Peptic ulcer disease in the elderly poses challenges to the physician distinct from those encountered in younger individuals. Factors predisposing to the more aggressive natural history of peptic ulcer disease in the elderly are examined. These are of great importance in considering diagnostic investigations, the choice of therapeutic agents, and the management of complications. Despite advances in operative technique and care, surgery, particularly when emergent, is attended by a high mortality in this group. The utility of diagnostic and therapeutic endoscopy is discussed, and strategies for short and longer term medical treatment are presented.
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