The Association of Diffuse Obstructive Pulmonary Emphysema and Chronic Gastroduodenal Ulceration

¹ Department of Internal Medicine, Lahey Clinic
² Lahey Clinic

The results of our studies confirm the previous reports in the literature of the frequent association of chronic pulmonary emphysema and gastroduodenal ulceration. In addition, this study demonstrates that there is an increased incidence of peptic ulcers in patients with mild and moderate emphysema as well as in those with severe disease. The majority of the ulcers were duodenal. Ulcer complications were slightly more frequent in patients with emphysema than in the general ulcer population. Bleeding was the most frequent complication. The presence of polycythemia and the use of respiratory medications, Rauwolfia derivatives and corticosteroids, were not factors contributing to the high incidence of ulcers in our emphysema group. Although many theories have been proposed to account for the coexistence of pulmonary emphysema and peptic ulcer, the actual cause or causes of this association are unknown. Retrospective studies such as ours leave many unanswered questions but serve as the necessary preparation for more penetrating prospective research. Because of the frequent association of these two diseases, however, it is important that the patient with peptic ulcer have a careful examination of his chest, especially if surgery is needed, and that in the patient with pulmonary emphysema a careful search for peptic ulcer be made.