Peptic ulcer on a Kibbutz in Israel: 1930-1990.

In the last 30 years, many changes have occurred in the epidemiology and natural history of peptic ulcer disease. During the 60 years since Kibbutz Afikim's beginning, 94 members have been diagnosed with duodenal or gastric ulcer. Seventy-one percent were males, 29% died. Ninety-four percent of the patients were diagnosed by barium meal only. Six patients had a gastric ulcer. The incidence rate among adults was 0.6% through the mid-1940s; the rate decreased to 0.3% by the end of the 1970s and to 0.1% in the 1980s. The decrease was noted for both sexes. The prevalence rate among adults since the 1970s has been 7%. In one-fourth of the patients, an ulcer was diagnosed before age 30 and in another fourth after age 50. An average of 3.1 upper gastrointestinal radiographs were done per patient. There was no temporal relationship between the incidence and the stressful effects of arrival in Israel or at the Kibbutz. Twenty-four patients underwent surgery: In the last decade there seemed to be a slight decrease in elective surgery.