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Peptic Ulcer: The Changing Scene

D U O DEN A L ulcer was first described in 1817. In the 160 years since then the disease has increased in frequency until it now affects one person in ten at some time during their lives; but the cause of chronic duodenal ulceration and, indeed, chronic gastric ulcer, remains unknown. This paper will present evidence for the changing pattern in the epidemiology of chronic peptic ulceration. Unfortunately data to support this are not always satisfactory. Some authors have used the term peptic ulcer without definition or qualification and there is good reason to believe that duodenal and gastric ulcers may be different diseases. Furthermore it may well be, as discussed below, that duodenal ulceration is a common manifestation of a variety of aetiologic mechanisms. A further difficulty is the problem of relating information from one country to another. Recent reviews of the subject have come from Langman (1,2), Grossman (3) and Sturdevant (4).