Peptic ulcer: duodenal ulcers were less likely to heal in cigarette smokers, men or elderly patients.

Clinical bottom line (level 2b)

  1. Patients with duodenal ulcers were less likely to heal if they were
    • male
    • smoked cigarettes
    • elderly
    • received no cimetidine
Sonnenberg et al: Gastroenterology 1981; 81: 1061-1067
Expires November 2002

The study

Prospective cohort study with objective outcomes, adjusted for confounding factors, not validated in an independent set of patients.

Setting: 3 acute hospitals, Germany and Switzerland

144 patients (aged mean ~ 48, 77% male)

Excluded if
  • pyloric or prepyloric ulcers
  • simultaneous gastric ulcers or past history of ulcer surgery
  • aged < 17
  • on long-term antiphlogistic medication or other drugs influencing ulcer healing
  • unlikely to take medication or attend for control examinations
  • pregnant

 

Factors studied:

  • sex, family history, concomittant disease, smoking, alcohol consumption, age, initial number of ulcers, intial ulcer size, symptoms
    •  

Patients were part of a randomised controlled trial and received cimetidine or cimetidine and pirenzepine

Multiple stepwise regression analysis performed to adjust for confounding factors.

93% followed for 8weeks
Outcomes studied:

  • healed duodenal ulcer on endoscopy
    •  

The evidence

outcome time to outcome number of patients/total number %
(95% CI)
healed duodenal ulcer 8weeks 58/134 43%
(35% to 52%)

  • These factors may be irrelevant once H Pylori status has been taken into account. Of note, SES was not studied

Citation

  1. Sonnenberg A, Mueller-Lissner SA, Vogel E, et al: Predictors of duodenal ulcer healing and relapse. Gastroenterology 1981; 81: 1061-1067
Search Terms: ?
Contributor: Chris Ball and Musab Hayatli, November 1999
Reviewer: Daniel Sontheimer

          Clinical Question.
    Patient duodenal ulcer
    Intervention or Exposure clinical features
    Outcome ulcer healing