A multicenter prospective study on the prevalence of H elicobacter pylori ‐negative and nonsteroidal anti‐inflammatory drugs‐negative idiopathic peptic ulcers in J apan

Background and Aim The prevalence of H elicobacter pylori ‐negative and nonsteroidal anti‐inflammatory drug‐negative peptic ulcers, commonly known as idiopathic peptic ulcers ( IPUs ), has been reported to be very low (0.9–2.6%) in J apan based on data from the 1990s. However, recent trends have yet to be been reported. Herein, we present a multicenter prospective analysis between 2012 and 2013 investigating current trends in the prevalence and characteristics of IPUs in J apan. Methods Clinical data of all peptic ulcer subjects detected via endoscopy at four participating hospitals were prospectively collected between A pril 2012 and M arch 2013. Enrolled subjects were classified according to H . pylori infection status and intake of nonsteroidal anti‐inflammatory drugs. Multiple logistic regression analyses were used to determine the risk factors for IPUs . Results Of 382 enrolled patients with peptic ulcers, 46 (12%) were judged to have IPUs . Compared with those with simple H . pylori ‐positive ulcers, patients with IPUs were significantly older ( P  < 0.02) and more often had underlying comorbidities such as hypertension ( P  < 0.02) and hyperlipidemia ( P  < 0.05). Multivariate regression analysis indicated that the presence of multiple underlying diseases was the only significant risk factor for IPUs , with an odds ratio of 3.8 (95% confidence interval, 1.3–11.1). Conclusions This study revealed that the prevalence of IPUs in patients with peptic ulcers in J apan is 12%, much higher than previously reported. Presence of multiple underlying comorbid diseases, rather than aging itself, is an important risk factor for IPUs .