Life Change and the Postoperative Course of Duodenal Ulcer Patients

Abstract

This study of the natural history of peptic ulcer disease reports on the association of medical and surgical data with life change data generated by the Schedule of Recent Experience (SRE). Surgery tended to follow increasing life change and symptomatic complaints, and intractable pain as the primary indication for operation portended a less favorable surgical result. Distribution of postoperative illness within the population was not random, but rather tended to be confined to a susceptible segment of the population in which the more symptomatic patients were inclined to have both gastrointestinal and nongastrointestinal symptoms. There was no association between type of operation (hemigastrectomy vs. drainage procedure) and post-operative clinical course with respect to gastrointestinal and nongastrointestinal symptoms. Postoperative magnitude of life change was associated with a preponderance of postoperative gastrointestinal symptoms. An unstable and/or decreasing trend in the patient's estimate of improvement after operation was highly associated with increased life changes as well as increased postoperative gastrointestinal and nongastrointestinal symptoms. Conversely, a stable trend in the patient's estimate of improvement was associated with decreased life changes and decreased occurrence of postoperative symptoms. The conclusion is that candidates for surgical alleviation of duodenal ulcer face not only operative risks and possibly more and varied postoperative gastrointestinal problems, but also a tumultuous postoperative period of life change and whatever it may harbinger.

Index Terms:

• life change
• duodenal ulcer
• postoperative symptoms
• Schedule of Recent Experience (SRE)