scholarly journals Peptic Ulcer: Chapter Closed?

2020 ◽  
Vol 38 (Suppl. 2) ◽  
pp. 112-116 ◽  
Author(s):  
Peter Malfertheiner ◽  
Christian Schulz
Keyword(s):  
Peptic Ulcer ◽  
High Speed ◽  
High Rate ◽  
Ulcer Bleeding ◽  
Accurate Identification ◽  
Ulcer Disease ◽  
History Of ◽  
Ulcer Complications ◽  
H Pylori ◽  
The Individual

The incidence of peptic ulcer disease (PUD) peaked in the late 19th century while transiting into the 20th century. With entry in the new millennium a significant decrease of PUD has occurred. However, demographic changes with an increasing elderly population associated with multiple comorbidities and polypharmacy became responsible for a persistent high rate of peptic ulcer complications. The acid driven concept of PUD has directed the development of surgical procedures and drugs with an increasing potency in acid suppression. High speed of symptom resolution and rapid ulcer healing was obtained with the introduction of proton pump inhibitors, but cure of PUD has failed. The arrival of Helicobacter pylori has revolutionized the history of PUD which has become a curable disease by successful cure of the infection. However, new challenges have emerged with an increase of treatment failures due to increasing antibiotic resistance of H. pylori. The changing pattern in the prevalence of etiologies other than H. pylori demands for accurate identification of the ulcerogenic cause in the individual patient to allow for proper selection of therapy. Management of peptic ulcer bleeding remains a critical clinical challenge. The chapter of PUD is reduced in size and has become more heterogeneous – but is not closed!

Peptic Ulcer Disease

2014 ◽  
pp. 710-718
Author(s):  
Tyler M. Berzin ◽  
Kenneth R. Falchuk
Keyword(s):  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
The United States ◽  
Dietary Factors ◽  
Pathogenic Agent ◽  
Ulcer Disease ◽  
History Of ◽  
Ulcer Complications ◽  
H Pylori

Peptic ulcer disease (PUD) involves the stomach or duodenum and is a significant cause of morbidity and mortality both in the United States and worldwide, with a lifetime prevalence estimated at 5–15%. For a good part of the 20th century PUD was felt to be a condition related to stress and dietary factors. More recently, our understanding of PUD has been advanced by research into the role of gastric acid secretion and the benefits of various classes of antisecretory medications and, perhaps most importantly, in 1984, by Warren and Marshall, who identified Helicobacter pylori (H. pylori) as a pathogenic agent in this disease. Proton pump inhibitor (PPI) therapy and H. pylori eradication regimens have altered the natural history of what once was a chronic disease, and they have also reduced peptic ulcer complications, limiting the need for surgery.

scholarly journals Evidence-based clinical practice guidelines for peptic ulcer disease 2020

2021 ◽  
Author(s):  
Tomoari Kamada ◽  
Kiichi Satoh ◽  
Toshiyuki Itoh ◽  
Masanori Ito ◽  
Junichi Iwamoto ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Clinical Practice ◽  
Practice Guidelines ◽  
Eradication Therapy ◽  
Ulcer Recurrence ◽  
Evidence Based ◽  
Peptic Ulcers ◽  
Ulcer Disease ◽  
History Of ◽  
H Pylori

AbstractThe Japanese Society of Gastroenterology (JSGE) revised the third edition of evidence-based clinical practice guidelines for peptic ulcer disease in 2020 and created an English version. The revised guidelines consist of nine items: epidemiology, hemorrhagic gastric and duodenal ulcers, Helicobacter pylori (H. pylori) eradication therapy, non-eradication therapy, drug-induced ulcers, non-H. pylori, and nonsteroidal anti-inflammatory drug (NSAID) ulcers, remnant gastric ulcers, surgical treatment, and conservative therapy for perforation and stenosis. Therapeutic algorithms for the treatment of peptic ulcers differ based on ulcer complications. In patients with NSAID-induced ulcers, NSAIDs are discontinued and anti-ulcer therapy is administered. If NSAIDs cannot be discontinued, the ulcer is treated with proton pump inhibitors (PPIs). Vonoprazan (VPZ) with antibiotics is recommended as the first-line treatment for H. pylori eradication, and PPIs or VPZ with antibiotics is recommended as a second-line therapy. Patients who do not use NSAIDs and are H. pylori negative are considered to have idiopathic peptic ulcers. Algorithms for the prevention of NSAID- and low-dose aspirin (LDA)-related ulcers are presented in this guideline. These algorithms differ based on the concomitant use of LDA or NSAIDs and ulcer history or hemorrhagic ulcer history. In patients with a history of ulcers receiving NSAID therapy, PPIs with or without celecoxib are recommended and the administration of VPZ is suggested for the prevention of ulcer recurrence. In patients with a history of ulcers receiving LDA therapy, PPIs or VPZ are recommended and the administration of a histamine 2-receptor antagonist is suggested for the prevention of ulcer recurrence.

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.

A STUDY ON PREVALENCE OF HELICOBACTER PYLORI IN BLEEDING PEPTIC ULCER USING RAPID UREASE TEST

2021 ◽  
pp. 82-83
Author(s):  
Lokesh M N ◽  
Anil Kumar K N ◽  
Madan M
Keyword(s):  
Duodenal Ulcer ◽  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Bleeding Peptic Ulcer ◽  
Ulcer Bleeding ◽  
Rapid Urease Test ◽  
Ulcer Disease ◽  
Urease Test ◽  
H Pylori

BACKGROUND: Helicobacter pylori (H. pylori) is the leading cause of peptic ulcer disease in India. Timely diagnosis and proper treatment is required for the eradication of H. pylori infection and prevention of its associated complications. AIMS AND OBJECTIVES: This study aims to evaluate the prevalence of H. pylori infection in patients presenting with bleeding peptic ulcer. MATERIAL AND METHODS: This is prospective study conducted from January 2019 till January 2021 in patients with bleeding peptic ulcer admitted at BGS Global Institute of Medical Sciences. All the patients under went endoscopy and biopsy was taken from Antral region for Rapid Urease Test. RESULT: 164 patients were included in the study with duodenal ulcer bleeding in 129 (78.6%) patients, gastric ulcer in 30 (18.3%) patients and both gastric and duodenal ulcer in 5 (3.1%) patients. Positivity for RUT was seen in 147 patients (89.6%). CONCLUSION: Early intervention in the patients with peptic ulcer disease in the form of endoscopic biopsy will help in prevention of recurrent bleeding episodes and other associated complications.

Lifestyle and Peptic Ulcer Disease

2018 ◽  
Vol 24 (18) ◽  
pp. 2034-2040 ◽  
Author(s):  
Berrak C. Yegen
Keyword(s):  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Alcohol Intake ◽  
Night Sleep ◽  
Unhealthy Lifestyle ◽  
Coping With Stress ◽  
Analgesic Drugs ◽  
Ulcer Disease ◽  
Balanced Diet ◽  
H Pylori

The risk of developing Peptic Ulcer Disease (PUD) was shown to be associated with genetic inheritance, lifestyle and social status of the patients. Unhealthy lifestyle habits and failure in coping with stress have been closely associated with the occurrence of PUD. In contrary, limiting the use of analgesic drugs and glucocorticoids, controlling environmental and socioeconomic factors that predispose to H. Pylori infection, having a balanced diet, exercising regularly, coping successfully with stress, avoiding smoking, limiting alcohol intake and getting sufficient night sleep are essential in prevention and healing of PUD.

scholarly journals The number of household members as a risk factor for peptic ulcer disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mi Hong Yim ◽  
Keun Ho Kim ◽  
Bum Ju Lee
Keyword(s):  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Living Alone ◽  
Cross Sectional ◽  
Ulcer Disease ◽  
Logistic Regression Models ◽  
Household Members ◽  
H Pylori

AbstractPeptic ulcer disease (PUD) is caused by many sociodemographic and economic risk factors other than H. pylori infection. However, no studies reported an association between PUD and the number of household members. We showed the number of family members affected by PUD based on sex in a Korean population. This cross-sectional study used 1998–2009 data from the Korea National Health and Nutrition Examination Survey of the Korea Centers for Disease Control and Prevention. Multiple binary logistic regression models adjusted for confounders were constructed to analyze the association of PUD with the number of household members. The number of household members was associated with PUD, age, body mass index (BMI), waist circumference, systolic blood pressure, hemoglobin, glucose, location (urban/rural), income, education level, stress, current drinking, and smoking in both sexes. Men with other household members had a higher PUD risk compared to men or women living alone (reference), and the opposite was observed for women. Men with 4 household members had a higher PUD risk than men living alone in the model adjusted for age, BMI, income, location, education, and stress (OR = 2.04 [95% CI 1.28–3.27], p value = .003). Women with more than 6 household members had a lower PUD risk than women living alone in the adjusted model (OR = 0.50 [0.33–0.75], p value = .001). Women with more household members had a lower PUD risk. However, more men had PUD than women regardless of the number of household members.

scholarly journals Performance Comparison of the Deep Learning and the Human Endoscopist for Bleeding Peptic Ulcer Disease

2021 ◽  
Author(s):  
Hsu-Heng Yen ◽  
Ping-Yu Wu ◽  
Pei-Yuan Su ◽  
Chia-Wei Yang ◽  
Yang-Yuan Chen ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Deep Learning ◽  
Sensitivity And Specificity ◽  
Endoscopic Therapy ◽  
Learning Model ◽  
Ulcer Bleeding ◽  
Learning Models ◽  
Peptic Ulcer Bleeding ◽  
Ulcer Disease ◽  
Deep Learning Model

Abstract Purpose Management of peptic ulcer bleeding is clinically challenging. Accurate characterization of the bleeding during endoscopy is key for endoscopic therapy. This study aimed to assess whether a deep learning model can aid in the classification of bleeding peptic ulcer disease. Methods Endoscopic still images of patients (n = 1694) with peptic ulcer bleeding for the last 5 years were retrieved and reviewed. Overall, 2289 images were collected for deep learning model training, and 449 images were validated for the performance test. Two expert endoscopists classified the images into different classes based on their appearance. Four deep learning models, including Mobile Net V2, VGG16, Inception V4, and ResNet50, were proposed and pre-trained by ImageNet with the established convolutional neural network algorithm. A comparison of the endoscopists and trained deep learning model was performed to evaluate the model’s performance on a dataset of 449 testing images. Results The results first presented the performance comparisons of four deep learning models. The Mobile Net V2 presented the optimal performance of the proposal models. The Mobile Net V2 was chosen for further comparing the performance with the diagnostic results obtained by one senior and one novice endoscopists. The sensitivity and specificity were acceptable for the prediction of “normal” lesions in both 3-class and 4-class classifications. For the 3-class category, the sensitivity and specificity were 94.83% and 92.36%, respectively. For the 4-class category, the sensitivity and specificity were 95.40% and 92.70%, respectively. The interobserver agreement of the testing dataset of the model was moderate to substantial with the senior endoscopist. The accuracy of the determination of endoscopic therapy required and high-risk endoscopic therapy of the deep learning model was higher than that of the novice endoscopist. Conclusions In this study, the deep learning model performed better than inexperienced endoscopists. Further improvement of the model may aid in clinical decision-making during clinical practice, especially for trainee endoscopist.

scholarly journals Identification of Markers for Helicobacter pylori Strains Isolated from Children with Peptic Ulcer Disease by Suppressive Subtractive Hybridization

2006 ◽  
Vol 74 (7) ◽  
pp. 4064-4074 ◽  
Author(s):  
Mónica Oleastro ◽  
Lurdes Monteiro ◽  
Philippe Lehours ◽  
Francis Mégraud ◽  
Armelle Ménard
Keyword(s):  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Subtractive Hybridization ◽  
Suppressive Subtractive Hybridization ◽  
Ulcer Disease ◽  
Lipopolysaccharide Biosynthesis ◽  
The Difference ◽  
H Pylori

ABSTRACT Peptic ulcer disease (PUD) occurs after a long-term Helicobacter pylori infection. However, the disease can develop earlier, and rare cases have been observed in children, suggesting that these H. pylori strains may be more virulent. We used suppressive subtractive hybridization for comparative genomics between H. pylori strains isolated from a 5-year-old child with duodenal ulcer and from a sex- and age-matched child with gastritis only. The prevalence of the 30 tester-specific subtracted sequences was determined on a collection of H. pylori strains from children (15 ulcers and 30 gastritis) and from adults (46 ulcers and 44 gastritis). Two of these sequences, jhp0562 (80.0% versus 33.3%, P = 0.008) and jhp0870 (80.0% versus 36.7%, P = 0.015), were highly associated with PUD in children and a third sequence, jhp0828, was less associated (40.0% versus 10.0%, P = 0.048). Among adult strains, none of the 30 sequences was associated with PUD. However, both jhp0562 and jhp0870 were less prevalent in adenocarcinoma strains than in PUD strains from children and adults, the difference being statistically significant for jhp0870. In conclusion, two H. pylori genes were identified as being strongly associated with PUD in children, and their putative roles as an outer membrane protein for jhp0870 and in lipopolysaccharide biosynthesis for jhp0562, suggest that they may be novel virulence factors of H. pylori.

scholarly journals TWO YEARS FOLLOW UP AFTER ERADICATION THERAPY OF PEPTIC ULCER

2020 ◽  
pp. 28-31
Author(s):  
HASSAN KHUDER RAJAB ◽  
ALI ESMAIL AL-SNAFI
Keyword(s):  
Peptic Ulcer ◽  
Eradication Therapy ◽  
Endoscopic Examination ◽  
Urea Breath Test ◽  
Ulcer Recurrence ◽  
Follow Up Study ◽  
History Of ◽  
Second Year ◽  
H Pylori

Objective: This study was performed to detect the recurrence rate for two years after eradication therapy of peptic ulcer. Methods: Sixty-nine patients included in this study in Kirkuk city from January 2004 to January 2005 as 1st year follow up, and 49 patients from January 2005 to January 2006 as second year follow up study. A urea breath test and re-endoscopic examination were carried out to confirm peptic ulcer recurrence. A questionnaire was prepared to take the history of the disease and other relevant data of each patient. Results: The recurrence was occurred in 6 (8.7%) and 8 patients (16.33%) in the 1st and 2nd years after eradication therapy. Highly risk of recurrence was smoking, age below 50 y and stress in 1st year follow up, and stress was the highly risk in the 2nd year follow up. Conclusion: After triple and quadruple therapy of peptic ulcer, the recurrence is low, However, the possibility of H. pylori resistance should be considered.

scholarly journals Correlation of Clinical, Endoscopic, and Pathological Findings among Suspected Peptic Ulcer Disease Patients in Abuja, Nigeria

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Onyedika Godfrey Okoye ◽  
Oluwole Olayemi Olaomi ◽  
Alexander M.E. Nwofor ◽  
Paul Jibrin ◽  
Cephas Shallangwa Batta ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Gastrointestinal Endoscopy ◽  
Upper Gastrointestinal Endoscopy ◽  
Pathological Findings ◽  
Histological Findings ◽  
National Hospital ◽  
Ulcer Disease ◽  
Endoscopic Findings ◽  
H Pylori ◽  
Upper Gastrointestinal

Background. Peptic ulcer disease (PUD) remains one of the most prevalent gastrointestinal diseases and has been linked to Helicobacter pylori (H. pylori) infection. This condition may be suspected on clinical grounds, but diagnosis is established using upper gastrointestinal endoscopy. Aims. To determine the correlation between the endoscopic and pathological findings among suspected PUD patients who have been referred for diagnostic upper gastrointestinal endoscopy in National Hospital Abuja. Methods. This is a hospital-based prospective study conducted among suspected PUD patients at National Hospital Abuja over a one-year period. Clinical, endoscopic, and histological findings were ascertained and documented. Data obtained were analyzed using SPSS version 21.0. Tests of significance were done using the chi-square test and Student t -test at 95% confidence intervals. Results. One hundred and thirty-two patients were included in the study. The ages ranged from 15 to 87 years, mean age 43.30 ± 11.94 years. Seventy-seven (58.3%) patients had abnormal endoscopic findings, of whom 37 (28.0%) had PUD. Prevalence of H. pylori infection was 42.2% and was found in 81.1% of PUD patients. H. pylori was significantly associated with confirmed PUD ( p < 0.001 ) and abnormal endoscopic findings ( p < 0.001 ). No association was found between normal endoscopic findings and histological findings ( p = 0.924 ). Conclusion. There is a poor correlation between clinical and endoscopic diagnoses of PUD. H. pylori was found to be significantly associated with PUD and abnormal endoscopic findings. Endoscopic facilities should therefore be made available and accessible for proper PUD diagnosis. Empirical treatment of H. pylori in patients with diagnosed PUD is strongly recommended.

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