Change in prevalence and pattern of peptic ulcer disease in the Northern Savannah of Nigeria: An endoscopic study

Background: Peptic ulcer disease (PUD) is common worldwide. Its incidence and prevalence have been declining in recent years in developed countries, and a similar trend has been observed in many parts of Africa including Nigeria. Aim: This study aimed to provide an endoscopic update on PUD in the Northern Savannah of Nigeria and compare with past reports from the region and recent reports from Nigeria, Africa, and the rest of the world. Methods: Upper gastrointestinal endoscopy records of consecutive patients diagnosed with PUD between January 2014 and September 2022 at an endoscopy unit of a tertiary institution in North West Nigeria were retrieved and demographic data, types of peptic ulcer, and their characteristics were extracted and analyzed. Results: Over a 9 year period, 171/1958 (8.7%) patients were diagnosed with PUD: mean age 48.8 years (range 14­85), 68.4% male, and 70% >40 years. 59.6% were gastric ulcers (GU), 31.6% duodenal ulcers (DU), and 8.8% were both. The mean age of patients with GU was slightly higher than those with DU (49.9 years vs. 46.6 years, P = 0.29); patients aged 40 years significantly more GU than DU (74.6% vs. 54.7%, P = 0.016). There were no significant gender differences between GU and DU. Conclusion: The prevalence and pattern of PUD in Northern Savannah of Nigeria have changed ­ patients were predominantly male and older, and GU predominated.

Ulcères gastriques et duodenaux à Cotonou: aspects épidémiologiques, cliniques, endoscopiques et thérapeutiques

L'ulcère gastrique ou duodénal (UGD) est une affection plurifactorielle. Une prévalence de 16,6% en avait été rapportée en 2005 au Bénin. Le but de notre étude est de décrire les aspects épidémiologiques, cliniques, endoscopiques et thérapeutiques des UGD observés de nos jours à Cotonou. Patients et méthodes : Il s'agissait d'une étude prospective, transversale, descriptive et analytique. Elle a colligé du 1er octobre 2015 au 30 avril 2016, tous les sujets de plus de 15 ans ayant présenté un UGD à l'endoscopie dans les services des maladies digestives de l'hôpital de Zone de Mènontin et de l'hôpital d'Instruction des Armées de Cotonou. Résultats : Sur 411 patients inclus, 30 avaient un UGD soit une prévalence de 7,3 %. Les ulcères duodénaux étaient observés chez des sujets jeunes avec un âge moyen de 38 ± 6,9 ans ; tandis que les ulcères gastriques étaient observés chez des sujets plus âgés avec un âge moyen de 58 ± 7 ans. La sex-ratio était de 2,8. Les épigastralgies étaient la principale manifestation présente dans 70% des cas. La localisation de l'ulcère était gastrique dans 36,7%, duodénale dans 53,3 %, double dans 10% des cas. Les principales causes étaient la consommation de médicaments gastro-toxiques et l'Helicobacter pylori. Les Inhibiteurs de la pompe à protons étaient prescrits dans tous les cas et l'éradication de l'Helicobacter pylori faite dans 94,7% des cas avec une évolution favorable à 2 mois de contrôle. Conclusion : la prévalence des UGD a diminué de plus de 50% en onze ans à Cotonou. L'amélioration du niveau d'hygiène et la sensibilisation contre l'automédication pourraient davantage contribuer à réduire cette prévalence

Declining prevalence of duodenal ulcer at endoscopy in Ile-Ife, Nigeria

Background. Duodenal ulcer is the most common peptic ulcer disease worldwide. In the past, sub-Saharan Africa has been described as an area of mixed prevalence for peptic ulcer disease, but recent reports have disputed this. Changes in the prevalence of duodenal ulcer have been reported, with various reasons given for these.Objective. To describe the change in endoscopic prevalence of duodenal ulcer at Obafemi Awolowo University Teaching Hospital (OAUTH), Ile-Ife, Nigeria, between January 2000 and December 2010.Methods. This was a retrospective, descriptive study of patients who underwent upper gastrointestinal endoscopy in the endoscopy unit of OAUTH between January 2000 and December 2010. The data were obtained from the endoscopy register, demographic indices, presenting symptoms and post-endoscopic diagnoses being retrieved for each patient. The study period was divided into the years 2000 - 2004 and 2005 - 2010, the frequencies of duodenal ulcer and other post-endoscopic diagnoses being compared between these two time periods to see whether there were changes.Results. Over the study period, 292 patients (15.8%) were diagnosed with duodenal ulcer, second only to 471 patients (26.2%) with acute gastritis. The prevalence of duodenal ulcer for 2000 - 2004 was 22.9% (n=211 patients) compared with 9.2% (n=81) for 2005 - 2010 (p<0.001).Conclusion. There was a significant decline in the endoscopic prevalence of duodenal ulcer over the decade

Experience with Acute Perforated Duodenal Ulcer in a West African Population

Background: The advent of proton pump inhibitors and helicobacter pylori eradication in the management of chronic peptic ulcer disease has reduced the operative treatment of this condition to its complications. Perforated duodenal ulcer remains a major life threatening complication of chronic peptic ulcer disease. This retrospective study reviews our experience at the Royal Victoria Teaching Hospital . Methods: All patients with clinical diagnosis of perforated duodenal ulcer seen in this hospital between June 2003 and October 2005 were included in this study. Data extracted from their hospital records were analyzed for age; sex; duration of symptoms; previous history of peptic ulcer disease; use of NSAIDS; main presenting features; investigations; resuscitative measures; time of surgery; operative findings; and type of surgery offered; complications and mortality. After resuscitation; laparotomy followed by simple closure or definitive ulcer surgery and helicobacter pylori eradication therapy was given to all the patients. Duration of follow up ranged 8 to 12 months with endoscopy in some patients. Results: There were 41 patients with intraoperative diagnosis of acute perforated duodenal ulcer seen over the study period; comprising 34 males (82.9) and 7 females (17.1); a male female ratio of 4.8:1; age range of 18-77 years and a mean age of 45.49+/-14.46 years. Previous history of peptic ulcer disease was found in 32 (78.6) of the patient and the main presenting features were sudden onset of severe abdominal pain in 95.1of cases and fever in 65.8. Features of frank peritonitis were demonstrable in all the patients and 11(26.8) presented in shock. Plain chest x-rays demonstrated gas under the diaphragm in 21(65.6) of the patients. After adequate resuscitation; all the patients underwent laparotomy where the abdomen was explored; the diagnosis of perforated duodenal ulcer was confirmed and 29(70.7) had simple closure of the perforation with omentum (after Graham). The average time between presentation and surgery was 9 hours (range 6-11hours). The mean size of perforation was 10.5mm (range 5- 15mm). Definitive peptic ulcer surgery was done in 12 (29.3) patients. 8 had truncal vagotomy and pyloroplasty. The major complications included wound infection in 14 (34.1); postoperative fever in 16 (39.0) and prolonged ileus in 15 (36.6) There were 7 deaths; mortality rate of 17.1and the causes of death included severe electrolyte imbalance in 1 and gram negative septicaemia and shock in 6. The average duration of hospital stay was 10 days (range 8 36). Conclusion: Perforated duodenal ulcer is a major complication of chronic peptic ulcer disease. Simple omental patch by open method and helicobacter pylori eradication therapy is sufficient to prevent reperforation

Gastrites et infection a helicobacter pylori a Kinshasa (Zaire)

La prevalence de la gastrite chronique associee a l'infection a H. Pylori est inconnue dans notre milieu. Le but de ce travail est de determiner cette prevalence dans un echantillon de la population zairoise. Tous les patients consultant pour epigastralgies diverses entre le 1er janvier et le 30 juin ont subi une endoscopie digestive haute avec prelevement biopsique pour recherche de H. pylori. 46 patients souffraient d'epigastralgies sans ulcere; 3 avaient un ulcere gastrique et 9 un ulcere duodenal. Une gastrite chronique etait presente dans 82;8 pour cent des cas. L'infection a H. Pylori etait associee a la gastrite chronique dans 68;75 pour cent des cas; a l'ulcere gastrique dans 100 pour cent des cas et a l'ulcere duodenal dans 66;6 pour cent des cas. Au total; la presence de l'infection a H. Pylori etait etroitement en correlation avec l'activite de la gastrite