A Nationwide Population-Based Cohort Study Shows Reduced Hospitalization for Peptic Ulcer Disease Associated With H pylori Eradication and Proton Pump Inhibitor Use

Background & Aims: The incidence of peptic ulcer diseases has decreased significantly during past decades. Despite several significant population-based studies in Western countries, studies of Asian populations are lacking. We therefore investigated the incidence of hospital admissions for peptic ulcer disease in Taiwan during a 10-year period. Methods: This nationwide population-based cohort study was based on data obtained from the Taiwan National Health Insurance Database (a population of 23 million). In total, 403,567 patients with peptic ulcer diseases were recruited for the study. Standardized incidences of admissions were calculated to estimate changes. Results: Hospitalization for peptic ulcer diseases decreased significantly between 1997 and 2006 in Taiwan. The incidences of admissions decreased from 68.3 to 39.6 per 100,000 for uncomplicated gastric ulcer, from 116.9 to 61.1 for bleeding gastric ulcer, and from 11.0 to 6.3 for perforated gastric ulcer. The incidences decreased from 46.4 to 13.6 per 100,000 for uncomplicated duodenal ulcer, from 108.0 to 40.1 for bleeding duodenal ulcer, and from 9.8 to 5.8 for perforated duodenal ulcer. The declines were observed in both genders, in all age groups, and at all hospital levels. Significant increases in Helicobacter pylori eradication therapy (202% increase) and proton pump inhibitor use (1071% increase) might have contributed to these decreases. Conclusions: The incidences of gastric and duodenal ulcer diseases decreased 42%-48% and 41%-71%, respectively, in Taiwan between 1997 and 2006.