Duodenal ulcer and Helicobacter pylori infection at high altitude: Experience from southern Saudi Arabia

OBJECTIVE: To study the clinical presentation, endoscopic features and prevalence of Helicobacter pylori in duodenal ulcer (DU) patients in southern Saudi Arabia, located 3150 m above sea level, and to compare results with those from low altitude regions of the Kingdom. METHODS: Prospective study of patients with proven DU referred for upper gastrointestinal endoscopy at Asir Central Hospital Abha, southern Saudi Arabia over an 18-month period. RESULTS: Of 126 patients with proven DU, 72% were men and mean age was 40.4 years (range 18 to 68). Twenty-eight percent a were smokers and only 5% used nonsteroidal anti-inflammatory drugs. Thirty-eight patients (30%) presented with hematemesis or melena, and the majority had a single ulcer. Nineteen per cent of patients with dyspepsia had DU and 96% had H pylori. These results are comparable with those reported from the low altitude, warmer regions of Saudi Arabia. CONCLUSIONS: Age of patients and the male:female ratio were similar to those in developing countries. The frequency of smoking is lower than in western countries and no patient in this report consumed alcohol. High altitude did not affect the prevalence of DU or the frequency of H pylori because the results were comparable with those from the low altitude areas of the Kingdom Saudi Arabia and other lowland developing countries. Although great socioeconomic changes have increased the incidence of heart disease, the patterns of DU and H pylori infection assume those in developing nations.