Factors Affecting the Incidence of Recurrences and Complications of Peptic Ulcer Disease

Aim: to analyze risk factors for relapses and complications of peptic ulcer disease in a cohort of patients.
Materials and methods. Retrospective analysis of hospital records of 253 patients (average age — 52.1 ± 8.2 years) with peptic ulcer disease in the acute stage. Patients were stratified by gender, age and anamnestic risk factors, the phenotype of peptic ulcer disease being stratified by etiology, endoscopic characteristics of ulcerative defects of the gastric mucosa and duodenum.
Results. The proportion of complicated forms of peptic ulcer disease varies depending on gender, age and ulcer localization. The total number of complications in the cohort is 38.3 %, men developing complications in every second case (47.9 %). Among complications, bleeding is the most common one and accounts for 52.6 %, 42.9 % and 41.2 % of all complications in duodenal, simultaneous and gastric ulcers correspondingly. Cicatricial and ulcerative deformations are associated with localization in the duodenum and combined location of ulcerative defects, the complication being recorded in men 2 times more often than in women. Perforations of gastric ulcer are associated with the male gender (3 times more often). Stenosis is a rare complication, predominantly in women with duodenal ulcer. Significant predictors of complications of peptic ulcer disease are male gender and smoking. Factors associated with the manifestation of peptic ulcer disease include H. pylori and smoking in men, and H. pylori, nonsteroidal anti-inflammatory drugs or combination of these factors in women.
Conclusions. The factors influencing the incidence of complications and recurrences of peptic ulcer disease in the hospital cohort have been established: male gender, age of 36–59 years, H. pylori infection, tobacco smoking, NSAID use and simultaneous exposure to several factors in one individual.

1. Tsukanov V.V., Vasyutin A.V., Tonkikh Yu.L., Peretyatko O.V. The prevalence and risk factors of peptic ulcer disease. Vrach. 2018;29(12):63–5. (In Russ.). DOI: 10.29296/25877305-2018-12-15

2. Alhalabi M.M. Mortality and risk factors associated with peptic ulcer bleeding among adult inpatients of Damascus hospital, Syria: A cross-sectional study. Medicine (Baltimore). 2023;102(17):e33699. DOI: 10.1097/MD.0000000000033699

3. Kolesnikov D.L., Nogteva V.E., Lobanova A.V., Kukosh M.V. Risk assessment of ulcerative gastroduodenal bleeding recurrence. Journal of Experimental and Clinical Surgery. 2019;12(1):17–22. (In Russ.). DOI: 10.18499/2070-478X-2019-12-1-17-22

4. Ivashkin V.Т., Mayev I.V., Tsarkov Р.V., Korolev М.Р., Andreev D.N., Baranskaya Е.К., et al. Diagnostics and treatment of peptic ulcer in adults (Clinical guidelines of the Russian Gastroenterological Association, the Russian Society of Colorectal Surgeons, the Russian Endoscopic Society and the Scientific Society for the Clinical Study of Human Microbiome). Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2024;34(2):101–31. (In Russ.). DOI: 10.22416/1382-4376-2024-34-2-101-131

5. Brullet E., Garcia-Iglesias P., Calvet X., Papo M., Planella M., Pardo A., et al. Endoscopist’s judgment is as useful as risk scores for predicting outcome in peptic ulcer bleeding: A multicenter study. J Clin Med. 2020;9(2):408. DOI: 10.3390/jcm9020408

6. Xie X., Ren K., Zhou Z., Dang C., Zhang H. The global, regional and national burden of peptic ulcer disease from 1990 to 2019: A population-based study. BMC Gastroenterol. 2022;22(1):58. DOI: 10.1186/s12876-022-02130-2

7. Zahir S., Tariq A., Latif A., Ali M., Din J.U., Jahan S., et al. Exploring the associations of age, gender, and blood group with peptic ulcer disease: A comprehensive study of frequency, clinical manifestations, risk factors, and ulcer types. Journal of Population Therapeutics and Clinical Pharmacology. 2023;30(19):899–906. DOI: 10.53555/jptcp.v30i19.3769

8. Malik T.F., Gnanapandithan K., Singh K. Peptic ulcer disease. 2023 StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024.

9. Valeev M.V., Timerbulatov Sh.V. Risk factors for rebleeding in patients with peptic ulcer bleeding. Kazan Medical Journal. 2020;101(3):435–40. (In Russ.). DOI: 10.17816/KMJ2020-435

10. Rohit D.K., Verma R.S., Pandey G. Clinical study and management of peritonitis secondary to perforated peptic ulcer. Int Surg J. 2017;4(8):2721–6. DOI: 10.18203/2349-2902.isj20173209

11. Lim S., Kim N., Kwon J., Kim S., Baik G., Lee J., et al. Trends in the seroprevalence of Helicobacter pylori infection and its putative eradication rate over 18 years in Korea: A cross-sectional nationwide multicenter study. PLoS One. 2018;13(10):e0204762 DOI: 10.1371/journal.pone.0204762

12. Hooi J.K.Y., Lai W.Y., Ng W.K., Suen M.M.Y., Underwood F.E., Tanyingoh D., et al. Global prevalence of Helicobacter pylori infection: Systematic review and meta-analysis. Gastroenterology. 2017;153(2):420–9. DOI: 10.1053/j.gastro.2017.04.022

13. Malfertheiner P., Megraud F., O’Morain C.A., Gisbert J.P., Kuipers E.J., Axon A.T., et al.; European Helicobacter and Microbiota Study Group and Consensus panel. Management of Helicobacter pylori infection — the Maastricht V/Florence Consensus Report. Gut. 2017;66(1):6–30. DOI: 10.1136/gutjnl-2016-312288

14. Chey W.D., Leontiadis G.I., Howden C.W., Moss S.F. ACG clinical guideline: Treatment of Helicobacter pylori infection. Am J Gastroenterol. 2017;112(2):212–39. DOI: 10.1038/ajg.2016.563