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{{Peptic ulcer}}
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==Overview==
 
''[[Helicobacter pylori]]'' eradication has been proved as the most cost-effective strategy for primary prevention of [[NSAID]]-associated [[peptic ulcer]], especially for patients above the age of 50 years.<ref name="pmid15948807">{{cite journal| author=Vergara M, Catalán M, Gisbert JP, Calvet X| title=Meta-analysis: role of Helicobacter pylori eradication in the prevention of peptic ulcer in NSAID users. | journal=Aliment Pharmacol Ther | year= 2005 | volume= 21 | issue= 12 | pages= 1411-8 | pmid=15948807 | doi=10.1111/j.1365-2036.2005.02444.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15948807  }} </ref><ref name="pmid18021578">{{cite journal| author=Leontiadis GI, Sreedharan A, Dorward S, Barton P, Delaney B, Howden CW et al.| title=Systematic reviews of the clinical effectiveness and cost-effectiveness of proton pump inhibitors in acute upper gastrointestinal bleeding. | journal=Health Technol Assess | year= 2007 | volume= 11 | issue= 51 | pages= iii-iv, 1-164 | pmid=18021578 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18021578  }} </ref>
 
 
==Primary Prevention==
==Primary Prevention==
Lifestyle changes may help prevent peptic ulcers:
Lifestyle changes may help prevent peptic ulcers:



Revision as of 15:44, 6 June 2014

Peptic ulcer Microchapters

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Overview

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Case #1

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: Guillermo Rodriguez Nava, M.D. [2]

Overview

Helicobacter pylori eradication has been proved as the most cost-effective strategy for primary prevention of NSAID-associated peptic ulcer, especially for patients above the age of 50 years.[1][2]


Primary Prevention

Lifestyle changes may help prevent peptic ulcers:

Tips include:

  • Avoid aspirin, ibuprofen, naproxen, and other NSAIDs. Try acetaminophen instead. If you must take such medicines, talk to your doctor first.
  • Don't smoke or chew tobacco.
  • Limit alcohol to no more than two drinks per day.

Patients on long-term NSAID therapy and with the following risk factors, present an elevated risk of gastrointestinal bleeding and perforation:[3][4]

  • History of ulcer complication.
  • History of ulcer disease (non-bleeding).
  • Dual antiplatelet therapy.
  • Concomitant anticoagulant therapy
  • ≥60 years
  • Corticosteroid use
  • Dyspepsia
  • GERD symptoms.
  • Helicobacter pylori infection: there is a potential advantage of eradicating the infection

References

  1. Vergara M, Catalán M, Gisbert JP, Calvet X (2005). "Meta-analysis: role of Helicobacter pylori eradication in the prevention of peptic ulcer in NSAID users". Aliment Pharmacol Ther. 21 (12): 1411–8. doi:10.1111/j.1365-2036.2005.02444.x. PMID 15948807.
  2. Leontiadis GI, Sreedharan A, Dorward S, Barton P, Delaney B, Howden CW; et al. (2007). "Systematic reviews of the clinical effectiveness and cost-effectiveness of proton pump inhibitors in acute upper gastrointestinal bleeding". Health Technol Assess. 11 (51): iii–iv, 1–164. PMID 18021578.
  3. Lanza FL, Chan FK, Quigley EM, Practice Parameters Committee of the American College of Gastroenterology (2009). "Guidelines for prevention of NSAID-related ulcer complications". Am J Gastroenterol. 104 (3): 728–38. doi:10.1038/ajg.2009.115. PMID 19240698.
  4. Bhatt DL, Scheiman J, Abraham NS, Antman EM, Chan FK, Furberg CD; et al. (2008). "ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use: a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents". Circulation. 118 (18): 1894–909. doi:10.1161/CIRCULATIONAHA.108.191087. PMID 18836135.

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