The influence of the age of onset of symptoms on various clinical features of peptic ulcer was studied in a personal series of 492 patients (duodenal ulcer 363, gastric ulcer 98, combined gastric and duodenal ulcer 31). Duodenal ulcer patients whose age of onset of symptoms was within the first three decades (n = 166) were more likely to be men (77%) and to have a positive family history of dyspepsia (45%) and a history of haemorrhage (46%) when compared with late onset patients (n = 197, men 57%, positive family history 23%, history of haemorrhage 36%). Early onset duodenal ulcer patients also secreted more gastric acid than late onset patients. In contrast, while early onset gastric ulcer patients were more likely to be men, when compared to late onset patients, the two groups were similar in their family history of dyspepsia, their history of haemorrhage, and their gastric acid output. The age of onset of Malay duodenal ulcer patients (mean (SD) 43.6 (16.0] was higher than those for Chinese patients (33.7 (16.1].
A total of 1,688 non-repeat upper gastrointestinal endoscopies performed over a 33-month period from April 1985 to December 1987 at a University Medical Unit in Kuala Lumpur was analysed for a profile of peptic ulcer disease amongst Malaysians. There was a total of 360 peptic ulcer patients with a gastric ulcer to duodenal ulcer ratio of 1:1. The male: female ratio was 2.8: 1 for duodenal ulcer and 1.8:1 for gastric ulcer, and 2.3:1 for peptic ulcer overall. In both sexes, gastric ulcers were seen at an older age group compared to duodenal ulcers.
Of the three main Malaysian ethnic groups of Malays, Chinese and Indians, Chinese of both sexes had the highest frequency of gastric ulcers. Chinese females had the highest frequency of duodenal ulcers.
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.