Temporal Trends of Peptic Ulcer Disease in Kashmir, India

BACKGROUND: Since late 1960s, the prevalence of peptic ulcer disease and its complications has been steadily decreasing. OBJECTIVE: To ascertain the changing trends in the prevalence and complications of peptic ulcer in Kashmir. METHODS: A cohort of 10474 people aged 15-60 years in district Baramulla of Kashmir was interviewed about symptoms, complications, and surgery related to peptic ulcer. People were enquired about smoking, use of NSAIDs, H2 Receptor antagonists, proton pump inhibitors and endoscopies. All symptomatic and randomly selected group of asymptomatic people underwent esophago-gastro-cluodenoscopy. RESULTS: In symptomatic group, 286 (41.45%) people hod peptic ulcer and in asymptomatic group 24 (5.35%) had peptic ulcer. There were 71 already diagnosed cases of peptic ulcer; totaling 381. Thirty three people had surgery for peptic ulcer. The point prevalence of peptic ulcer was 3.54% and lifetime prevalence 8.96%. The highest prevalence was in 4th decade. Bleeding was seen in 23.63%, gastric outlet obstruction 4.20%, ulcer perforation 0.52%. 9.39% of peptic ulcer patients had undergone surgery. When compared to previous study in 1985 in Kashmir, there was decrease in point prevalence of 25%, in life-time prevalence of 20.14%, Gastric outlet obstruction by 51.7%, ulcer perforation by 87%, surgery rate by 60% and bleeding by a marginal 2%. CONCLUSION: Prevalence of peptic ulcerand its complications (except bleeding) are showing downward trend in Kashmir over the last 20 years. JMS 2012;15(2):136-40