[Guidelines in the management of gastric ulcer with special reference to elderly patients].

Special care must be taken for peptic ulcer disease in the elderly because of more frequent complications such as major bleeding that require hospitalization and may sometimes result in fatal outcome. In addition, elderly patients are more vulnerable to such complications due to accompanying systemic diseases such as cardiovascular, pulmonary or liver diseases. Therefore, it is important to prevent ulcer complications for the high-risk group in the elderly. For the prevention and treatment of ulcer disease in elderly patients, medication with fewer drug-interactions given in simple dose schedule is preferable for better compliance as well as for reducing side effects. Furthermore, consideration on cost-effectiveness of the treatment is increasingly important because of severe burden on the health insurance system. In an attempt to give better and more efficient management strategy for gastric ulcer, evidence-based clinical guideline is being prepared under the support of Japanese Ministry of Health and Welfare. Rational management of ulcer disease in the elderly, however, requires deliberate consideration of each patient status and stringent, inflexible application of the guideline should be avoided.