COMMENTARY
See article on page 452
The aging stomach or the stomachs of the ages
| The first 150 words of the full text of this article appear below. |
Although few would challenge the role of Helicobacter
pylori as a major gastroduodenal pathogen, many paradoxes
remain. Infection is mainly acquired in childhood, yet the major
symptomatic diseases, peptic ulcer and gastric cancer, occur
predominantly in adults or the elderly. Patterns of disease vary within
and between different populations. In some countries, the incidence of
duodenal ulcer is high whereas in others the progression of H
pylori associated pathology is more towards gastric ulcer and
adenocarcinoma. These patterns of disease are changing in certain
countries and this seems to correlate with improvements in
socioeconomic status. Thus in the United Kingdom and the United States,
peptic ulcer and gastric cancer were rare before the 19th
century.1 2
From the middle 1800s, gastric ulcer and
cancer increased and by the early 1900s duodenal ulcers appeared and
slowly started to surpass gastric ulcers in frequency. In more recent
times, there has been a decline
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