Peptic ulcer secondary prevention

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2017 ACG Guidelines for Peptic Ulcer Disease

Guidelines for the Indications to Test for, and to Treat, H. pylori Infection

Guidelines for First line Treatment Strategies of Peptic Ulcer Disease for Providers in North America

Guidlines for factors that predict the successful eradication when treating H. pylori infection

Guidelines to document H. pylori antimicrobial resistance in the North America

Guidelines for evaluation and testing of H. pylori antibiotic resistance

Guidelines for when to test for treatment success after H. pylori eradication therapy

Guidelines for penicillin allergy in patients with H. pylori infection

Guidelines for the salvage therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Manpreet Kaur, MD [2]

Overview

Helicobacter pylori eradication alone was proved to be insufficient for secondary prevention of peptic ulcer bleeding, and therefore long-term proton pump inhibitor therapy is needed.FDA approved proton pump ihibitors include lansoprazole, omeprazole, esomeprazole, and rabeprazole, which are indicated for risk reduction of duodenal ulcer recurrence.

Secondary Prevention

The following measures have been used in the secondary prophylaxis of peptic ulcer and its complications:

  • Stop NSAID
  • H. pylori eradication
  • Maintenance acid suppressive therapy
  • Acid-reducing surgical procedures[1][2]

References

  1. Chan FK, Chung SC, Suen BY, Lee YT, Leung WK, Leung VK; et al. (2001). "Preventing recurrent upper gastrointestinal bleeding in patients with Helicobacter pylori infection who are taking low-dose aspirin or naproxen". N Engl J Med. 344 (13): 967–73. doi:10.1056/NEJM200103293441304. PMID 11274623.
  2. Malfertheiner P, Mégraud F, O'Morain C, Hungin AP, Jones R, Axon A; et al. (2002). "Current concepts in the management of Helicobacter pylori infection--the Maastricht 2-2000 Consensus Report". Aliment Pharmacol Ther. 16 (2): 167–80. PMID 11860399.

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