What is the role of peptic ulcer disease in abdominal pain in elderly persons?

Updated: Jul 17, 2018
  • Author: E David Bryan, MD; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Peptic ulcer disease (PUD) deserves special mention, since the incidence among elderly patients is increasing. This may be due in part to the increasing availability and use of nonsteroidal anti-inflammatory drugs (NSAIDs). Users of NSAIDs are 5-10 times more likely to develop PUD than nonusers.

Mortality of elderly patients with PUD is approximately 100 times higher than that of younger patients with PUD.

Diagnosis of PUD in elderly patients can be difficult. Approximately 35% of elderly patients with PUD have no pain. The most common presenting symptom is melena.

Complications include hemorrhage and perforation. In elderly patients perforation is often painless, and free air may be absent on plain radiographs in more than 60% of patients.

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