Epidemiological Study of Duodenal Erosive Disease; Its Prevalence and Nosological Position in Relation to Ulcerative Peptic Disease

Abstract

The prevalence of erosive lesions was found to be 27.5 % in 11838 cases examined during the last 10 years. In almost 66 % of the cases, erosive lesions were localized in the duodenal bulb but mainly isolated and less often in the antropyloric area. In 55 % of the cases, duodenal erosions coexist with ulcerative peptic disease, 20 % in “active” phase and 35 % in “inactive” phase. Erosive lesions, appeared autonomously in 45 % of the cases. Morphologically, they can be divided in: a) periulcerative marginal erosions closely connected with activity of the ulcers; b) clustered, complete or incomplete erosions, which may or may not be associated with the ulcerative disease and often have a prolonged acyclic behaviour; c) scattered flat erosions which can at times be associated with the ulcerative peptic disease but are always related to a chronic widespread duodenitis. An epidemiological study was performed on 564 cases which were divided into 3 groups: a) cases with autonomous erosive disease; b) those with erosions associated with post-ulcerative scars; and c) those with erosions associated with active ulcers. The control group of 111 cases was characterised by duodenal active ulcers with no erosions. Statistical evaluation of the percentage differences between the 4 groups revealed that in duodenal erosive disease predisposing factors such as psychic temper, enviromental and work conditions and eating habits are evident. In atuonomous disease drug intake and spices and, to a less extent, alcohol and/or stress situations play a more important role. In erosions associated with an active ulcer, a dominant obsessive temper facilitated by a difficult family situation, bad eating habits and a great amount of smoking are prominent factors. In erosions which interchange with uider activity, healthier habits and less difficult life situations are present but a depressive temper remains evident. In duodenal ulcers without erosions, the psychic temper is not significant but stressful work situations, bad eating habits and smoking can assume a predisposition role.

Key Words:

• Duodenal erosions
• duodenitis drugs
• epidemiology
• family and work situations
• life habits
• psychic temper
• ulcerative peptic disease