Prevalence of H. pylori–Positive Peptic Ulcers Is Decreasing in the U.S.

With only 17% of peptic ulcers estimated to be H. pylori–positive, prompt endoscopy should be the preferred management strategy in dyspeptic patients, even those under 60.

During the past 30 years, the prevalence of Helicobacter pylori as well as peptic ulcers has been decreasing. To examine the current relationship between H. pylori and peptic ulcers in the U.S., investigators conducted a cross-sectional study of histopathologic records of almost 1.3 million patients nationwide who underwent upper endoscopy in outpatient endoscopy centers from 2009 to 2018. Results were as follows:

The overall prevalence of H. pylori infection was only 10%.
There were approximately 48,000 patients with gastric ulcers and 12,000 with duodenal ulcers, including 2200 with both gastric and duodenal ulcers; the overall proportion of patients with H. pylori–positive ulcers was 17%.
The proportion of H. pylori–positive gastric ulcers …

Reviewing Author

John R. Saltzman, MD

Disclosures

Consultant/Advisory BoardIterative Scopes

Editorial BoardsGastrointestinal Endoscopy; UpToDate

Leadership Positions in Professional SocietiesAmerican College of Gastroenterology (Trustee)

OtherVice President of Medical Affairs, 1Globe Health Institute