Drug-induced gastropathy in elderly Taiwanese

Background/Aims: Drug-induced gastropathy was common in developing countrie s in which drug consumption was heavy. The aim of this study is to evaluate the difference in the distribution of clinical features and endoscopic fin dings between elderly and non-elderly and to determine the risk factors of drug-induced gastrointestinal mucosal damage in elderly. Methodology: Four hundred and fifty patients with gastrointestinal mucosal damages were recruited from the outpatient clinic or emergency room. All pa tients were confirmed by endoscopic examination with Olympus Videoscope QX- 200 or GIF-p20. Patient's clinical symptoms, endoscopic findings and risk f actors were collected. Data was analyzed by chi(2) test and expressed as Od ds ratio. Results: The age distribution of gastropathy was predominant at 60-69 years old, and the case number gradually declined as age increased or decreased, respectively. The clinical presentation of asymptomatic bleeding was signi ficantly higher in the elderly than in the non-elderly, while epigastric pa in combined with dyspepsia or bleeding was not different between elderly an d non-elderly groups. The endoscopic findings of gastric ulcer and erosions were significantly predominant in the elderly group, while no difference w as found for duodenal ulcer between these 2 groups. Non-steroidal antiinfla mmatory drugs were the popular drug which lead to gastropathy in both elder ly and non-elderly groups, Drugs, especially steroids, history of arthritis or peptic ulcer, and alcohol consumption were found to be the risk factors associated with increased risk of gastropathy in the elderly. Stress was a lso significantly associated with increased risk of gastropathy in the non- elderly. There was no significant difference in smoking habit and use of ot her drugs between these 2 groups. Conclusions: The clinical features of symptoms, endoscopic findings and ris k factors of gastropathy varied significantly between the elderly and the n onelderly. Drug-induced gastropathy, especially steroid treatment for arthr itis, was a significant risk factor in the elderly. Program for assessment and management of these elderly patients under treatment is important.