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International Journal of Epidemiology 2002;31:13-17
© International Epidemiological Association 2002

Reprints and Reflections

Civilization and peptic ulcer*

Mervyn Sussera and Zena Steinb

a Department of Social and Preventive Medicine, University of Manchester and Salford Health Department.
b Mental Health Research Fund, Department of Social and Preventive Medicine, University of Manchester.

Remarkable changes have occurred in the sex and age incidence of peptic ulcer in North-West Europe. The fluctuations over the previous hundred and fifty years were studied by Jennings (1940).1 He examined the incidence of perforations, which provide perhaps the most uniform index of the incidence of ulcers for the total period. His interpretation suggested that during this period there had been three observable syndromes: perforations of acute gastric ulcers in young women; perforations of duodenal ulcers in young and middle-aged men; and perforations of gastric ulcers in older men.1

Perforations began to be noted with increasing frequency at the beginning of the 19th century. Half of all perforations were then in young women in their twenties, and these reached a peak in the latter half of the century. They seemed to be acute gastric ulcers, which caused death from perforations near the cardia, or from haemorrhage.1,2 By the . . . [Full Text of this Article]

Analysis by Cohorts

Death by age and sex
Perforations
Social class
Discussion

Aetiology
Summary

Notes

References


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