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In a retrospective study of endoscopy clinic patients in Northern Italy from 1981 to 1985, the number of confirmed duodenal ulcers (DU) exceeded that of gastric ulcers (GU) by a ratio of 6.6 to 1. This is in marked contrast to findings from recent studies in Northern Europe, but similar to those in the United States. Of 1,383 patients studied, 33% exhibited DU, 5% had GU, and 1% had both duodenal and gastric lesions; 20% were diagnosed with nonulcer dyspepsia (NUD), while the remaining 41% had other upper gastrointestinal diseases. Patients with confirmed peptic ulcers (n = 531) were compared to those with NUD (n = 271). Significant differences were noted regarding sex, smoking habits, symptomatology, and hospitalization rates. Patients with endoscopically or radiologically confirmed peptic ulcers were more often males and smokers. They more often presented with typical symptoms and had higher total hospitalization rates than NUD patients. No differences were noted regarding age distribution or coffee or alcohol consumption.