Abdominal and dyspeptic symptoms in patients with peptic ulcer treated medically or surgically

Abstract

Background: Abdominal and dyspeptic complaints, which are prominent symptoms in patients with peptic ulceration, are commonly reported in the general population. There are few reports of follow- up study of peptic ulcer therapies in which clinical outcome has been compared with symptom reporting in community controls. Methods: Three populations of patients with peptic ulcer disease (patients who had elective proximal gastric vagotomy (PGV), those having PGV for emergency indications and those receiving medical treatment with H2- receptor antagonists) were included in a questionnaire survey and compared with a group of randomly selected community controls. Results: The vagotomized patients reported fewer abdominal complaints (P = 0.0003) and fewer dyspeptic complaints lasting for more than 1 week (P = 0.05) than those treated medically. There was no significant difference between vagotomized patients and community controls in the reporting of abdominal (P = 0.2) or dyspeptic (P = 0.9) complaints. Conclusion: Taking abdominal complaints as the endpoint for former peptic ulcer treatment, surgical treatment with PGV seemed to be superior to therapy with H2-receptor antagonists and produced an almost identical level of complaints to that seen in the community population.