Protocolo diagnóstico y terapéutico de la enfermedad péptica en el anciano

Abstract

The incidence of peptic ulcer is decreasing in the general population. On the contrary, hospitalization and mortality rates for gastrointestinal ulcers remain high in older patients. The factors that may explain this epidemiological feature in older adults are age-related physiological changes, the high prevalence of H. pylori infection, and increasing prescribing of gastroduodenal-damaging drugs such as NSAIDs or antiplatelet therapy. The main goals of peptic ulcer treatment in the older adult population are to reduce recurrence of the disease and prevent complications. The general approach to an older adult patient should include a comprehensive geriatric assessment. The treatments available for peptic ulcer are based primarily on suppression of gastric acid with antisecretory drugs and the eradication of H. pylori infection. Treatment with PPI antisecretory agents has a favorable tolerability profile in older adult patients; however, their use must be rational and it is necessary to respect the treatment indications.