A review of the records at a teaching hospital in Kelantan revealed that 175 new cases of peptic ulcer disease were diagnosed endoscopically over a period of 5 years. The ratio of duodenal to gastric ulcers was 2:1. Male patients outnumbered females by 2.7:1. There was a disproportionately high number of Chinese patients. A striking observation was that an unusually large proportion (45%) of patients had presented with acute gastrointestinal bleeding. The implication is that peptic ulcer disease in this region may be underdetected; the diagnosis often coming to light only after a serious complication has supervened.
The objective of the study was to determine whether discriminant analysis of characteristics of dyspepsia can differentiate peptic ulcer from non-ulcer dyspepsia in a Malaysian population. Two hundred and twenty six patients with dyspepsia were interviewed using a standard history questionnaire before undergoing upper gastrointestinal endoscopy. Forty seven patients had peptic ulcer while 149 others were classified as having non-ulcer dyspepsia. Stepwise logistic regression analysis was done on 25 variables. The study showed that only five of these variables could differentiate peptic ulcer from non-ulcer dyspepsia, namely, nocturnal pain, pain before meals or when hungry, absence of nausea, age and sex. A scoring system was devised based on these discriminant symptoms. At a sensitivity of 51%, the specificity for peptic ulcer was 83%, but only prospective studies will determine if this scoring system is of actual clinical value.
Marked epidemiological changes in upper gastrointestinal diseases and Helicobacter pylori infection have taken place in the Asian Pacific region. In particular, differences with respect to race in the multiracial Asian population in Malaysia have been important and interesting.