Risk factors for duodenal ulcer in north India.

OBJECTIVES: The present study was designed to evalutate the association of various risk factors such as smoking, alcohol, NSAIDs, inadequate dietary intake of fibres and consumption of spicy foods with chronic duodenal ulcer using a case-control design and to establish the association of Helicobacter pylori and duodenal ulcer using different diagnostic techniques in Indian subjects. MATERIALS: A total of 16 consecutive patients with endoscopically proven duodenal ulcer (DU) constituted the test group while 160 subjects with non-ulcer dyspepsia (NUD) were recruited as controls. METHODS: All subjects were interviewed based on a standard questionnaire and underwent an upper gastrointestinal endsocopy wherein multiple biopsies were taken for rapid urease test (RUT), histology and culture for detection of H. pylori. The serum samples of all the subjects were tested for the presence of antibodies against H. pylori using ELISA. RESULTS: There were significantly greater number of smokers (80%) and alcoholics (58%) in the male population of DU group as compared to the controls (49% smokers & 15% alcoholics). Similar trend was seen in relation to history of chronic exposure to NSAIDs (29% in DU & 11% in NUD) and inadequate intake of fibre in diet (66% and 39% respectively). The overall prevalence of H. pylori was 82.5% in DU and 50.6% in NUD [p < 0.001]. CONCLUSIONS: In North Indian subjects, alcohol consumption, smoking, inadequate intake of fibre in diet and use of NSAIDs are the risk factors associated with doudenal ulcer disease. Further, infection with H. pylori is strongly associated with DU in the North Indian population.