How Common Is Silent Peptic Ulcer Disease?

Not all peptic ulcers cause symptoms. Asymptomatic ulcers are common in patients who take nonsteroidal anti-inflammatory drugs (NSAIDs), but the prevalence of asymptomatic peptic ulcer disease (PUD) in the general population is not known. Investigators in Taiwan prospectively studied 6457 consecutive asymptomatic patients who were undergoing screening upper endoscopy. Before the endoscopy, all patients answered three questions about abdominal pain or dyspepsia.

Seventy-eight percent of patients had Helicobacter pylori infection. Overall, 10.9% of patients had endoscopic evidence of PUD (ulcer >0.5 cm); 70% of PUD patients reported no symptoms. Multivariate analysis indicated that asymptomatic ulcers were more common in patients with higher b…