Peptic ulcer data from 4 years of endoscopy in 955 pilots of the Japan Air Self Defense Force.

BACKGROUND

The treatment of peptic ulcer disease has undergone profound changes due to the recognition of Helicobacter pylori as a causative factor. A survey of medical records was made to determine the prevalence of peptic ulcer among pilots of the Japan Air Self Defense Force (JASDF) and to decide on a possible change in JASDF medical policy toward an ulcer-treatment regime involving therapy to eradicate Helicobacter pylori.

METHODS

The subjects were 955 male pilots, age 40 or older. Between 1996 and 1999, they underwent gastrointestinal endoscopy 2.47 times on average. Annual ulcer rates and recurrence rates were obtained from the endoscopic file data. Smoking habits and use of NSAIDs were also assessed as important risk factors for peptic ulcer.

RESULTS

The detection rate of open ulcer for each year was 2.3-3.1% in the stomach and 1.9-4.4% in the duodenum. For ulcers including scarring, the corresponding figures were 7.3-9.5% and 12.7-19.9%. The recurrence rate from S1 scars in the duodenum was 34%, significantly higher than that from S2 scars (7%) (p < 0.0005). There was no significant difference in recurrence rate between S1 scars and S2 scars in the stomach. There was a significant association between gastric ulcer and smoking (p < 0.0005). None of the pilots took long-term NSAID medications.

CONCLUSIONS

Peptic ulcer occurs more frequently in the JASDF pilots than in the general population. S1 scarring in the duodenum, as well as open ulcers in either stomach or duodenum, are candidates for Helicobacter pylori eradication therapy if the bacterium is detected. Other types of scars are also candidates for this therapy when pilots have symptoms related to infection with Helicobacter pylori.