EXPERIENCES WITH PEPTIC ULCER IN ELDERLY MEN IN YORK

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Abstract
The incidence of new cases of peptic ulcer was studied in the City of York and environs in the period 1952–63. Each year just under 2 per 1000 men aged 65 and over developed ulcer symptoms for the first time in the period 1952–56. One hundred and forty-six men with duodenal ulcer and 40 with gastric ulcers first diagnosed when aged 60 years or over and treated on medical lines were followed up, at yearly intervals, for 12 years. A total of 187 men undergoing elective surgery for either a gastric or duodenal ulcer were also followed up in a similar manner. They were assessed clinically by a modification of the ‘Visick’ grading. The results of medical treatment varied slightly with age, time from diagnosis, and type of ulcer, but every year there was an average 68–93 per cent ‘good’ (Grade 1 and 2) and 10–19 per cent ‘bad’ results (Grade 3 and 4) for duodenal ulcers, and 55–69 per cent ‘good’ and 15–24 per cent ‘bad’ results for gastric ulcers. The operative mortality for Polya type resections was very high, but low for Billroth I resections, and for vagotomy in association with gastro-enterostomy, pyloroplasty, or antrectomy. The comparative results of elective surgery are reported.

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