Factors Associated with Peptic Ulcer Disease in Buddhist Monks at Priest Hospital from the Case-control Study

Abstract

Background: Peptic ulcer disease (PUD) embraces both gastric and duodenal ulcers.   PUD is a source of significant morbidity and mortality worldwide. The predominant symptom of PUD is epigastric pain but some patients are asymptomatic. The causes of PUD are multifactorial. Buddhist monks who practice religious asceticism by monastic living, abbot environment and one or twice eating before mid-day. The previous studies found different risk factors of PUD. However, nearly total of studies were conducted among laity. Objective: To identify the factors associated with PUD in Thai monks. Methods: A case-control study was conducted among monks who underwent esophagogastroduodenoscopy (EGD) from 1^st September 2018 to 31^st October 2021 at Department of Medicine, Priest Hospital. From 215 monks, after exclusion criteria, 179 monks were included. The statistics was used by binary logistic regression for identifying risk factors of PUD. Results: Total of 179 monks were enrolled in this study. The median age was 63 years old (ranged 22-88). In all, 72 monks (40.2%) had PUD. The prevalence of H. pylori infection was 44.7% (80 of 179 monks). The factors associated with PUD were statistically significant in tobacco smoking (adjusted OR 7.40, 95% CI: 2.99, 18.29), prior history of PUD (adjusted OR 8.94, 95% CI: 2.11, 37.76) and H. pylori infection (adjusted OR 4.20, 95% CI: 1.88, 9.42). However, PUD was not significantly associated with age, intake of nonsteroidal anti-inflammatory drugs (NSAIDS), number of meals per day or duration of ordination. Conclusion: Tobacco smoking, prior history of PUD and H. pylori infection are the factors associated with PUD in Buddhist monks at Priest Hospital. Nonetheless, the Buddhist priests way of living is not a risk factor causing PUD.