MANAGING THE ELDERLY PATIENT WITH PEPTIC-ULCER DISEASE

Peptic ulcer disease accounts for 27% of hospitalizations and 20% of d eaths in the elderly population. Among the factors associated with inc reased risk of peptic ulcer disease are nonsteroidal anti-inflammatory drug ingestion and infection with Helicobacter pylori. Because the sy mptoms of gastric and duodenal ulcer may overlap, the ideal diagnostic workup includes an upper gastrointestinal radiographic series or endo scopy. Options for treatment include antacids, antisecretory drugs, dr ugs that enhance mucosal defense, misoprostol, antibiotics, and pro-ki netic agents. Maintenance therapy can decrease the rate of ulcer recur rence to 20%.