THE ROLE OF DIFFERENT FACTORS IN THE DEVELOPMENT OF COMPLICATIONS OF GASTRIC AND DUODENAL PEPTIC ULCER DISEASE

Peptic ulcer disease (PUD) of the stomach and duodenum remains an important clinical problem despite significant advances in the diagnosis and treatment of gastrointestinal diseases. The clinical significance of PUD is determined not only by its prevalence and recurrent course but also by the possibility of developing severe complications, including gastroduodenal bleeding, perforation, penetration, and pyloroduodenal stenosis [1,2]. These complications are associated with increased morbidity, prolonged hospitalization, the need for endoscopic or surgical treatment, and an increased risk of mortality. The development of complications of PUD is multifactorial. The most important risk factors include Helicobacter pylori infection, the use of non-steroidal anti-inflammatory drugs (NSAIDs), acetylsalicylic acid, anticoagulants and antiplatelet agents, smoking, alcohol consumption, advanced age, severe comorbidities, previous ulcer disease and gastrointestinal bleeding, as well as the characteristics of the ulcer itself [3–6]. The interaction between several risk factors may substantially increase the probability of complications. The highest risk of ulcer-related bleeding and perforation is observed in elderly patients, particularly those receiving NSAIDs, aspirin or antithrombotic therapy and those with cardiovascular or renal comorbidities [6,8]. Therefore, modern management of PUD requires not only treatment of the ulcerative defect but also comprehensive assessment of individual risk factors and preventive measures.