MANAGING THE ELDERLY PATIENT WITH PEPTIC-ULCER DISEASE

Peptic ulcer disease accounts for 27% of hospitalizations and 20% of deaths in the elderly population. Among the factors associated with increased risk of peptic ulcer disease are nonsteroidal anti-inflammatory drug ingestion and infection with Helicobacter pylori. Because the symptoms of gastric and duodenal ulcer may overlap, the ideal diagnostic workup includes an upper gastrointestinal radiographic series or endoscopy. Options for treatment include antacids, antisecretory drugs, drugs that enhance mucosal defense, misoprostol, antibiotics, and pro-kinetic agents. Maintenance therapy can decrease the rate of ulcer recurrence to 20%.