Anderson, J.R. and Small, W.P. (1982). Late mortality after surgery for peptic ulcer. N. Engl J. Med., 307, 519–22Google Scholar
  94. 94.
    Doll, R., Jones, F.A. and Pygott, F. (1958). Effect of smoking on the production and maintenance of gastric and duodenal ulcers. Lancet, i, 657–62Google Scholar
  95. 95.
    Piper, D.W., Hunt, J. and Heap, T.R. (1980). The healing rate of chronic gastric ulcer in patients admitted to hospital. Scand. J. Gastroenterol., 15, 113–17PubMedGoogle Scholar
  96. 96.
    Okada, M., Yao, T., Fuchigami, T., Imamura, K. and Omae, T. (1984). Factors influencing the healing rate of gastric ulcer in hospitalised subjects. Gut, 25, 881–5PubMedGoogle Scholar
  97. 97.
    Sonnenberg, A. (1986). Smoking and mortality from peptic ulcer in the United Kingdom. Gut, 27, 1369–72PubMedGoogle Scholar
  98. 98.
    Wald, N., Doll, R. and Copeland, G. (1981). Trends in tar, nicotine, and carbon monoxide yields of UK cigarettes manufactured since 1934. Br. Med. J., 282, 763–5Google Scholar
  99. 99.
    Gillies, M.A. and Skyring, A. (1969). Gastric and duodenal ulcer — The association between aspirin ingestion, smoking and family history of ulcer. Med. J. Aust., 2, 280–5PubMedGoogle Scholar
  100. 100.
    Levy, M. (1974). Aspirin use in patients with major upper gastrointestinal bleeding and peptic-ulcer disease. N. Engl. J. Med., 290, 1158–62PubMedGoogle Scholar
  101. 101.
    McIntosh, J.H., Byth, K. and Piper, D.W. (1985). Environmental factors in aetiology of chronic gastric ulcer: a case control study of exposure variables before the first symptoms. Gut, 26, 789–98PubMedGoogle Scholar
  102. 102.
    Piper, D.W., Mcintosh, J.H., Ariotti, D.E., Fenton, B.H. and MacLennan, R. (1981). Analgesic ingestion and chronic peptic ulcer. Gastroenterology, 80, 427–32PubMedGoogle Scholar
  103. 103.
    Piper, D.W., Mcintosh, J.H., Greig, M. and Shy, C.M. (1982). Environmental factors and chronic gastric ulcer. A case control study of the association of smoking, alcohol, and heavy analgesic ingestion with the exacerbation of chronic gastric ulcer. Scand. J. Gastroenterol, 17, 721–9PubMedGoogle Scholar
  104. 104.
    Silvoso, G.R., Ivey, K.J., Butt, J.H., Lockard, O.O., Holt, S.D., Sisk, C, Baskin, W.N., Mackercher, P.A. and Hewett, J. (1979). Incidence of gastric lesions in patients with rheumatic disease on chronic aspirin therapy. Ann. Int. Med., 91, 517–20PubMedGoogle Scholar
  105. 105.
    Collier, D.S.J. and Pain, J.A. (1985). Non-steroidal anti-inflammatory drugs and peptic ulcer perforation. Gut, 26, 359–63PubMedGoogle Scholar
  106. 106.
    Sommerville, K., Faulkner, G. and Langman, M.J.S. (1986). Non-steroidal anti-inflammatory drugs and bleeding peptic ulcer. Lancet, i, 462–4Google Scholar
  107. 107.
    Steinheber, F.C. (1985). Aging and the stomach. Clin. Gastroenterol, 14, 657–88PubMedGoogle Scholar
  108. 108.
    Robert, A. (1979). Cytoprotection by prostaglandins. Gastroenterology, 77, 761–7PubMedGoogle Scholar
  109. 109.
    Swisher, W.P., Baker, L.A. and Bennett, H.D. (1955). Peptic ulcer in Laennec’s cirrhosis. Am. J. Dig. Dis., 22, 291–4PubMedGoogle Scholar
  110. 110.
    Tabaqchali, S. and Dawson, A.M. (1964). Peptic ulcer and gastric secretion in patients with liver disease. Gut, 5, 417–21PubMedGoogle Scholar
  111. 111.
    Kirk, A.P., Dooley, J.S. and Hunt, R.H. (1980). Peptic ulceration in patients with chronic liver disease. Dig. Dis. Sci., 25, 756–60PubMedGoogle Scholar
  112. 112.
    Westlund, K. (1963). Mortality of peptic ulcer patients. Acta Med. Scand., 174, (Suppl. 402), 1–110PubMedGoogle Scholar
  113. 113.
    Bonnevie, O. (1977). Causes of death in duodenal and gastric ulcer. Gastroenterology, 73, 1000–4PubMedGoogle Scholar
  114. 114.
    Hagnell, O. and Wretmark, G. (1957). Peptic ulcer and alcoholism. A statistical study in frequency, behaviour, personality traits, and family occurrence. J. Psychosomatic Res., 2, 35–44Google Scholar
  115. 115.
    Piper, D.W., Mcintosh, J. and Hudson, H.M. (1985). Factors relevant to the prognosis of chronic duodenal ulcer. Digestion, 31, 9–16PubMedGoogle Scholar
  116. 116.
    Malhotra, S.L. (1978). A comparison of unrefined wheat and rice diets in the management of duodenal ulcer. Postgrad. Med. J., 54, 6–9PubMedGoogle Scholar
  117. 117.
    Rydning, A., Berstad, A., Aadland, E. and Odegaard, B. (1982). Prophylactic effect of dietary fibre in duodenal ulcer disease. Lancet, ii, 736–9Google Scholar
  118. 118.
    Rydning, A. and Berstad, A. (1985). Fibre diet and antacids in the short-term treatment of duodenal ulcer. Scand. J. Gastroenterol, 20, 1078–82PubMedGoogle Scholar
  119. 119.
    Kurata, J.H., Haile, B.M. and Elashoff, J.D. (1985). Sex differences in peptic ulcer disease. Gastroenterology, 88, 96–100PubMedGoogle Scholar
  120. 120.
    Doll, R. and Pygott, F. (1952). Factors influencing the rate of healing of gastric ulcers. Admission to hospital, phenobarbitone, and ascorbic acid. Lancet, i, 171–5Google Scholar
  121. 121.
    Binder, HJ., Cocco, A., Crossley, R.J., et al. (1978). Cimetidine in the treatment of duodenal ulcer. A multicentre double blind study. Gastroenterology, 74, 380–8PubMedGoogle Scholar
  122. 122.
    Malchow, H., Sewing, K.F., Albinus, M., Horn, H., Schomerus, H. and Dölle, W. (1979). Cimetidin in der stationären Behandlung des peptischen Ulkus. Dtsch. Med. Wschr., 103, 149–52Google Scholar
  123. 123.
    Hall, W.H., Read, R.C., Wesard, L., Lee, L.E. and Robinette, C.D. (1972). The calendar and duodenal ulcer. Gastroenterology, 62, 1120–4PubMedGoogle Scholar
  124. 124.
    Gibinski, K., Rybicka, J., Nowak, A. and Czarnecka, K. (1982). Seasonal occurrence of abdominal pain and endoscopic findings in patients with gastric and duodenal ulcer disease. Scand. J. Gastroenterol, 17, 481–5PubMedGoogle Scholar
  125. 125.
    Palmas, F., Andriulli, A., Canepa, G., Gardino, L., Boero, M., Rocca, G. and Verme, G. (1984). Monthly fluctuations of active duodenal ulcers. Dig. Dis. Sci., 29, 983–7PubMedGoogle Scholar
  126. 126.
    Glynn, M.J. and Kane, S.P. (1985). Benign gastric ulceration in a health district: incidence and presentation. Postgrad. Med. J., 61, 695–700PubMedGoogle Scholar
  127. 127.
    Kühlmayer, R. and Rokitansky, P. (1954). Das Magenstumpfkarzinom als Spätproblem der Ulkustherapie. Langenbeck’s Arch. Chir., 278, 361–75Google Scholar
  128. 128.
    Griesser, G. and Schmidt, H. (1964). Statistische Erhebungen über die Häufigkeit des Karzinoms nach Magenoperation wegen eines Geschwürsleidens. Med. Welt, 15, 1836–40Google Scholar
  129. 129.
    Kootz, F. (1967). Das Stumpfkarzinom nach Operation eines benignen Magenleidens. Brun’s Beitr. Klin. Chir., 215, 275–94Google Scholar
  130. 130.
    Hilbe, G., Salzer, G.M., Hussl, H. and Kutschera, H. (1968). Die Carcinomgefährdung des Resektionsmagens. Langenbeck’s Arch. Chir., 323, 142–53Google Scholar
  131. 131.
    Caygill, C.P., Hill, M.J., Kirkham, J.S. and Northfield, T.C. (1986). Mortality from gastric cancer following gastric surgery for peptic ulcer. Lancet, i, 929–30Google Scholar

Copyright information

© MTP Press Limited 1988

Authors and Affiliations

  • A. Sonnenberg
  • A. Sengupta
  • P. Bauerfeind

There are no affiliations available

Personalised recommendations