Peptic Ulcers and Chronic Gastritis

Gastric ulcers, chronic gastritis and hiatus hernia are increasingly common conditions in old age. Both morbidity and mortality from bleeding stomach ulcers have increased in persons over 75 and this is in contrast to the lowered incidence in other 

Aging is one of the major risk factors for developing gastric ulcers because of an increased incidence of Helicobacter pylori infections and a widely spread use of non-steroidal anti-inflammatory drugs (NSAID). Co-morbidity, with the need for prophylactic medication with antiplatelet therapy, warfarin and other anticoagulants, also increases the risk of gastrointestinal bleeding and ulcerations (Murakami et al. 1968). 

Infection with Helicobacter pylori is widely spread in the world and as many as 50% of the population is estimated to be infected, with the highest incidence in Asia and developing countries. The bacterial toxins of Helicobacter pylori damage the epithelial cells in the stomach and can in the long term lead to gastric atrophy (Pilotto 1996, Faisal et al. 1990, Pilotto et al. 1999). The consequential decrease in secretion of acid causes a higher gastric pH level which can increase the risk of enteric infections, for example, with Campylobacter and Clostridium difficile. 

2 Drugs that increases the risk for gastritis, ulcers and esophagitis 

A friend of mine is concerned about his 78 years old mother who has recently been to her doctor for an annual health check up. He is worried because at his mothers last visit her blood pressure had risen to 160/90 and she was prescribed an antihypertensive, a diuretic (thiazide). The medication is giving her a lot of problems due to the diuretic effect, and because of arthritis of the knees she moves slowly and this make it difficult for her to reach the bathroom in time. She has now developed urinary incontinence due to her medication. 

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