> There was a massive decline in diagnosis of peptic ulcers. People just stopped getting them so often in the first place.
Once we understood the causes (H. pylori infection primarily, NSAID overuse secondarily) we were able to manage the second and intervene to control the first based on symptoms that develop before the peptic ulcers.
Additionally, the H. pylori infection rates are much higher in older Americans (H. pylori infections typically have a long lead time before developing any symptoms), probably because of lifestyle changes that have reduced environmental exposure. So with less and less people having H. pylori infection in succeeding cohorts, there's a decline in peptic ulcers.
We know the connection between the causes and the decline. And, yes, some of it is that medicine cured the problem (earlier intervention for H. pylori infections), and some of it is awareness of medicine side effects reduced actions causing the problem (NSAIDs), and some of it is that the age cohort that had been most exposed to H. pylori infection and was most at risk became a smaller share of the population as time progressed.
Once we understood the causes (H. pylori infection primarily, NSAID overuse secondarily) we were able to manage the second and intervene to control the first based on symptoms that develop before the peptic ulcers.
Additionally, the H. pylori infection rates are much higher in older Americans (H. pylori infections typically have a long lead time before developing any symptoms), probably because of lifestyle changes that have reduced environmental exposure. So with less and less people having H. pylori infection in succeeding cohorts, there's a decline in peptic ulcers.
We know the connection between the causes and the decline. And, yes, some of it is that medicine cured the problem (earlier intervention for H. pylori infections), and some of it is awareness of medicine side effects reduced actions causing the problem (NSAIDs), and some of it is that the age cohort that had been most exposed to H. pylori infection and was most at risk became a smaller share of the population as time progressed.