B0637 - Prevalence of Non-Helicobacter pyloriPeptic Ulcers in Patients With Chronic Pancreatitis: A Population-Based National Study

Monday, October 24, 2022

10:00 AM – 12:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

Akash T. Khurana, MD

University Hospitals/CMC
Cleveland, OH

Akash T. Khurana, MD¹, Syed Ahmad Adil, MD¹, Mohammed Z. Sheriff, MD², Gregory Cooper, MD²
¹University Hospitals/CMC, Cleveland, OH; ²University Hospitals Digestive Health Institute, Cleveland, OH

Introduction: Acute and chronic pancreatitis are recognized as a continuum of the same disease, with a significant overlap in clinical manifestations. The association between peptic ulcer disease (PUD) and acute pancreatitis (AP) has been described in the literature. However, there is no available data on the prevalence of PUD in patients with chronic pancreatitis (CP).

Methods: The aim of this study was to investigate if CP is associated with increased overall risk of PUD, gastric ulcers, and duodenal ulcers. Data was collected from a commercial database (Explorys Inc, Cleveland, OH), an aggregate of EHR data from 27 integrated healthcare systems in the US between 12/2016-12/2021. We identified patients with CP based on Systemized Nomenclature of Medicine – Clinical Terms and excluded patients with H. pylori infection of the gastrointestinal tract. We compared the prevalence of peptic ulcer, gastric ulcer, and duodenal ulcer after at least 30 days following a diagnosis of CP to a cohort without CP.

Results: Of the 33,660,510 patients in the database without H. pylori, we identified 66,550 cases of CP. We identified 2,480 cases of peptic ulcer, 2,680 cases of gastric ulcer and 1,420 cases of duodenal ulcer in patients with CP. In comparison, we identified 160,270 cases of peptic ulcer, 201,600 cases of gastric ulcer and 81,920 cases of duodenal ulcer in patients without CP. Overall prevalence for peptic ulcer, gastric ulcer, and duodenal ulcer in patients with CP was 3727/100000, 4027/100000 and 2134/100000 people, respectively. In comparison, overall prevalence for peptic ulcer, gastric ulcer, and duodenal ulcer in patients without CP was 477/100000, 600/100000 and 244/100000 people, respectively. The prevalence ratios (PR) for developing each diagnosis after at least 30 days of a CP diagnosis were 7.81 (95% CI 7.51-8.12, p< 0.001), 6.71 (95% CI 6.47-6.97, p< 0.001), and 8.75 (95% CI 8.31-9.22, p< 0.001), respectively. Table 1 describes the prevalence of PUD among various demographics.

Discussion: In this large population-based study, peptic ulcer, gastric ulcer, and duodenal ulcer were all significantly more prevalent among patients with a diagnosis of CP. Future investigation will be useful in understanding the pathophysiology of this association.

	Chronic Pancreatitis (CP)	No CP	Prevalence in CP /100,000	Prevalence in No CP /100,000	Prevalence Ratio	95% CI	p-value
Peptic Ulcer	2480	160270	3726.52	477.08	7.81	7.51-8.12	< 0.001
Adults (18-65)	1640	74130	3964.23	374.11	10.60	10.1-11.1	< 0.001
65)"}" > Elderly ( >65)	840	85440	3362.69	1088.74	3.09	2.89-3.30	< 0.001
Caucasian	1700	119480	3739.55	657.53	5.69	5.43-5.96	< 0.001
African American	670	24730	5153.85	648.38	7.95	7.38-8.57	< 0.001
Asian	20	2860	2985.07	536.31	5.57	3.61-8.58	< 0.001
Male	1210	64750	3587.31	434.60	8.25	7.81-8.73	< 0.001
Female	1270	95450	3861.36	516.79	7.47	7.08-7.89	< 0.001
Gastric Ulcer	2680	201600	4027.05	600.11	6.71	6.47-6.97	< 0.001
Adults (18-65)	1730	88420	4181.77	446.23	9.37	8.95-9.82	< 0.001
65)"}" > Elderly ( >65)	940	112280	3763.01	1430.75	2.63	2.47-2.80	< 0.001
Caucasian	1830	149090	4025.52	820.48	4.91	4.69-5.13	< 0.001
African American	740	28950	5692.31	759.02	7.50	6.99-8.05	< 0.001
Asian	30	3690	4477.61	691.96	6.47	4.56-9.19	< 0.001
Male	1260	77990	3735.55	523.46	7.14	6.76-7.54	< 0.001
Female	1420	123300	4317.42	667.58	6.47	6.15-6.81	< 0.001
Duodenal Ulcer	1420	81920	2133.73	243.85	8.75	8.31-9.22	< 0.001
Adults (18-65)	860	31370	2078.80	158.31	13.10	12.3-14.0	< 0.001
65)"}" > Elderly ( >65)	560	49880	2241.79	635.61	3.53	3.25-3.83	< 0.001
Caucasian	960	60480	2111.75	332.84	6.35	5.96-6.76	< 0.001
African American	400	11250	3076.92	294.96	10.40	9.46-11.5	< 0.001
Asian	20	1720	2985.07	322.54	9.26	6.00-14.3	< 0.001
Male	850	45120	2520.01	302.84	8.32	7.78-8.90	< 0.001
Female	570	36660	1733.05	198.49	8.73	8.04-9.48	< 0.001

Table: Table 1. Prevalence of peptic ulcer, gastric ulcer and duodenal ulcer in patients with and without chronic pancreatitis

Disclosures:

Akash Khurana indicated no relevant financial relationships.

Syed Ahmad Adil indicated no relevant financial relationships.

Mohammed Sheriff indicated no relevant financial relationships.

Gregory Cooper indicated no relevant financial relationships.

Akash T. Khurana, MD¹, Syed Ahmad Adil, MD¹, Mohammed Z. Sheriff, MD², Gregory Cooper, MD². B0637 - Prevalence of Non-Helicobacter pyloriPeptic Ulcers in Patients With Chronic Pancreatitis: A Population-Based National Study, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.