Tobacco use as contributory factor in peptic ulcer disease

To find out the association of tobacco as a contributory factor in patients presenting with peptic ulcer disease [PUD]. Design: A descriptive case study. Place and Duration of Study: Department of Medicine, Postgraduate Medical Institute, Lady Reading Hospital, Peshawar, from May 2001 to April 2002. Subjects and A total number of 100 consecutive patients, 76 males and 24 females, with endoscopically proven peptic ulcer were enrolled in the study. The ages of the patients ranged from 25 to 70 years; with mean age of 48 years + 12.26 standard deviations, [mean age of men 49 years + 12.88 SD, and mean age of women 45 years + 9.67 SD]. All the patients underwent endoscopy after an overnight fast, using lignocaine [4% solution or jelly] as topical anaesthetic, with Pentax FG29 video-endoscope. Fifty-six% of all the patients with PUD used tobacco, 33% as cigarette, 18% took it as 'naswar' and 5% of patients used it in both the forms. Of these, 85.7% [48/56] patients had duodenal ulcer and 14.3% [8/56] patients had gastric ulcer. All these patients were male, none of the female patients used tobacco in any form. Moreover, 40% of PUD patients reported long-term use of nonsteroidal anti-inflammatory drugs [NSAIDs]. This study supports the view that use of tobacco is associated with PUD in men