scholarly journals Update on the Role ofH pyloriInfection in Gastrointestinal Disorders

2001 ◽  
Vol 15 (4) ◽  
pp. 251-255 ◽  
Author(s):  
Hugh Chaun
Keyword(s):  
Peptic Ulcer ◽  
Proton Pump ◽  
Term Treatment ◽  
Ulcer Bleeding ◽  
Gastrointestinal Disorders ◽  
Onset Of Action ◽  
Ulcer Disease ◽  
Long Term Treatment ◽  
Anti Inflammatory ◽  
H Pylori

Infection withHelicobacter pyloriis accepted as the primary cause of peptic ulcer disease, and there is evidence to suggest its role in other gastrointestinal disorders. An estimated 20% to 40% of the Canadian population is infected withH pylori; however, clinically relevant disease is present in only approximately 10% to 20% of these individuals. Therefore, it is crucial to identify the diseases for which eradication ofH pyloriis beneficial to ensure that patients do not receive unnecessary treatment. In patients with ulcers induced by long term treatment with nonsteroidal anti-inflammatory drugs, preliminary results suggest that eradication ofH pylorimay reduce the risk of peptic ulcer bleeding. Furthermore, a benefit has been observed for the eradication ofH pyloribefore patients commence therapy with a nonsteroidal anti-inflammatory drug. An association between the presence ofH pyloriand specific dyspeptic symptoms has yet to be established; however, there may be a subset of patients with functional dyspepsia who benefit from the eradication ofH pylori. The relationship between gastroesophageal reflux disorder andH pyloriinfection remains unclear. In Canada, the recommended therapy for the eradication ofH pyloriis seven days of twice-daily treatment with a proton pump inhibitor, clarithromycin, and amoxicillin or metronidazole. Although the proton pump inhibitors are treated as a class for use in these regimens, there is suggestion that a faster onset of action may lead to a higher rate of eradication.

Peptic ulcer disease

2020 ◽  
pp. 2849-2861
Author(s):  
Joseph Sung
Keyword(s):  
Peptic Ulcer ◽  
Proton Pump Inhibitor ◽  
Peptic Ulcer Disease ◽  
Proton Pump ◽  
Gastric Ulcers ◽  
High Dose ◽  
Recurrent Bleeding ◽  
Ulcer Disease ◽  
H Pylori ◽  
Line Of Therapy

Helicobacter pylori infection, use of nonsteroidal anti-inflammatory drugs (NSAIDs) including aspirin, and smoking are the most important causes of peptic ulcer disease. Peptic ulcer disease is characterized by a history of waxing and waning symptoms of localized, dull, aching pain in the upper abdomen. Bleeding is the most common complication; free perforation of the stomach or duodenum into the peritoneal cavity is uncommon but serious. The diagnosis of peptic ulcer disease is made by endoscopy, which offers an opportunity for biopsy of gastric ulcers (which may be malignant) and reveals important prognostic indicators in patients with bleeding ulcers. A single daily dose of a proton pump inhibitor gives quick relief of symptoms and effective healing of peptic ulcers in 4 to 6 weeks. The management of patients with upper gastrointestinal haemorrhage requires a multidisciplinary medical and surgical approach. Early risk stratification based on clinical and endoscopic criteria allows delivery of appropriate care, with endoscopic intervention now widely accepted as the first line of therapy. This should be followed by administration of a high dose of an intravenous proton pump inhibitor to further reduce recurrent bleeding. Treatment of H. pylori is a cure for peptic ulcer disease in most patients. This usually requires at least two antimicrobial agents, with the most popular triple therapy combining a proton pump inhibitor with any two of amoxicillin, metronidazole, and clarithromycin for 7 to 14 days. Eradication of H. pylori infection, avoidance of high-dose NSAIDs or aspirin, and the maintenance use of proton pump inhibitors in high-risk individuals are the best ways to prevent recurrence of ulcer and ulcer complications.

scholarly journals Risk of Recurrent Peptic Ulcer Disease in Patients Receiving Cumulative Defined Daily Dose of Nonsteroidal Anti-Inflammatory Drugs

2019 ◽  
Vol 8 (10) ◽  
pp. 1722
Author(s):  
Chih-Ming Liang ◽  
Shih-Cheng Yang ◽  
Cheng-Kun Wu ◽  
Yu-Chi Li ◽  
Wen-Shuo Yeh ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Eradication Therapy ◽  
Case Control ◽  
Defined Daily Dose ◽  
Ulcer Disease ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
H Pylori

The purpose of this population-based case–control study was to clarify the impact of cumulative dosage of nonsteroidal anti-inflammatory drugs (NSAIDs) on recurrent peptic ulcers among chronic users after Helicobacter pylori (H. pylori) eradication. We analyzed data of 203,407 adult peptic ulcer disease (PUD) patients from the National Health Insurance Research Database in Taiwan entered between 1997 and 2013. After matching for age/gender frequencies and the length of follow-up time in a ratio of 1:1, the matched case–control groups comprised 1150 patients with recurrent PUD and 1150 patients without recurrent PUD within 3 years of follow-up. More recurrent PUDs occurred in NSAID users than in the control group (75.30% versus 69.74%; p = 0.0028). Independent risk factors for recurrent PUD included patients using NSAIDs (adjusted OR (aOR): 1.34, p = 0.0040), H. pylori eradication (aOR: 2.73; p < 0.0001), concomitant H2 receptor antagonist (aOR: 1.85; p < 0.0001) and anti-coagulant (aOR: 4.21; p = 0.0242) use. Importantly, in the initial subgroup analysis, the risk ratio of recurrent PUD did not increase in NSAID users after H. pylori eradication compared with that in non-users (p = 0.8490) but a higher risk for recurrent PUD with the increased doses of NSAIDs without H. pylori eradication therapy (aOR: 1.24, p = 0.0424; aOR: 1.47, p = 0.0074; and aOR: 1.64, p = 0.0152 in the groups of ≤28, 29–83, and ≥84 cumulative defined daily doses, respectively). The current study suggested that H. pylori eradication therapy could decrease the risk of recurrent PUD among patients with high cumulative doses of NSAIDs.

scholarly journals Significance of Helicobacter pylori infection and nonsteroidal anti-inflammatory drugs in patients with bleeding from upper part of the gastrointestinal tract

2007 ◽  
Vol 64 (7) ◽  
pp. 445-448
Author(s):  
Gradimir Golubovic ◽  
Ratko Tomasevic ◽  
Biljana Radojevic ◽  
Aleksandar Pavlovic ◽  
Predrag Dugalic
Keyword(s):  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Ulcer Bleeding ◽  
Significant Difference ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
H Pylori ◽  
Upper Gastrointestinal

Background/Aim. Helicobacter pylori (H. pylori) infection and nonsteroidal anti-inflammatory drugs (NSAIDs) use are considered to be the most important risk factors having influence on the onset of bleeding gastroduodenal lesions. Whether there is an interaction between H. pylori infection and the use of NSAIDs in the development of peptic ulcer disease is still controversial. The aim of the present study was to evaluate the prevalence of NSAIDs use and H. pylori infection in patients presented with bleeding gastroduodenal lesions. Methods. During the period from January 2003 - December 2003 we prospectively obtained data of all the patients (n=106) presented with signs of upper gastrointestinal bleeding. All the patients were admitted to the intensive care unit, with the endoscopy performed within 12 hours after admission. Histologic analysis was used for the detection of H. pylori infection. The NSAIDs and aspirin use data were obtained by anamnesis. Results. The results of our study revealed that the most common sources of upper gastrointestinal bleeding were duodenal (57 patients, 53.77%) and ventricular (36 patients, 33.96%) ulcers. The majority of the examined cases were associated with both H. pylori infection and NSAIDs use. A statistically significant difference among the studied groups of patients was proven. Conclusion. The majority of bleeding gastroduodenal lesions were associated with the coexistence of H. pylori infection and NSAIDs use, while their independent influences were statistically less important. Eradication of H. pylori infection in patients using NSAIDs might prevent upper gastrointestinal hemorrhage and reduce peptic ulcer bleeding risk. .

Three computer models for the calculation of prevalence of peptic ulcer disease during long-term treatment

2007 ◽  
Vol 2 (5) ◽  
pp. 407-418 ◽  
Author(s):  
D. D. UNDERWOOD ◽  
J. C. AMOS ◽  
C. W. VENABLES ◽  
K. D. BARDHAN ◽  
J. BERESFORD ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Computer Models ◽  
Term Treatment ◽  
Ulcer Disease ◽  
Long Term Treatment

scholarly journals Dyspepsia: literature review and evidence for management in primary care

2018 ◽  
Vol 60 (3) ◽  
pp. 25-32
Author(s):  
M. Torlutter ◽  
S. C. Onwukwe ◽  
D. Pretorius ◽  
N. M. Mpangula ◽  
O. B. Omole
Keyword(s):  
Primary Care ◽  
Peptic Ulcer ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Literature Review ◽  
Proton Pump ◽  
Ulcer Disease ◽  
Clinical Encounters ◽  
Common Causes ◽  
H Pylori

Dyspepsia is a common reason for the clinical encounters in primary care. Two common causes of dyspepsia are gastroesophageal reflux disease (GERD) and peptic ulcer disease (PUD). These diseases clinically overlap and may present diagnostic and management challenges in primary care, especially in low resource settings. Proton pump inhibitors, eradication of H. pylori infection and endoscopy form the backbone of management of both diseases. This article reviews current considerations in the diagnosis and management of GERD and PUD in primary care.

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