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Sample records for bleeding peptic ulcers

  1. Acid inhibition and peptic ulcer bleeding.

    Science.gov (United States)

    Štimac, D; Franjić, N; Krznarić, Ž

    2011-01-01

    Peptic ulcer bleeding is one of the most common emergency situations in medicine. Combined pharmacological and endoscopic therapy together with emerging interventional radiological procedures are successfully treating peptic ulcer disease, reserving surgical procedures for only a small portion of patients unresponsive to 'conventional' therapy. Technological advancement has seen a great improvement in the field of endoscopic treatment in the form of various methods of hemostasis. However, pharmacological therapy with proton pump inhibitors still plays the central role in the peptic ulcer bleeding treatment algorithm.

  2. Endoscopic hemoclip treatment for bleeding peptic ulcer

    Institute of Scientific and Technical Information of China (English)

    Yung Chih Lai; Sien Sing Yang; Chi Hwa Wu; Tzen Kwan Chen

    2000-01-01

    AIM To evaluate the efficacy of endoscopic hemoclip in the treatment of bleeding peptic ulcer.METHODS Totally, 40 patients with F1a and F1b hemorrhagic activity of peptic ulcers were enrolled in this uncontrolled prospective study for endoscopic hemoclip treatment. We used a newly developed rotatable clip-device for the application of hemoclip (MD850) to stop bleeding. Endoscopy was repeated if there was any sign or suspicion of rebleeding, and reclipping was performed if necessary and feasible.RESULTS Initial hemostatic rate by clipping was 95%, and rebleeding rate was only 8%.Ultimate hemostatic rates were 87%, 96%, and 93% in the F1a and F1b subgroups, and total cases, respectively. In patients with shock on admission, hemoclipping achieved ultimate hemostasis of 71% and 83% in F1a and F1b subgroups, respectively. Hemostasis reached 100% in patients without shock regardless of hemorrhagic activity being F1a or F1b. The average number of clips used per case was 3.0 (range 2- 5). Spurting bleeders required more clips on average than did oozing bleeders (3.4 versus 2.8 ). We observed no obvious complications, no tissue injury, or impairment of ulcer healing related to hemoclipping.CONCLUSION Endoscopic hemoclip placement is an effective and safe method. With the improvement of the clip and application device,the procedure has become easier and much more efficient. Endoscopic hemoclipping deserves further study in the treatment of bleeding peptic ulcers.

  3. [Clinical pathway for bleeding peptic ulcers].

    Science.gov (United States)

    Mizuki, Akira; Tatemichi, Masayuki; Nikaido, Mitsuhiro; Hosoe, Naoki; Funakoshi, Sinsuke; Fukui, Kazuto; Maeda, Norio; Shigematsu, Takeharu; Nishiya, Hiromi; Hayashi, Tatsuhiko; Nagata, Hiroshi; Hibi, Norifumi; Tsukada, Nobuhiro

    2006-03-01

    We devised and evaluated a clinical pathway (CP) protocol for patients with bleeding peptic ulcers (BPU). Patients without severe comorbidities, who had been diagnosed with BPU and who had undergone endoscopic treatment, were enrolled in our study. The CP adaptation rate for BPU patients was 78.8% (89/113). The variance rate was 13.5% (12/89). The median length of admission was 10.0 +/- 4.6 days (n = 78) before and 7.4 +/- 2.9 days (n = 77) after introducing CP. Our CP for BPU was safe and resulted in shorter hospital stays and, therefore, cost reductions. In elder patients, our CP was also successful, but the variance rate was higher than in younger patients.

  4. Genotypes of Helicobacter pylori in patients with peptic ulcer bleeding

    Institute of Scientific and Technical Information of China (English)

    Chin-Lin Perng; Hwai-Jeng Lin; Wen-Ching Lo; Guan-Ying Tseng; I-Chen Sun; Yueh-Hsing Ou

    2004-01-01

    AIM: Helicobacter pyloricauses chronic gastritis, peptic ulcer,gastric cancer and MALT-lymphoma. Different genotypes of Helicobacter pylori are confirmed from diverse geographic areas. Its association with bleeding peptic ulcer remains controversial. The aim of this study was to investigate the Helicobacter pylori vac4 alleles, cagA and iceA in patients with bleeding peptic ulcer.METHODS: We enrolled patients with bleeding, nonbleeding peptic ulcers and chronic gastritis. Biopsy specimens were obtained from the antrum of the stomach for rapid urease test, bacterial culture and PCR assay. DNA extraction and polymerase chain reaction were used to detect the presence or absence of cagA and to assess the polymorphism of vac4 and iceA.RESULTS: A total of 168 patients (60.4%) (25 patients with chronic gastritis, 26 patients with bleeding gastric ulcer,51 patients with non-bleeding gastric ulcer, 26 patients with bleeding duodenal ulcer, and 40 patients with non-bleeding duodenal ulcer) were found to have positive PCR results between January 2001 and December 2002. Concerning genotypes, we found cagA (139/278, 50%), vacA s1a (127/278, 45.7%), and iceA1 (125/278, 45%) predominated in all studied patients. In patients with bleeding peptic ulcers,vac4 s1a and m1T were fewer than those in patients with non-bleeding peptic ulcers (37/106 vs69/135, P=0.017, and 4/106 vs21/135, P=0.002).CONCLUSION: In patients with peptic ulcers, Hpylori vacA s1a and m1T prevent bleeding complication.

  5. Modern issues on the treatment of peptic ulcer bleedings

    Directory of Open Access Journals (Sweden)

    Potakhin S.N.

    2014-03-01

    Full Text Available Despite the success of therapeutic treatment of peptic ulcer and the introduction of endoscopic technologies, the problem of peptic ulcer hemorrhage remains valid. A large number of publications in foreign literature are dedicated to epidemiology and prevention of bleeding, evaluation of modern tactics and search for new methods of treatment. The works relating to organization of aid to patients with peptic ulcer bleeding are of particular interest. According to the recent data not all clinics even in economically developed countries manage to follow the recommendations of an international consensus-2010 for non-variceal bleeding treatment of upper gastrointestinal tract. Among the causes of non-compliance of international recommendations there are subjective and objective factors, the understanding of which can significantly affect the optimization of aid to patients with peptic ulcer bleeding.

  6. [Guidelines of treatment for non-bleeding peptic ulcer disease].

    Science.gov (United States)

    Cheung, Dae Young; Jung, Hwoon Yong; Song, Ho June; Jung, Sung Woo; Jung, Hyun Chae

    2009-11-01

    Over the past century, since the introduction of non steroidal anti-inflammatory drugs (NSAID), antacid, histamine H2-receptor antagonists (H2RA), proton pump inhibitors (PPI), and discovery of Helicobacter pylori infection, the paradigm of peptic ulcer disease has changed with marked decrease in morbidity and mortality. However, peptic ulcer disease still occupies a position as a major health problem with increase of aged population and NSAIDs usage. In daily general practice, the management of peptic ulcer disease is directed according to the presence of bleeding or not. For non-bleeding peptic ulcer disease, proper acid suppression and the correction of underlying causes such as Helicobacter pylori infection and NSAID use is the main stay of treatment. Though a complete understanding of pathophysiology and a perfect treatment strategy are still a challenge, this guideline aims to provide practical recommendations based on evidences or consensus of experts through in-depth literature review and expert meeting.

  7. Photocoagulation in the treatment of bleeding peptic ulcer

    Science.gov (United States)

    Otto, Wlodzimierz; Paczkowski, Pawel M.

    1996-03-01

    The authors present their experience in the endoscopic laser photocoagulation of bleeding peptic ulcer. From 1991 to June 1995, 203 patients admitted for UGI bleeding from peptic ulcer have been treated by this method. The source of bleeding was confirmed by endoscopy. The patients were divided into two groups: actively bleeding peptic ulcer (group IA and IB according to Forrest's classification) and ulcer with stigmata of recent bleeding (group IIA/IIB). The former group consisted of 106 patients, among whom over 40 percent (45 patients) presented signs of hypovolemic shock on admission. Nd:YAG laser (Surgical Laser Technologies) was used in a continuous mode with a contact (8 - 20 watts) or non-contact (over 50 watts) method of coagulation. In actively bleeding patients photocoagulation resulted in stopping the hemorrhage in 95 (90%). Recurrent bleeding occurred in 16 cases; in 9 of them it was stopped by repeated photocoagulation. In this group 18 patients required surgical intervention. The mortality was of 10.3% (11 patients). In 97 patients with recent bleeding stigmata photocoagulation provoked heavy hemorrhage in 3 (in 2 cases stopped by prolonged coagulation). In 9 of the remaining 94 patients recurrent bleeding occurred. Nine patients required surgical intervention. Mortality in this group was of 6%.

  8. Update on the endoscopic management of peptic ulcer bleeding

    NARCIS (Netherlands)

    I.L. Holster (Ingrid); E.J. Kuipers (Ernst)

    2011-01-01

    textabstractUpper gastrointestinal bleeding is the most common gastrointestinal emergency, with peptic ulcer as the most common cause. Appropriate resuscitation followed by early endoscopy for diagnosis and treatment are of major importance in these patients. Endoscopy is recommended within 24 h of

  9. Improving Quality of Care in Peptic Ulcer Bleeding

    DEFF Research Database (Denmark)

    Rosenstock, Steffen Jais; Møller, Morten H; Larsson, Heidi

    2013-01-01

    OBJECTIVES:The treatment of peptic ulcer bleeding (PUB) is complex, and mortality remains high. We present results from a nationwide initiative to monitor and improve the quality of care (QOC) in PUB.METHODS:All Danish hospitals treating PUB patients between 2004 and 2011 prospectively registered...

  10. Challenges in the management of acute peptic ulcer bleeding.

    Science.gov (United States)

    Lau, James Y W; Barkun, Alan; Fan, Dai-ming; Kuipers, Ernst J; Yang, Yun-sheng; Chan, Francis K L

    2013-06-08

    Acute upper gastrointestinal bleeding is a common medical emergency worldwide, a major cause of which are bleeding peptic ulcers. Endoscopic treatment and acid suppression with proton-pump inhibitors are cornerstones in the management of the disease, and both treatments have been shown to reduce mortality. The role of emergency surgery continues to diminish. In specialised centres, radiological intervention is increasingly used in patients with severe and recurrent bleeding who do not respond to endoscopic treatment. Despite these advances, mortality from the disorder has remained at around 10%. The disease often occurs in elderly patients with frequent comorbidities who use antiplatelet agents, non-steroidal anti-inflammatory drugs, and anticoagulants. The management of such patients, especially those at high cardiothrombotic risk who are on anticoagulants, is a challenge for clinicians. We summarise the published scientific literature about the management of patients with bleeding peptic ulcers, identify directions for future clinical research, and suggest how mortality can be reduced.

  11. Mucosal polymerase chain reaction for diagnosing Helicobacter pylori infection in patients with bleeding peptic ulcers

    Institute of Scientific and Technical Information of China (English)

    Hwai-Jeng Lin; Wen-Ching Lo; Chin-Lin Perng; Guan-Ying Tseng; Anna Fen-Yau Li; Yueh-Hsing Ou

    2005-01-01

    AIM: Helicobacter pylori(Hpylori) has been linked to chronic gastritis, peptic ulcers, gastric cancer and MALT-lymphoma.Conventional invasive tests are less sensitive than noninvasive tests in diagnosing H pylori infection in patients with bleeding peptic ulcers. Polymerase chain reaction is a sensitive and accurate method for diagnosing H pylori infection. The aim of this study was to evaluate the diagnostic role of mucosal polymerase chain reaction for H pylori infection in patients with bleeding peptic ulcers.METHODS: In patients with bleeding, non-bleeding peptic ulcers and chronic gastritis, we checked rapid urease test,histology, bacterial culture and mucosal polymerase chain reaction for detecting H pylori infection. Positive H pylori infection was defined as positive culture or both a positive histology and a positive rapid urease test. For mucosal polymerase chain reaction of Hpylori, we checked vacA (s1a, s1b, s1c, s2, m1, m1T, m2),iceA1,iceA2 and cag A.RESULTS: Between October 2000 and April 2002, 88 patients with bleeding peptic ulcers (males/females: 60/28, gastric ulcers/duodenal ulcers: 55/33), 81 patients with non-bleeding peptic ulcers (males/females: 54/27, gastric ulcers/duodenal ulcers: 45/36) and 37 patients with chronic gastritis (males/females: 24/13) were enrolled in this study. In patients with bleeding peptic ulcers, non-bleeding peptic ulcers and chronic gastritis, 45 patients (51%), 71 patients (88%)and 20 patients (54%) respectively were found to have positive H pylori infection (P<0.001). In patients with bleeding peptic ulcers, non-bleeding peptic ulcers and chronic gastritis, polymerase chain reaction for H pylori infection was positive in 54 patients (61%), 70 patients (86%) and 20 patients (54%) respectively (P<0.001). The sensitivity,positive predictive value and diagnostic accuracy of mucosal polymerase reaction for Hpylori infection were significantly lower in patients with bleeding peptic ulcers (84%, 79%and 81%) than in

  12. Small bowel ulcerative lesions are common in elderly NSAIDs users with peptic ulcer bleeding

    Institute of Scientific and Technical Information of China (English)

    Panagiotis; Tsibouris; Chissostomos; Kalantzis; Periklis; Apostolopoulos; Antonios; Zalonis; Peter; Edward; Thomas; Isaacs; Mark; Hendrickse; Georgios; Alexandrakis

    2014-01-01

    AIM: To determine the frequency of small bowel ulcerative lesions in patients with peptic ulcer and define the significance of those lesions. METHODS: In our prospective study, 60 consecutive elderly patients with upper gastrointestinal bleeding from a peptic ulceration(cases) and 60 matched patients with a non-bleeding peptic ulcer(controls) underwent small bowel capsule endoscopy, after a negative colonoscopy(compulsory in our institution). Controls were evaluated for non-bleeding indications. Known or suspected chronic inflammatory conditions and medication that could harm the gut were excluded. During capsule endoscopy, small bowel ulcerative lesions were counted thoroughly and classified according to Graham classification. Other small bowellesions were also recorded. Peptic ulcer bleeding was controlled endoscopically, when adequate, proton pump inhibitors were started in both cases and controls, and Helicobacter pylori eradicated whenever present. Both cases and controls were followed up for a year. In case of bleeding recurrence upper gastrointestinal endoscopy was repeated and whenever it remained unexplained it was followed by repeat colonoscopy and capsule endoscopy.RESULTS: Forty(67%) cases and 18(30%) controls presented small bowel erosions(P = 0.0001), while 22(37%) cases and 4(8%) controls presented small bowel ulcers(P < 0.0001). Among non-steroidal antiinflammatory drug(NSAID) consumers, 39(95%) cases and 17(33%) controls presented small bowel erosions(P < 0.0001), while 22(55%) cases and 4(10%) controls presented small bowel ulcers(P < 0.0001). Small bowel ulcerative lesions were infrequent among patients not consuming NSAIDs. Mean entry hemoglobin was 9.3(SD = 1.4) g/d L in cases with small bowel ulcerative lesions and 10.5(SD = 1.3) g/dL in those without(P = 0.002). Cases with small bowel ulcers necessitate more units of packed red blood cells. During their hospitalization, 6(27%) cases with small bowel ulcers presented bleeding recurrence most

  13. Comparative efficiency of endoscopic hemostasis methods in bleeding undercomplicated peptic ulcer in children

    OpenAIRE

    Сокольник, Сергій Олександрович

    2015-01-01

    Aim. To compare the effectiveness of endoscopic hemostasis in complex treatment of gastrointestinal bleeding in children of Chernovtsy region with peptic ulcer disease.Methods. 43 cases of bleeding in peptic ulcer disease in children are analyzed. Argon plasma coagulation is undergone in order to stop the bleeding for 11 patients, for others – aminocaproic acid irrigation.Results. Using argon plasma coagulation, in contrast to the aminocaproic acid irrigation reduces the risk of rebleeding 0....

  14. Peptic Ulcer

    Science.gov (United States)

    A peptic ulcer is a sore in the lining of your stomach or your duodenum, the first part of your small ... and goes for several days or weeks Peptic ulcers happen when the acids that help you digest ...

  15. Diagnosis, Treatment, and Outcome in Patients with Bleeding Peptic Ulcers and Helicobacter pylori Infections

    Science.gov (United States)

    2014-01-01

    Upper gastrointestinal (UGI) bleeding is the most frequently encountered complication of peptic ulcer disease. Helicobacter pylori (Hp) infection and nonsteroidal anti-inflammatory drug (NSAID) administration are two independent risk factors for UGI bleeding. Therefore, testing for and diagnosing Hp infection are essential for every patient with UGI hemorrhage. The presence of the infection is usually underestimated in cases of bleeding peptic ulcers. A rapid urease test (RUT), with or without histology, is usually the first test performed during endoscopy. If the initial diagnostic test is negative, a delayed 13C-urea breath test (UBT) or serology should be performed. Once an infection is diagnosed, antibiotic treatment is advocated. Sufficient evidence supports the concept that Hp infection eradication can heal the ulcer and reduce the likelihood of rebleeding. With increased awareness of the effects of Hp infection, the etiologies of bleeding peptic ulcers have shifted to NSAID use, old age, and disease comorbidity. PMID:25101293

  16. Diagnosis, Treatment, and Outcome in Patients with Bleeding Peptic Ulcers and Helicobacter pylori Infections

    Directory of Open Access Journals (Sweden)

    Ting-Chun Huang

    2014-01-01

    Full Text Available Upper gastrointestinal (UGI bleeding is the most frequently encountered complication of peptic ulcer disease. Helicobacter pylori (Hp infection and nonsteroidal anti-inflammatory drug (NSAID administration are two independent risk factors for UGI bleeding. Therefore, testing for and diagnosing Hp infection are essential for every patient with UGI hemorrhage. The presence of the infection is usually underestimated in cases of bleeding peptic ulcers. A rapid urease test (RUT, with or without histology, is usually the first test performed during endoscopy. If the initial diagnostic test is negative, a delayed 13C-urea breath test (UBT or serology should be performed. Once an infection is diagnosed, antibiotic treatment is advocated. Sufficient evidence supports the concept that Hp infection eradication can heal the ulcer and reduce the likelihood of rebleeding. With increased awareness of the effects of Hp infection, the etiologies of bleeding peptic ulcers have shifted to NSAID use, old age, and disease comorbidity.

  17. Diagnosis, treatment, and outcome in patients with bleeding peptic ulcers and Helicobacter pylori infections.

    Science.gov (United States)

    Huang, Ting-Chun; Lee, Chia-Long

    2014-01-01

    Upper gastrointestinal (UGI) bleeding is the most frequently encountered complication of peptic ulcer disease. Helicobacter pylori (Hp) infection and nonsteroidal anti-inflammatory drug (NSAID) administration are two independent risk factors for UGI bleeding. Therefore, testing for and diagnosing Hp infection are essential for every patient with UGI hemorrhage. The presence of the infection is usually underestimated in cases of bleeding peptic ulcers. A rapid urease test (RUT), with or without histology, is usually the first test performed during endoscopy. If the initial diagnostic test is negative, a delayed (13)C-urea breath test (UBT) or serology should be performed. Once an infection is diagnosed, antibiotic treatment is advocated. Sufficient evidence supports the concept that Hp infection eradication can heal the ulcer and reduce the likelihood of rebleeding. With increased awareness of the effects of Hp infection, the etiologies of bleeding peptic ulcers have shifted to NSAID use, old age, and disease comorbidity.

  18. Comparative efficiency of endoscopic hemostasis methods in bleeding undercomplicated peptic ulcer in children

    Directory of Open Access Journals (Sweden)

    Сергій Олександрович Сокольник

    2015-05-01

    Full Text Available Aim. To compare the effectiveness of endoscopic hemostasis in complex treatment of gastrointestinal bleeding in children of Chernovtsy region with peptic ulcer disease.Methods. 43 cases of bleeding in peptic ulcer disease in children are analyzed. Argon plasma coagulation is undergone in order to stop the bleeding for 11 patients, for others – aminocaproic acid irrigation.Results. Using argon plasma coagulation, in contrast to the aminocaproic acid irrigation reduces the risk of rebleeding 0.59 times when the number of patients who must be treated – 2.99.Conclusions. The most effective method of endoscopic hemostasis of bleeding in peptic ulcer disease in children is argon plasma coagulation, which allows you to achieve a stable hemostasis and reduce the risk of rebleeding

  19. Intravenous proton pump inhibitors for peptic ulcer bleeding: Clinical benefits and limits.

    Science.gov (United States)

    Cheng, Hsiu-Chi; Sheu, Bor-Shyang

    2011-03-16

    Peptic ulcer bleeding is a common disease and recurrent bleeding is an independent risk factor of mortality. Infusion with proton pump inhibitors (PPIs) prevents recurrent bleeding after successful endoscopic therapy. A gastric acidic environment of less than pH 5.4 alters coagulation function and activates pepsin to disaggregate platelet plugs. Gastric acid is secreted by H(+), K(+)-ATPase, naming the proton pump. This update review focuses on the mechanism and the role of PPIs in the clinical management of patients with peptic ulcer bleeding. An intravenous omeprazole bolus followed by high-dose continuous infusion for 72 h after successful endoscopic therapy can prevent the recurrent bleeding. In the Asian, however, the infusion dosage can possibly be diminished whilst preserving favorable control of the intragastric pH and thereby still decreasing rates of recurrent bleeding. Irrespective of the infusion dosage of PPIs, rates of recurrent bleeding remain high in patients with co-morbidities. Because recurrent peptic ulcer bleeding may be prolonged in those with co-morbidities, a low-dose infusion of IV PPIs for up to 7-day may result in better control of recurrent bleeding of peptic ulcers. Due to the inter-patient variability in CYP2C19 genotypes, the infusion form of new generation PPIs, such as esomeprazole, should be promising for the prevention of recurrent bleeding. This article offers a comprehensive review of clinical practice, highlighting the indication, the optimal dosage, the duration, and the potential limitation of PPIs infusion for peptic ulcer bleeding.

  20. Incidence and Clinical Features of Peptic Ulcer Disease In Acute Upper Gastrointestinal Bleeding: -Experience of Moroccan University Hospital Unit-

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    Y. Cherradi

    2015-12-01

    Full Text Available Introduction: Peptic ulcer disease (PUD has been recognized as the leading cause of acute upper gastrointestinal bleeding (AUGIB. This study aims to report general features of bleeding peptic ulcers in patients who benefit of urgent endoscopy in our department after an acute upper gastrointestinal hemorrhage. Results: A total of 1809 patients were explored for acute upper gastrointestinal bleeding in our unit since 2003 to 2008. Gastroduodenal peptic ulcers were the most frequent diagnosed etiology. They present 38% of all reported causes of bleeding (n=527 (table I. 25% were located at duodenal mucosa (n= 347 and 13% were gastric ulcers (n=180. No esophageal ulcers were reported. Incidence of both duodenal and gastric ulcers decreases during the last years. Conclusion: In our department, incidence of bleeding peptic ulcer disease is decreasing but they continue to be the first cause of AUGIB.

  1. National consensus on management of peptic ulcer bleeding in Denmark 2014

    DEFF Research Database (Denmark)

    Laursen, Stig Borbjerg; Jørgensen, Henrik Stig; Schaffalitzky de Muckadell, Ove B

    2014-01-01

    endoscopic hemostasis. Patients with peptic ulcer bleeding who require secondary cardiovascular prophylaxis should start receiving acetylsalicylic acid (ASA) within 24 hours from primary endoscopy. Patients in need of continued treatment with ASA or a nonsteroidal anti-inflammatory drug should be put...

  2. Dysfunction of neutrophils in patients with peptic ulcers, complicated with bleeding

    Directory of Open Access Journals (Sweden)

    Sulayeva O.N.

    2011-01-01

    Full Text Available To analyze a role of leukocytes dysfunction in the pathogenesis of ulcer bleeding the oxygen dependent metabolism, phagocytic activity and cytochemical indices of neutrophils were estimated in 100 patients with gatric and duodenal ulcers bleeding with effective hemostasis (group 1, n = 77 and rebleeding (group 2, n = 23. It was shown that peptic ulcer bleeding in patients of group 1 was associated with moderate increase of spontaneous production of active oxygen radicals, restriction of induced NADPH oxidase activity, decrease of acid phosphatase and myeloperoxidase activity but enhancement of phagocytic index. Sharp increase of spontaneous NBT-reaction with lost of oxidize functional reserve in neutrophils with significant inhibition of ability to phagocytosis and decreased of lysosomal enzymes activity were risk factors for rebleeding in patients of group 2.

  3. Clinical Outcomes of the Marginal Ulcer Bleeding after Gastrectomy: As Compared to the Peptic Ulcer Bleeding with Nonoperated Stomach

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    Woo Chul Chung

    2012-01-01

    Full Text Available Background. Marginal ulcer is a well-known complication after gastrectomy. Its bleeding can be severe, but the severity has rarely been reported. We aim to evaluate the clinical outcomes of marginal ulcer bleeding (MUB as compared to peptic ulcer bleeding (PUB with nonoperated stomach. Methods. A consecutive series of patients who had nonvariceal upper gastrointestinal bleeding and admitted to the hospital between 2005 and 2011 were retrospectively analyzed. A total of 530 patients were enrolled in this study, and we compared the clinical characteristics between 70 patients with MUB and 460 patients with PUB. Results. Patients with MUB were older (mean age: 62.86±10.59 years versus 53.33±16.68 years, P=0.01. The initial hemoglobin was lower (8.16±3.05 g/dL versus 9.38±2.49 g/dL, P=0.01, and the duration of admission was longer in MUB (7.14±4.10 days versus 5.90±2.97 days, P=0.03. After initial hemostasis, the rebleeding rate during admission was higher (16.2% versus 6.5%, P=0.01 in MUB. However, the mortality rate did not differ statistically between MUB and PUB groups. Helicobacter pylori-positive rate with MUB was lower than that of PUB (19.4% versus 54.4%, P=0.01. Conclusions. Clinically, MUB after gastrectomy is more severe than PUB with nonoperated stomach. Infection with H. pylori might not appear to play an important role in MUB after gastrectomy.

  4. Endoscopic Injection Therapy in Bleeding Peptic Ulcers. Low Mortality in a High Risk Population

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    Joaqulm Balanzó

    1992-01-01

    Full Text Available Endoscoric injection therapy was performed in 341 patients consecutively admitted with a bleeding peptic ulcer at high risk of further hemorrhage, assessed by the presence of active arterial bleeding or a nonbleeding visible vessel at emergency endoscopy. Initial hemostasis was achieved in 111 of 119 actively bleeding patients (93%. Rebleeding ocurred in 75 cases (23%, at a mean interval of 53±52 h. A second emergency injection was a ttempted in 36 therapeutic failures, and was successful in 20 (55%. Emergency surgery was finally required in 52 patients (15%. Overall mortality was 4.9%. Major complications occurred in four patients (1.2% (two perforations and two aspiration pneumonia; therefore, injection therapy is an effective and simple method for treating bleeding ulcers, achieving the initial control of hemorrhage in a majority of cases although the rate of further hemorrhage is not negligible and complications are not irrelevant.

  5. Therapeutic Options for Patients Bleeding with Peptic Ulcers

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    ABR Thomson

    1994-01-01

    Full Text Available It is likely that the best outcome for the patient with an acute upper gastrointestinal bleed (GIB includes early diagnosis: for a bleeding lesion with a high risk of rebleeding, in an older patient with systolic h.ypotension or in a person with multiple medical problems. Early therapeutic endoscopy with meticulous control of intragastric pH will Likely achieve the best outcome. The ideal pH criterion to stop bleeding or to prevent recurrence is unknown. An algorithm is presented to guide the clinical management of patients with GIB, and to focus on important questi.ons for future therapeutic studies.

  6. Short-term mortality after perforated or bleeding peptic ulcer among elderly patients: a population-based cohort study

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    Sørensen Henrik T

    2007-04-01

    Full Text Available Abstract Background Mortality after perforated and bleeding peptic ulcer increases with age. Limited data exist on how the higher burden of comorbidity among elderly patients affects this association. We aimed to examine the association of age with short-term mortality after perforated and bleeding peptic ulcer and to determine the impact of comorbidity on this association. Methods In this population-based cohort study in three Danish counties between 1991 and 2003 we identified two cohorts of patients: those hospitalized with a first-time discharge diagnosis of perforated peptic ulcer and those with bleeding peptic ulcer. The diagnoses were ascertained from hospital discharge registries and mortality through the Danish Civil Registration System. Information on comorbidity and use of ulcer-related drugs was obtained through administrative medical databases. We computed age-, gender- and comorbidity-standardized 30-day mortality rates and used Cox's regression to estimate adjusted 30-day mortality rate ratios (MRR for elderly compared with younger patients. Results Among 2,061 patients with perforated peptic ulcer, 743 (36% were 65–79 years old and 513 patients (25% were aged 80+ years. Standardized 30-day mortality was 8.9% among patients younger than 65 years rising to 44.6% among patients aged 80+ years, corresponding to an adjusted MRR of 5.3 (95% CI: 4.0–7.0. Among 7,232 patients with bleeding peptic ulcer 2,372 (33% were aged 80+ years. Standardized 30-day mortality among patients younger than 65 was 4.3% compared with 16.9% among patients aged 80+ years, corresponding to an adjusted MRR of 3.7 (95% CI: 2.9–4.7. Analyses stratified by comorbidity consistently showed high MRRs among elderly patients, regardless of comorbidity level. Conclusion Ageing is a strong predictor for a poor outcome after perforated and bleeding peptic ulcer independently of comorbidity.

  7. Bleeding peptic ulcer. Prevalence of Helicobacter pylori and use of nonsteroidal anti-inflammatory drugs/acetylsalicylic acid

    DEFF Research Database (Denmark)

    Vestergard, A.; Bredahl, K.; Muckadell, O.B. de

    2009-01-01

    INTRODUCTION: Helicobacter pylori (HP) infection and use of nonsteroidal anti-inflammatory drugs (NSAIDs)/acetyl salicylic acid (ASA) are risk factors for bleeding peptic ulcer. HP eradication reduces the risk of rebleeding. Antibiotics, proton pump inhibitors (PPI) and presence of blood in the s......INTRODUCTION: Helicobacter pylori (HP) infection and use of nonsteroidal anti-inflammatory drugs (NSAIDs)/acetyl salicylic acid (ASA) are risk factors for bleeding peptic ulcer. HP eradication reduces the risk of rebleeding. Antibiotics, proton pump inhibitors (PPI) and presence of blood...

  8. Bleeding peptic ulcer. Prevalence of Helicobacter pylori and use of nonsteroidal anti-inflammatory drugs/acetylsalicylic acid

    DEFF Research Database (Denmark)

    Vestergard, A.; Bredahl, K.; Muckadell, O.B. de

    2009-01-01

    INTRODUCTION: Helicobacter pylori (HP) infection and use of nonsteroidal anti-inflammatory drugs (NSAIDs)/acetyl salicylic acid (ASA) are risk factors for bleeding peptic ulcer. HP eradication reduces the risk of rebleeding. Antibiotics, proton pump inhibitors (PPI) and presence of blood in the s......INTRODUCTION: Helicobacter pylori (HP) infection and use of nonsteroidal anti-inflammatory drugs (NSAIDs)/acetyl salicylic acid (ASA) are risk factors for bleeding peptic ulcer. HP eradication reduces the risk of rebleeding. Antibiotics, proton pump inhibitors (PPI) and presence of blood...

  9. Helicobacter pylori infection in bleeding peptic ulcer patients after non-steroidal antiinflammatory drug consumption

    Institute of Scientific and Technical Information of China (English)

    Francesco Manguso; Elena Trimarco; Antonio Balzano; Elisabetta Riccio; Germana de Nucci; Maria Luisa Aiezza; Gerardino Amato; Linda Degl'Innocenti; Maria Maddalena Piccirillo; Gianfranco De Dominicis; Tara Santoro

    2011-01-01

    AIM: To establish the prevalence of Helicobacter pylori (H. pylori ) infection in patients with a bleeding peptic ulcer after consumption of non-steroidal antiinflammatory drugs (NSAIDs). METHODS: A very early upper endoscopy was performed to find the source of upper gastrointestinal bleeding and to take biopsy specimens for analysis of H. pylori infection by the rapid urease (CLO) test, histological examination, and bacterial culture. IgG anti- CagA were also sought. The gold standard for identifying H. pylori infection was positive culture of biopsy specimens or contemporary positivity of the CLO test and the presence of H. pylori on tissue sections. RESULTS: Eighty patients, 61 males (76.3%), mean age 61.2 ± 15.9 years, were consecutively enrolled. Forty-seven (58.8%) patients occasionally consumed NSAIDs, while 33 (41.3%) were on chronic treatment with low-dose aspirin (LD ASA). Forty-four (55.0%) patients were considered infected by H. pylori . The infection rate was not different between patients who occasionally or chronically consumed NSAIDs. The culture of biopsy specimens had a sensitivity of 86.4% and a specificity of 100%; corresponding figures for histological analysis were 65.9% and 77.8%, for the CLO test were 68.2% and 75%, for the combined use of histology and the CLO test were 56.8% and 100%, and for IgG anti-CagA were 90% and 98%. The highest accuracy (92.5%) was obtained with the culture of biopsy specimens. CONCLUSION: Patients with a bleeding peptic ulcer after NSAID/LD ASA consumption frequently have H. pylori infection. Biopsy specimen culture after an early upper gastrointestinal tract endoscopy seems the most efficient test to detect this infection.

  10. Peptic ulcer disease today.

    Science.gov (United States)

    Yuan, Yuhong; Padol, Ireneusz T; Hunt, Richard H

    2006-02-01

    Over the past few decades, since the introduction of histamine H(2)-receptor antagonists, proton-pump inhibitors, cyclo-oxygenase-2-selective anti-inflammatory drugs (coxibs), and eradication of Helicobacter pylori infection, the incidence of peptic ulcer disease and ulcer complications has decreased. There has, however, been an increase in ulcer bleeding, especially in elderly patients. At present, there are several management issues that need to be solved: how to manage H. pylori infection when eradication failure rates are high; how best to prevent ulcers developing and recurring in nonsteroidal anti-inflammatory drug (NSAID) and aspirin users; and how to treat non-NSAID, non-H. pylori-associated peptic ulcers. Looking for H. pylori infection, the overt or surreptitious use of NSAIDs and/or aspirin, and the possibility of an acid hypersecretory state are important diagnostic considerations that determine the therapeutic approach. Combined treatment with antisecretory therapy and antibiotics for 1-2 weeks is the first-line choice for H. pylori eradication therapy. For patients at risk of developing an ulcer or ulcer complications, it is important to choose carefully which anti-inflammatory drugs, nonselective NSAIDs or coxibs to use, based on a risk assessment of the patient, especially if the high-risk patient also requires aspirin. Testing for and eradicating H. pylori infection in patients is recommended before starting NSAID therapy, and for those currently taking NSAIDs, when there is a history of ulcers or ulcer complications. Understanding the pathophysiology and best treatment strategies for non-NSAID, non-H. pylori-associated peptic ulcers presents a challenge.

  11. UPPER GASTRO-INTESTINAL BLEEDING IN THE YOUNG - GASTRIC GIST TUMOR OR PEPTIC ULCER DISEASE?

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    Ayodele Atolagbe

    2015-09-01

    Full Text Available GIST tumors is very unusual in the young and middle aged and a high index of suspicion is needed for the diagnosis in young patients who present with upper gastrointestinal bleeding. Appropriate imaging such as a Computed tomographic scan (CT scan may identify this tumor which may easily be misdiagnosed as a bleeding Peptic Ulcer Disease in the young. We present a case of a healthy 38 year old man with no alcohol use who presented with epigastric pain and melena and subsequent torrential bleeding uncontrolled during endoscopy necessitating an emergency exploratory laparotomy by the general surgery team. The bleeding intraluminal component of the tumor with gross splenic and pancreatic involvement was identified and surgical management consisted of a wedge resection of the greater curvature of the stomach incorporating the tumor and the spleen with successful dissection of the tumor off the tail of the pancreas. Histology was positive for C-KIT and DOG-1 markers. Postoperative course was uneventful and he is presently on Imatinib Mesylate.

  12. Relationship between timing of endoscopy and mortality in patients with peptic ulcer bleeding

    DEFF Research Database (Denmark)

    Laursen, Stig B; Leontiadis, Grigorios I; Stanley, Adrian J;

    2017-01-01

    BACKGROUND AND AIMS: The optimal timing of endoscopy in patients with peptic ulcer bleeding (PUB) remains unclear. The aim of this study was to examine the association between timing of endoscopy and mortality in PUB. METHODS: A nationwide cohort study based on a database of consecutive patients...... admitted to hospital with PUB in Denmark. Patients were stratified according to presence of hemodynamic instability at presentation and American Society of Anesthesiologists (ASA) score. Using descriptive statistics and logistic regression analyses, we identified optimal time frames for endoscopy...... and analyzed the association between timing of endoscopy and in-hospital mortality after adjusting for confounding factors. RESULTS: A total of 12,601 patients were included. We did not find any universal association between timing of endoscopy and mortality in hemodynamically stable patients with an ASA...

  13. Optimal injection volume of epinephrine for endoscopic treatment of peptic ulcer bleeding

    Institute of Scientific and Technical Information of China (English)

    Tai-Cherng Liou; Shee-Chan Lin; Horng-Yuan Wang; Wen-Hsiung Chang

    2006-01-01

    AIM: To define the optimal injection volume of epinephrine with high efficacy for hemostasis and low complication rate in patients with actively bleeding ulcers.METHODS: This prospective, randomized, comparative trial was conducted in a medical center. A total of 228 patients with actively bleeding ulcers (spurting or oozing) were randomly assigned to three groups with 20, 30 and 40 mL endoscopic injections of an 1:10000 solution of epinephrine. The hemostatic effects and clinical outcomes were compared between the three groups.RESULTS: There were no significant differences in all background variables between the three groups. Initial hemostasis was achieved in 97.4%, 98.7% and 100% of patients respectively in the 20, 30 and 40 mL epinephrine groups. There were no significant differences in the rate of initial hemostasis between the three groups. The rate of peptic ulcer perforation was significantly higher in the 40 mL epinephrine group than in the 20 and 30 mL epinephrine groups (P < 0.05). The rate of recurrent bleeding was significantly higher in the 20 mL epinephrine group (20.3%) than in the 30 (5.3%) and 40 mL (2.8 %) epinephrine groups (P < 0.01). There were no significant differences in the rates of surgical intervention, the amount of transfusion requirements, the days of hospitalization, the deaths from bleeding and 30 d mortality between the three groups. The number of patients who developed epigastric pain due to endoscopic injection, was significantly higher in the 40 mL epinephrine group (51/76) than in the 20 (2/76) and 30 mL (5/76) epinephrine groups (P < 0.001). Significant elevation of systolic blood pressure after endoscopic injection was observed in the 40 mL epinephrine group (P < 0.01). Significant decreasing and normalization of pulse rates after endoscopic injections were observed in the 20 mL and 30 mL epinephrine groups (P < 0.01).CONCLUSION: Injection of 30 mL diluted epinephrine (1:10000) can effectively prevent recurrent

  14. Peptic Ulcers

    Science.gov (United States)

    ... antacid is given for 2 months or longer. The ulcer may take 8 weeks to heal, but the ... indicate a serious problem, such as: perforation (when the ulcer becomes too deep and breaks through the stomach ...

  15. Adrenaline Injection Plus Argon Plasma Coagulation versus Adrenaline Injection Plus Hemoclips for Treating High-Risk Bleeding Peptic Ulcers: A Prospective, Randomized Trial

    Directory of Open Access Journals (Sweden)

    Seyed Alireza Taghavi

    2009-01-01

    Full Text Available BACKGROUND/OBJECTIVE: Several combination endoscopic therapies are currently in use. The present study aimed to compare argon plasma coagulation (APC + adrenaline injection (AI with hemoclips + AI for the treatment of high-risk bleeding peptic ulcers.

  16. Validity of peptic ulcer disease and upper gastrointestinal bleeding diagnoses in administrative databases: a systematic review protocol.

    Science.gov (United States)

    Montedori, Alessandro; Abraha, Iosief; Chiatti, Carlos; Cozzolino, Francesco; Orso, Massimiliano; Luchetta, Maria Laura; Rimland, Joseph M; Ambrosio, Giuseppe

    2016-09-15

    Administrative healthcare databases are useful to investigate the epidemiology, health outcomes, quality indicators and healthcare utilisation concerning peptic ulcers and gastrointestinal bleeding, but the databases need to be validated in order to be a reliable source for research. The aim of this protocol is to perform the first systematic review of studies reporting the validation of International Classification of Diseases, 9th Revision and 10th version (ICD-9 and ICD-10) codes for peptic ulcer and upper gastrointestinal bleeding diagnoses. MEDLINE, EMBASE, Web of Science and the Cochrane Library databases will be searched, using appropriate search strategies. We will include validation studies that used administrative data to identify peptic ulcer disease and upper gastrointestinal bleeding diagnoses or studies that evaluated the validity of peptic ulcer and upper gastrointestinal bleeding codes in administrative data. The following inclusion criteria will be used: (a) the presence of a reference standard case definition for the diseases of interest; (b) the presence of at least one test measure (eg, sensitivity, etc) and (c) the use of an administrative database as a source of data. Pairs of reviewers will independently abstract data using standardised forms and will evaluate quality using the checklist of the Standards for Reporting of Diagnostic Accuracy (STARD) criteria. This systematic review protocol has been produced in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol (PRISMA-P) 2015 statement. Ethics approval is not required given that this is a protocol for a systematic review. We will submit results of this study to a peer-reviewed journal for publication. The results will serve as a guide for researchers validating administrative healthcare databases to determine appropriate case definitions for peptic ulcer disease and upper gastrointestinal bleeding, as well as to perform outcome research using

  17. BLEEDING PEPTIC ULCER, NONSTEROIDAL ANTIINFLAMMATORY DRUGS AND HELICOBACTER PYLORI INFECTION – A PROSPECTIVE, CONTROLLED, RANDOMIZED STUDY

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    Pavel Skok

    2002-06-01

    Full Text Available Background. The explanation of peptic ulcer etiology has changed significantly in the past decade after the clarification of the significance of Helicobacter pylori infection.Aim. To evaluate the effectiveness of Helicobacter pylori eradication in patients with hemorrhaging peptic ulcer and patients with peptic ulcer without complications.Study ethics. The study was approved in 1998 by the Medical Ethics Committee of the Republic of Slovenia (No. 90/09/98.Type of study. Prospective, controlled and randomized study, carried out between 1998–2000.Patients and methods. The study included 80 patients (50 male and 30 female, av.age 57.5 years, SD ± 17.1, range 22– 80 in which endoscopy confirmed hemorrhage from peptic ulcer of stomach or duodenum and Helicobacter pylori infection. In all cases endoscopic hemostasis was performed: injection sclerotherapy with diluted adrenalin 1:10,000 and 1% polidocanol or argon plasma coagulation. The control group was made up of 80 patients (50 male and 30 female, av.age 56.8 years, SD ± 16.8, range 19–80 with peptic ulcer of stomach or duodenum and Helicobacter pylori infection. Infection was confirmed by a rapid urease test and histologic investigation of the gastric mucosa. In all cases the recommended drug combinations were used in the treatment of the infection: a proton pump inhibitor, omeprazol (4 weeks, and combination of antibiotics, claritromycin and metronidazole or with regard to the antibiogram (1 week. The therapeutic success was ascertained endoscopically four weeks after inclusion in the study. Infection eradication was confirmed by the rapid urease test and histologic investigation of the gastric mucosa.Results. Four weeks after inclusion in the study the success of infection eradication was 92.5% in the study group, in the control group it was 91.3% (p > 0.05. In 6 patients (7.5%, 6/ 80 from the study group and in 7 (8.8%, 7/80 from the control group we introduced a replacement treatment

  18. Real-time PCR improves Helicobacter pylori detection in patients with peptic ulcer bleeding.

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    María José Ramírez-Lázaro

    Full Text Available BACKGROUND AND AIMS: Histological and rapid urease tests to detect H. pylori in biopsy specimens obtained during peptic ulcer bleeding episodes (PUB often produce false-negative results. We aimed to examine whether immunohistochemistry and real-time PCR can improve the sensitivity of these biopsies. PATIENTS AND METHODS: We selected 52 histology-negative formalin-fixed paraffin-embedded biopsy specimens obtained during PUB episodes. Additional tests showed 10 were true negatives and 42 were false negatives. We also selected 17 histology-positive biopsy specimens obtained during PUB to use as controls. We performed immunohistochemistry staining and real-time PCR for 16S rRNA, ureA, and 23S rRNA for H. pylori genes on all specimens. RESULTS: All controls were positive for H. pylori on all PCR assays and immunohistochemical staining. Regarding the 52 initially negative biopsies, all PCR tests were significantly more sensitive than immunohistochemical staining (p<0.01. Sensitivity and specificity were 55% and 80% for 16S rRNA PCR, 43% and 90% for ureA PCR, 41% and 80% for 23S rRNA PCR, and 7% and 100% for immunohistochemical staining, respectively. Combined analysis of PCR assays for two genes were significantly more sensitive than ureA or 23S rRNA PCR tests alone (p<0.05 and marginally better than 16S rRNA PCR alone. The best combination was 16S rRNA+ureA, with a sensitivity of 64% and a specificity of 80%. CONCLUSIONS: Real-time PCR improves the detection of H. pylori infection in histology-negative formalin-fixed paraffin-embedded biopsy samples obtained during PUB episodes. The low reported prevalence of H. pylori in PUB may be due to the failure of conventional tests to detect infection.

  19. Outcome of Holiday and Nonholiday Admission Patients with Acute Peptic Ulcer Bleeding: A Real-World Report from Southern Taiwan

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    Tsung-Chin Wu

    2014-01-01

    Full Text Available Background. Recent findings suggest that patients admitted on the weekend with peptic ulcer bleeding might be at increased risk of adverse outcomes. However, other reports found that there was no “holiday effect.” The purpose of this study was to determine if these findings hold true for a real-life Taiwanese medical gastroenterology practice. Materials and Methods. We reviewed the medical files of hospital admissions for patients with peptic ulcer bleeding who received initial endoscopic hemostasis between January 2009 and March 2011. A total of 744 patients were enrolled (nonholiday group, n=615; holiday group, n=129 after applying strict exclusion criteria. Holidays were defined as weekends and national holidays in Taiwan. Results. Our results showed that there was no significant difference in baseline characteristics between the two groups. We also observed that, compared to the nonholiday group, patients in the holiday group received earlier endoscopy treatment (12.20 hours versus 16.68 hours, P=0.005, needed less transfused blood (4.8 units versus 6.6 units, P=0.02, shifted from intravenous to oral proton-pump inhibitors (PPIs more quickly (5.3 days versus 6.9 days, P=0.05, and had shorter hospital stays (13.05 days versus 17.36 days, P=0.005. In the holiday and nonholiday groups, the rebleeding rates were 17.8% and 23.41% (P=0.167, the mortality rates were 11.63% versus 13.66% (P=0.537, and surgery was required in 2.11% versus 4.66% (P=0.093, respectively. Conclusions. Patients who presented with peptic ulcer bleeding on holidays did not experience delayed endoscopy or increased adverse outcomes. In fact, patients who received endoscopic hemostasis on the holiday had shorter waiting times, needed less transfused blood, switched to oral PPIs quicker, and experienced shorter hospital stays.

  20. Accommodation in a refugee shelter as a risk factor for peptic ulcer bleeding after the Great East Japan Earthquake: a case-control study of 329 patients.

    Science.gov (United States)

    Kanno, Takeshi; Iijima, Kastunori; Koike, Tomoyuki; Abe, Yasuhiko; Shimada, Norihiro; Hoshi, Tatsuya; Sano, Nozomu; Ohyauchi, Motoki; Ito, Hirotaka; Atsumi, Tomoaki; Konishi, Hidetomo; Asonuma, Sho; Shimosegawa, Tooru

    2015-01-01

    We have reported that the total number of peptic ulcers (PUs) had increased 1.5-fold after the Great East Japan Earthquake compared with those of the previous year, and that hemorrhagic ulcers were more prominently increased by 2.2-fold. The aim of this study is to determine the risk factors for bleeding ulcers after the Great East Japan Earthquake. Clinical data of all peptic ulcer subjects endoscopically detected at the 7 major hospitals in the middle of the stricken area during the 3 months after the earthquake were retrospectively collected. Based on endoscopic and laboratory findings, peptic ulcer cases were divided into 227 bleeding ulcer cases and 102 non-bleeding controls. Other than ordinary risk factors for bleeding ulcers, the refugee shelter was included in the analysis as a unique confounder after the earthquake. Multiple logistic regression analyses were used to adjust for potential confounders. Eighty-seven (27%) of 329 PUs emerged from refuge shelters, and the majority (76 of 87) of PUs occurring in such shelters was the bleeding type. Multivariate regression showed that residence in a shelter was a strong risk factor for ulcer bleeding with OR (95% CI): 4.4 (2.1-9.6, p < 0.0001), independent of the progressiveness of ulcer diseases. Accommodation in a refugee shelter can be a strong risk factor for ulcer bleeding after a large-scale disaster. Since acid-suppressive drugs are supposed to decrease the risk for stress-induced ulcer bleeding, our results will encourage effective use of a limited medical resource in such catastrophic events.

  1. Effects of intravenous and oral esomeprazole in the prevention of recurrent bleeding from peptic ulcers after endoscopic therapy.

    Science.gov (United States)

    Sung, Joseph J Y; Suen, Bing-Yee; Wu, Justin C Y; Lau, James Y W; Ching, Jessica Y L; Lee, Vivian W Y; Chiu, Philip W Y; Tsoi, Kelvin K F; Chan, Francis K L

    2014-07-01

    The use of intravenous proton-pump inhibitors (PPIs) has shown to reduce recurrent bleeding and improve patient outcome after endoscopic hemostasis on patients with peptic ulcer. However, the efficacy of oral PPI is uncertain. Studies from Asia indicated that even oral PPI can achieve the same therapeutic effect. This study is designed to compare the efficacy of high-dose intravenous PPI to oral PPI in preventing recurrent bleeding after endoscopic hemostasis. This is a single-center, randomized-controlled, double-blind, and double-dummy study. Patients had Forrest IA/IB or IIA/IIB peptic ulcer bleeding and received endoscopic hemostasis before recruitment into the study. They were randomized to receive either (i) esomeprazole IV bolus at a dose of 80 mg plus infusion at 8 mg/h for 72 h and oral placebo every 12 h (IVP group), or (ii) IV placebo bolus plus infusion for 72 h and high-dose oral esomeprazole at a dose of 40 mg every 12 h (ORP group). Patients were followed up for 30 days after index bleeding. The primary end point was defined as the 30-day recurrent bleeding after successful endoscopic hemostasis. A total of 118 patients were randomized to the IVP group and 126 to the ORP group in this study. In all, 39.8% in the IVP and 42.9% in the ORP group used non-steroidal anti-inflammatory drug and/or aspirin before bleeding. In the IVP group (vs. ORP), Forrest IA represented 1.7% (5.6%), IB 41.5% (38.1%), IIA 52.5% (50.8%), and IIB 4.2% (5.6%). Recurrent bleeding in 30 days was reported in 7.7% of patients in the IVP group and 6.4% of patients in the ORP group, and the difference of recurrent bleeding was -1.3% (95% CI: -7.7%, 5.1%). There was no difference in blood transfusion, repeated endoscopic therapy, and hospital stay between the two groups. High-dose oral esomeprazole at 40 mg BID may be considered as a useful alternative to IV bolus plus infusion of esomeprazole in the management of ulcer bleeding in patients who are not candidates for high-dose IV

  2. Intravenous Proton Pump Inhibitors before Endoscopy in Bleeding Peptic Ulcer with High-Risk Stigmata: A Multicentre Comparative Study

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    Christopher N Andrews

    2005-01-01

    Full Text Available BACKGROUND: It is not clear if starting intravenous proton pump inhibitors (IV PPI before endoscopic therapy provides additional benefit over starting it afterward in patients with high-risk ulcer stigmata of peptic ulcer disease.

  3. Transcatheter arterial embolization is the first-line therapy of choice in peptic ulcer bleeding not responding to endoscopic therapy

    DEFF Research Database (Denmark)

    Laursen, Stig Borbjerg; Jakobsen, Mark; Nielsen, Michael Milek

    2015-01-01

    Abstract Objective. In 5-10% of patients with peptic ulcer bleeding (PUB) it is impossible to achieve endoscopic hemostasis because of severe bleeding. These patients have traditionally been treated surgically. Transcatheter arterial embolization (TAE) may, however, be associated with a better...... outcome because of the less-invasive nature of the procedure. The aim of the present study was to identify the treatment of choice in endoscopy-refractory PUB. Materials and methods. A retrospective study. Consecutive patients treated with surgery or TAE for endoscopy-refractory PUB during a period of 16...... years at a university hospital were included. Primary hemostasis, rebleeding rate, mortality, and complications were assessed. Mortality was compared between groups after adjustment for age, comorbidity, and anemia using logistic regression analyses. Comorbidity was quantified using the Charlson...

  4. Absence of Helicobacter pylori is not protective against peptic ulcer bleeding in elderly on offending agents: lessons from an exceptionally low prevalence population.

    Science.gov (United States)

    Lee, Yeong Yeh; Noridah, Nordin; Syed Hassan, Syed Abdul Aziz; Menon, Jayaram

    2014-01-01

    Aim. Helicobacter pylori (H. pylori) infection is exceptionally rare in population from the north-eastern region of Peninsular Malaysia. This provides us an opportunity to contemplate the future without H. pylori in acute non-variceal upper gastrointestinal (GI) bleeding. Methods. All cases in the GI registry with GI bleeding between 2003 and 2006 were reviewed. Cases with confirmed non-variceal aetiology were analysed. Rockall score > 5 was considered high risk for bleeding and primary outcomes studied were in-hospital mortality, recurrent bleeding and need for surgery. Results. The incidence of non-variceal upper GI bleeding was 2.2/100,000 person-years. Peptic ulcer bleeding was the most common aetiology (1.8/100,000 person-years). In-hospital mortality (3.6%), recurrent bleeding (9.6%) and need for surgery (4.0%) were uncommon in this population with a largely low risk score (85.2% with score ≤5). Elderly were at greater risk for bleeding (mean 68.5 years, P = 0.01) especially in the presence of duodenal ulcers (P = 0.04) despite gastric ulcers being more common. NSAIDs, aspirin and co-morbidities were the main risk factors. Conclusions. The absence of H. pylori infection may not reduce the risk of peptic ulcer bleeding in the presence of risk factors especially offending drugs in the elderly.

  5. Absence of Helicobacter pylori is not protective against peptic ulcer bleeding in elderly on offending agents: lessons from an exceptionally low prevalence population

    Directory of Open Access Journals (Sweden)

    Yeong Yeh Lee

    2014-02-01

    Full Text Available Aim. Helicobacter pylori (H. pylori infection is exceptionally rare in population from the north-eastern region of Peninsular Malaysia. This provides us an opportunity to contemplate the future without H. pylori in acute non-variceal upper gastrointestinal (GI bleeding. Methods. All cases in the GI registry with GI bleeding between 2003 and 2006 were reviewed. Cases with confirmed non-variceal aetiology were analysed. Rockall score > 5 was considered high risk for bleeding and primary outcomes studied were in-hospital mortality, recurrent bleeding and need for surgery. Results. The incidence of non-variceal upper GI bleeding was 2.2/100,000 person-years. Peptic ulcer bleeding was the most common aetiology (1.8/100,000 person-years. In-hospital mortality (3.6%, recurrent bleeding (9.6% and need for surgery (4.0% were uncommon in this population with a largely low risk score (85.2% with score ≤5. Elderly were at greater risk for bleeding (mean 68.5 years, P = 0.01 especially in the presence of duodenal ulcers (P = 0.04 despite gastric ulcers being more common. NSAIDs, aspirin and co-morbidities were the main risk factors. Conclusions. The absence of H. pylori infection may not reduce the risk of peptic ulcer bleeding in the presence of risk factors especially offending drugs in the elderly.

  6. Perforated peptic ulcer

    DEFF Research Database (Denmark)

    Søreide, Kjetil; Thorsen, Kenneth; Harrison, Ewen M

    2015-01-01

    Perforated peptic ulcer is a common emergency condition worldwide, with associated mortality rates of up to 30%. A scarcity of high-quality studies about the condition limits the knowledge base for clinical decision making, but a few published randomised trials are available. Although Helicobacte...

  7. Peptic Ulcer Disease

    Science.gov (United States)

    ... include:Protein pump inhibitors, like esomeprazole (Nexium) or lansoprazole (Prevacid).Histamine receptor blockers, like famotidine (Pepcid) or ranitidine (Zantac).Protectants, like sucralfate (Carafate).If using NSAIDs caused your peptic ulcer and there’s no H. pylori infection, you may ...

  8. Pharmacotherapy of Peptic Ulcer Disease

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    F Molina

    1991-01-01

    Full Text Available The etiology of peptic ulcer is multifactorial; except for omeprazole, all drugs used for the treatment of peptic ulcer result in healing with no statistical difference at four weeks. The healing rare increases with time for active medication and placebo, and is lower among smokers than nonsmokers for all drugs but misoprostol. Mucosal protectives (or ‘cytoprotectives’ as a group seem to have a lower relapse rate than the H2 receptor antagonists at one year. Combination therapy has not yet proved to be better than single drug therapy; however, the number of studies is still small, and more clinical trials are necessary. Resistant ulcers have demonstrated that acid is one of several etiological factors and that more research is needed to elucidate the reason(s for refractoriness. The choice of therapeutic agent is generally made according to patient compliance, medication cost, side effects, effectiveness, relapse rate and physician experience with the drug. Long term maintenance therapy is effective in the prevention of ulcer relapse and is especially recommended for selected patient groups, including patients with recurrent or bleeding ulcer, patients with concomitant nonsteroidal anti-inflammatory drug use, and elderly women. Omeprazole is the treatment of choice for moderate to severe esophagitis and should be reserved for large and resistant ulcers.

  9. Management of Peptic Ulcer Bleeding in Different Case Volume Workplaces: Results of a Nationwide Inquiry in Hungary

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    István Rácz

    2012-01-01

    Full Text Available The aim of this study was to conduct a national survey to evaluate the recent endoscopic treatment and drug therapy of peptic ulcer bleeding (PUB patients and to compare practices in high and low case volume Hungarian workplaces. A total of 62 gastroenterology units participated in the six-month study. A total of 3033 PUB cases and a mean of 8.15±3.9 PUB cases per month per unit were reported. In the 23 high case volume units (HCV, there was a mean of 12.9±5.4 PUB cases/month, whereas in the 39 low case volume units (LCV, a mean of 5.3±2.9 PUB cases/month were treated during the study period. In HCV units, endoscopic therapies for Forrest Ia, Ib, and IIa ulcers were significantly more often used than in LCV units (86% versus 68%; P=0.001. Among patients with stigmata of recent haemorrhage (Forrest I, II, bolus + continuous infusion PPI was given significantly more frequently in HCV than in LCV units (49.6% versus 33.2%; P=0.001. Mortality in HCV units was less than in LCV units (2.7% versus 4.3%; P=0.023. The penetration of evidence-based recommendations for PUB management is stronger in HCV units resulting lower mortality.

  10. [Peptic ulcer disease and stress].

    Science.gov (United States)

    Herszényi, László; Juhász, Márk; Mihály, Emese; Tulassay, Zsolt

    2015-08-30

    The discovery that Helicobacter pylori infection is the major cause of peptic ulcer disease revolutionised our views on the etiology and treatment of the disease. This discovery has tempted many experts to conclude that psychological factors and, specifically, stress are unimportant. However, Helicobacter pylori infection alone does not explain fully the incidence and prevalence of peptic ulcer disease. It has been demonstrated that stress can cause peptic ulcer disease even in the absence of Helicobacter pylori infection, supporting a multicausal model of peptic ulcer etiology. Psychological stress among other risk factors can function as a cofactor with Helicobacter pylori infection.

  11. Early Diagnosis of Helicobacter pylori Infection in Vietnamese Patients with Acute Peptic Ulcer Bleeding: A Prospective Study

    Directory of Open Access Journals (Sweden)

    Duc Trong Quach

    2017-01-01

    Full Text Available Aims. To investigate H. pylori infection rate and evaluate a combined set of tests for H. pylori diagnosis in Vietnamese patients with acute peptic ulcer bleeding (PUD. Methods. Consecutive patients with acute PUB were enrolled prospectively. Rapid urease test (RUT with 3 biopsies was carried out randomly. Patients without RUT or with negative RUT received urea breath test (UBT and serological and urinary H. pylori antibody tests. H. pylori was considered positive if RUT or any noninvasive test was positive. Patients were divided into group A (RUT plus noninvasive tests and group B (only noninvasive tests. Results. The overall H. pylori infection rate was 94.2% (161/171. Groups A and B had no differences in demographic characteristics, bleeding severity, endoscopic findings, and proton pump inhibitor use. H. pylori-positive rate in group A was significantly higher than that in group B (98.2% versus 86.7%, p=0.004. The positive rate of RUT was similar at each biopsy site but significantly increased if RUT results from 2 or 3 sites were combined (p<0.05. Conclusions. H. pylori infection rate in Vietnamese patients with acute PUB is high. RUT is an excellent test if at least 2 biopsies are taken.

  12. Early Diagnosis of Helicobacter pylori Infection in Vietnamese Patients with Acute Peptic Ulcer Bleeding: A Prospective Study

    Science.gov (United States)

    Quach, Duc Trong; Luu, Mai Ngoc; To, Thuy-HuongThi; Bui, Quy Nhuan; Tran, Tuan Anh; Tran, Binh Duy; Vo, Minh-Cong Hong; Tanaka, Shinji; Uemura, Naomi

    2017-01-01

    Aims. To investigate H. pylori infection rate and evaluate a combined set of tests for H. pylori diagnosis in Vietnamese patients with acute peptic ulcer bleeding (PUD). Methods. Consecutive patients with acute PUB were enrolled prospectively. Rapid urease test (RUT) with 3 biopsies was carried out randomly. Patients without RUT or with negative RUT received urea breath test (UBT) and serological and urinary H. pylori antibody tests. H. pylori was considered positive if RUT or any noninvasive test was positive. Patients were divided into group A (RUT plus noninvasive tests) and group B (only noninvasive tests). Results. The overall H. pylori infection rate was 94.2% (161/171). Groups A and B had no differences in demographic characteristics, bleeding severity, endoscopic findings, and proton pump inhibitor use. H. pylori-positive rate in group A was significantly higher than that in group B (98.2% versus 86.7%, p = 0.004). The positive rate of RUT was similar at each biopsy site but significantly increased if RUT results from 2 or 3 sites were combined (p < 0.05). Conclusions. H. pylori infection rate in Vietnamese patients with acute PUB is high. RUT is an excellent test if at least 2 biopsies are taken. PMID:28133477

  13. Treatment for Peptic Ulcer Disease

    Science.gov (United States)

    ... Protectants Protectants coat ulcers and protect them against acid and enzymes so that healing can occur. Doctors only prescribe one protectant— sucralfate (Carafate) —for peptic ulcer disease. Tell your doctor if the medicines make you ...

  14. Helicobacter pylori and Peptic Ulcers

    Centers for Disease Control (CDC) Podcasts

    2010-08-17

    In this podcast, CDC's Dr. David Swerdlow discusses the relationship between Helicobacter pylori and peptic ulcer disease and trends in hospitalization rates for peptic ulcer disease in the United States between 1998 and 2005.  Created: 8/17/2010 by National Center for Emerging and Zoonotic Infectious Diseases.   Date Released: 8/17/2010.

  15. Preadmission use of SSRIs alone or in combination with NSAIDs and 30-day mortality after peptic ulcer bleeding

    DEFF Research Database (Denmark)

    Gasse, Christiane; Christensen, Steffen; Riis, Anders

    2009-01-01

    ; for those younger than 80 years, the adjusted MRR was 1.54 (0.72-3.29), and 2.57 (1.47-4.49) for those older than 80 years. CONCLUSIONS. Use of SSRIs, alone or in combination with NSAIDs, was not associated with increased 30-day mortality following PUB. However, increased mortality was found in patients who...... with NSAIDs on 30-day mortality after peptic ulcer bleeding (PUB). MATERIAL AND METHODS. A population-based cohort study of patients with a first hospitalization with PUB in three Danish counties was carried out between 1991 and 2005 using medical databases. We calculated 30-day mortality rate ratios (MRRs......) associated with the use of SSRIs, alone or in combination with NSAIDs, adjusted for important covariates. RESULTS. Of 7415 patients admitted with PUB, 5.9% used SSRIs only, and 3.8% used SSRIs in combination with NSAIDs, with a 30-day mortality of 11.8% and 11.3%, respectively. Compared with patients who...

  16. Prevalence and outcome of peptic ulcer bleeding in patients with liver cirrhosis

    Directory of Open Access Journals (Sweden)

    Ahmed Gado

    2014-06-01

    Conclusion: The commonest cause of NVUGIB in patients with liver cirrhosis was PUB. Mortality in patients with PUB was particularly high among males, patients who had adherent clot, bleeding recurrence, development of complications and a high Rockall score.

  17. Anaesthesia care with and without tracheal intubation during emergency endoscopy for peptic ulcer bleeding

    DEFF Research Database (Denmark)

    Lohse, N; Lundstrøm, L H; Vestergaard, T R;

    2015-01-01

    index score, BMI, age, sex, alcohol use, referral origin (home or in-hospital), Forrest classification, ulcer localization, and postoperative care. RESULTS: The study group comprised 3580 patients under anaesthesia care: 2101 (59%) for the TI group and 1479 (41%) for the MAC group. During the first 90...

  18. Independent risk factors of 30-day outcomes in 1264 patients with peptic ulcer bleeding in the USA

    DEFF Research Database (Denmark)

    Camus, M.; Jensen, D. M.; Kovacs, T. O.;

    2016-01-01

    were predictors of 30-day surgery. Risk factors for 30-day death were major SRH, in-patient bleeding, and any initial platelet transfusion or fresh frozen plasma transfusion ≥2 units. Among patients with major SRH and out-patient start of bleeding, larger ulcer size was also a risk factor for death (OR...

  19. Endoscopic treatment for high-risk bleeding peptic ulcers: A randomized, controlled trial of epinephrine alone with epinephrine plus fresh frozen plasma

    Directory of Open Access Journals (Sweden)

    Mahsa Khodadoostan

    2016-01-01

    Full Text Available Background: Acute upper gastrointestinal bleeding is a common and potentially life-threatening emergency with substantial mortality. Fresh frozen plasma (FFP, a good source of coagulation factors, might be an ideal injection agent based on its physiologic properties. Therefore, we evaluated the role of FFP as a hemostatic agent in patients with high-risk bleeding peptic ulcers. Materials and Methods: From August 2015 to April 2016, 108 consecutive patients with high-risk bleeding ulcers were admitted to our university hospital. They were randomly assigned to undergo injection of epinephrine alone (A or epinephrine plus FFP (B. The primary outcomes assessed were the initial hemostasis, recurrent bleeding, hospital stay, blood transfusion, surgery rate, and 14-day mortality. Results: Initial hemostasis was achieved in 47 of 50 patients (94% in the Group A and 49 of 50 patients (98% in the Group B (P = 0.61. There were no significant differences in the rate of recurrent bleeding between Group A (14% and Group B (8% (P = 0.52. We found no significant differences between Group A and Group B with respect to the surgery rate, bleeding death, procedure-related death, and duration of hospitalization (P > 0.05. Conclusion: It is concluded the injection of epinephrine alone was equally effective as injection of epinephrine plus FFP to endoscopic hemostasis. Epinephrine alone and epinephrine plus FFP were not different in recurrent bleeding, rate of surgery, blood transfusion, or mortality.

  20. State-of-the-art management of acute bleeding peptic ulcer disease

    Directory of Open Access Journals (Sweden)

    Hisham Al Dhahab

    2013-01-01

    Full Text Available The management of patients with non variceal upper gastrointestinal bleeding has evolved, as have its causes and prognosis, over the past 20 years. The addition of high-quality data coupled to the publication of authoritative national and international guidelines have helped define current-day standards of care. This review highlights the relevant clinical evidence and consensus recommendations that will hopefully result in promoting the effective dissemination and knowledge translation of important information in the management of patients afflicted with this common entity.

  1. Management of bleeding gastroduodenal ulcers

    DEFF Research Database (Denmark)

    Laursen, Stig Borbjerg; Jørgensen, Henrik Stig; Schaffalitzky de Muckadell, Ove B.

    2012-01-01

    -risk stigmata. Although selected patients can be discharged promptly after endoscopy, high-risk patients should be hospitalized for at least 3 days after endoscopic hemostasis. Patients with peptic ulcer bleeding who require secondary cardiovascular prophylaxis should start receiving acetylsalicylic acid (ASA...

  2. A head to head comparison of oral vs intravenous omeprazole for patients with bleeding peptic ulcers with a clean base, flat spots and adherent clots

    Institute of Scientific and Technical Information of China (English)

    (S)erif Y(i)lmaz; Kadim Bayan; Yekta Tüzün; Mehmet Dursun; Fikri Canoru(c)

    2006-01-01

    AIM: To compare the effect of intravenous and oral omeprazole in patients with bleeding peptic ulcers without high-risk stigmata.METHODS: This randomized study included 211 patients [112 receiving iv omeprazole protocol (Group 1),99 receiving po omeprazole 40 mg every 12 h (Group 2)] with a mean age of 52.7. In 144 patients the ulcers showed a clean base, and in 46 the ulcers showed fiat spots and in 21 old adherent clots. The endpoints were re-bleeding, surgery, hospital stay, blood transfusion and death. After discharge, re-bleeding and death were reevaluated within 30 d.RESULTS: The study groups were similar with respect to baseline characteristics. Re-bleeding was recorded in 5 patients of Group 1 and in 4 patients of Group 2 (P = 0.879). Three patients in Group 1 and 2 in Group 2 underwent surgery (P = 0.773). The mean length of hospital stay was 4.6 ± 1.6 d in Group 1 vs 4.5 ± 2.6 d in Group 2 (P = 0.710); the mean amounts of blood transfusion were 1.9 ± 1.1 units in Group 1 vs 2.1 ± 1.7 units in Group 2 (P = 0.350). Four patients, two in each group died (P = 0.981). After discharge, a new bleeding occurred in 2 patients of Group 1 and in 1 patient of Group 2, and one patient from Group 1 died.CONCLUSION: We demonstrate that the effect of oral omeprazole is as effective as intravenous therapy in terms of re-bleeding, surgery, transfusion requirements,hospitalization and mortality in patients with bleeding ulcers with low risk stigmata. These patients can be treated effectively with oral omeprazole.

  3. A Mysterious Cause of Gastrointestinal Bleeding Disguising Itself as Diverticulosis and Peptic Ulcer Disease: A Review of Diagnostic Modalities for Aortoenteric Fistula

    Directory of Open Access Journals (Sweden)

    Viplove Senadhi

    2010-11-01

    Full Text Available An 81-year-old male with a history of hypertension, hyperlipidemia, smoking, and peptic ulcer disease (PUD presented with 2 episodes of maroon stools for 3 days and was found to be orthostatic. His PUD was thought to have accounted for a previous upper gastrointestinal (GI bleed. A colonoscopy revealed 3 polyps and a few diverticuli throughout the colon that were considered to be the source of the bleeding. Two months later, the patient had massive lower GI bleeding and developed hypovolemic shock with a positive bleeding scan in the splenic flexure; however, angiography was negative. A repeat colonoscopy revealed transverse/descending colon diverticular disease and the patient was scheduled for a left hemicolectomy for presumed diverticular bleeding. Intraoperatively, an aortoenteric (AE fistula secondary to an aorto-bi-iliac bypass graft placed during an abdominal aortic aneurysm (AAA repair 14 years prior was discovered and was found to be the source of the bleeding. The patient had an AE fistula repair and did well postoperatively without further bleeding. AE fistulas can present with either upper GI or lower GI bleeding, and are universally deadly if left untreated. AE fistulas often present with a herald bleed before life-threatening bleeding. A careful history should always be elicited in patients with risk factors of AAAs such as hypertension, hyperlipidemia and a history of smoking. Strong clinical suspicion in the setting of a scrupulous patient history is the most important factor that allows for the diagnosis of an AE fistula. There are numerous diagnostic modalities for AE fistula, but there is not one specific test that universally diagnoses AE fistulas. Nuclear medicine scans and angiography should not be completely relied on for the diagnosis of AE fistulas or other lower GI bleeds for that manner. Although the conventional paradigm for evaluating lower GI bleeds incorporates nuclear medicine scans and angiography, there is

  4. [Guidelines of diagnosis for peptic ulcer disease].

    Science.gov (United States)

    Kim, Sang Gyun; Kim, Jae Gyu; Shin, Sung Kwan; Kim, Hyun Soo; Seol, Sang Young

    2009-11-01

    Peptic ulcer is one of the most prevalent diseases in gastrointestinal field. Recently, evolution was made for pathophysiology of peptic ulcer from "no acid, no ulcer" to Helicobacter pylori and non-steroidal anti-inflammatory drugs. The prevalence of peptic ulcer disease is estimated about 10% in Korea, and has declined due to Helicobacter pylori eradication therapy. Peptic ulcer has the cycle of exacerbation and improvement in the clinical course, and has not occasionally any clinical symptom. Helicobacter pylori eradication has made the marked reduction of relapse of peptic ulcer disease. Although nationwide endoscopic screening has enabled accurate diagnosis of peptic ulcer disease, general guideline for diagnosis of peptic ulcer has not made in Korea. Herein, we propose a guideline for the diagnosis of peptic ulcer according to domestic, international clinical studies, and experts opinions with level of evidence and grade of recommendation.

  5. Clinical Medical Treatment of Peptic Ulcer Bleeding%消化性溃疡并发出血的临床内科治疗分析

    Institute of Scientific and Technical Information of China (English)

    鲁林东

    2015-01-01

    目的:探讨消化性溃疡病并发出血在的临床内科治疗方法效果。方法选取2014年1月~2015年3月收治的消化性溃疡出血21例临床药物治疗资料方法进行分析。结果本组21例患者经药物和内镜治疗,20例患者止血成功,1例患者转外科行手术治疗,成功率为95.24%;住院时间平均为(13±2.5)d。结论多数胃十二指肠溃疡大出血,经内科治疗可以止血。稳定生命体征,抗休克治疗,局部使用止血药物,全身用药采取H2受体拮抗剂和PPI抑制胃酸分泌。%ObjectiveTo investigate the clinical medical effect of peptic ulcer disease complicated by bleeding.MethodsTwenty-one cases of peptic ulcer bleeding were treated in January 2014 to March 2015,then clinical drug treatment data were analyzed.ResultsThe group of 21 patients after drug and endoscopic therapy,20 patients hemostasis,and 1 patient underwent surgery surgical revolution,the success rate was 95.24%,the average length of stay was(13±2.5)d.Conclusion Most gastric ulcer bleeding,the medical treatment can stop the bleeding. Stable vital signs,anti-shock therapy, topical hemostatic agents,systemic medication taken H2 receptor antagonists and PPI inhibition of gastric acid secretion.

  6. Peptic Ulcer Disease

    Science.gov (United States)

    ... ulcers”. These names refer to the location where the ulcer is found. Gastric ulcers are located in the ... however, the food is not the cause of the ulcer. People diagnosed with ulcers do not need to ...

  7. Peptic ulcer disease - discharge

    Science.gov (United States)

    ... of your ulcer and increase the chance that the ulcer will come back. Talk to your doctor about ... see how your ulcer is healing especially if the ulcer was in the stomach. Your provider may want ...

  8. Gastric ulcer bleeding: diagnosis by computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Voloudaki, Argyro; Tsagaraki, Kaliopi; Mouzas, John; Gourtsoyiannis, Nickolas

    1999-06-01

    A case of CT demonstration of a bleeding gastric ulcer is presented, in a patient with confusing clinical manifestations. Abdominal CT was performed without oral contrast medium administration, and showed extravasation of intravenous contrast into a gastric lumen distended with material of mixed attenuation. It is postulated that if radiopaque oral contrast had been given, peptic ulcer bleeding would probably have been masked. CT demonstration of gastric ulcer bleeding, may be of value in cases of differential diagnostic dilemmas.

  9. Hematologic and laboratory parameters in patientis with peptic ulcer bleeding treated by two modalities of endoscopic haemostasis and proton pompe inhibitors

    Directory of Open Access Journals (Sweden)

    Amila Mehmedović-Redžepović

    2011-02-01

    Full Text Available Aim To compare two schedules (continuous infusion or bolus iv. ofPPI in treatment after endoscopic homeostasis of bleeding ulcers. Methods Patients with gastrointestinal bleeding caused by peptic ulcer, or a recent history (<24 h before presentation were included in the study. All cases with actively bleeding ulcers were treated with epinephrine injection and/or thermal coagulation, and randomized to receive intravenous PPIs according to the continuousregimen (in continuous infusion or the standard regimen (40 mg bolus twice a day for 3 days. Results 69 patients were treated. Bleeding recurred in 5 of 34 patients (14.7% receiving the intensive regimen, and in 8 of 35 (22.8% patients receiving the standard regimen. Hemoglobine rate in standard regimen group was 93,5 g/L (SD 23,8, and in intensive regimen group 106,6 g/L (SD 22,4 (p = 0.042. Total protein rate in the standard regimen group was 65,1 g/L (SD 7,3 and in the intensive regimen group 67,7 g/L (SD 8,15, (p = 0.525. Albumin rate in the standard regimen group was 31,0 g/L (SD 5,2, whereas in the intensive regimen group it was 34,8 g/L (SD 7,4, (p = 0.652. Globulin rate in the standard regimen group was 31,0 g/L (SD 5,2 and in the intensive regimen group 32,3 g/L (5,3, (p = 0.875. Fibrinogen rate in the standard regimen group was 11,1 (SD 2,6 and 10,8 g/L (SD 2,4 p = 0.622 in the intensive regimen group. A mean number of units of blood transfusion for patients in the intensive group was 2,18 (SD 0,8 and 1,34 (SD 1,02 in the standard group, with statistical level of difference p = 0.0004, using Student t-test. The duration of hospital stay was 6,4 days (SD 2,8 in the standard group and 5,8 days (SD 2,8 in the intensive group (p = 0.40. There were fewer surgical interventions in the intensive versus standard regimen.Conclusion In patients with bleeding peptic ulcers with successfulendoscopic hemostasis the standard IPP regimen had advantage for transfusion requirements, but no advantage with

  10. [Treatment of peptic ulcer related to rheumatic diseases].

    Science.gov (United States)

    Imaeda, Hiroyuki; Ishii, Hiromasa; Goto, Makoto

    2002-08-01

    Rheumatic diseases often have gastrointestinal(GI) manifestations, and may present as GI bleeding and perforation due to peptic ulcer associated with high mortality. Major causes of peptic ulcer related to rheumatic diseases are drugs such as nonsteroidal anti-inflammatory drug(NSAID) and corticosteroid, and vasculitis. The analgesic effects of NSAID often mask abdominal pain until they cause GI bleeding and perforation. Therefore, it is important to make early diagnosis of peptic ulcer with upper gastrointestinal endoscope. Fundamental treatment of NSAID induced peptic ulcer is to quit it, however it is difficult because of activity of rheumatic diseases. Also, most NSAID induced peptic ulcers heal by administration of proton pump inhibitor or misoprostol. Corticosteroid pulse therapy or administration of immunosuppressant agents is effective for vasculitis induced peptic ulcer, however it is difficult to make diagnosis of it. Development of NSAID with less side effects such as cyclooxygenase-2 selective inhibitors and establishment of diagnosis and treatment of peptic ulcer related to rheumatic diseases are expected.

  11. Perforated Peptic Ulcer: new insights

    NARCIS (Netherlands)

    M.J.O.E. Bertleff (Marietta)

    2011-01-01

    textabstractMuch has been written on perforated peptic ulcer (PPU) during the last hundred years. In 1500, when necropsies were first allowed, often a small hole was found in the anterior wall of the stomach, giving an explanation for symptoms of acute abdominal pain, nausea, vomiting which often le

  12. Peptic ulcers: mortality and hospitalization.

    Science.gov (United States)

    Riley, R

    1991-01-01

    This study analyzes data on peptic ulcer disease based on deaths for 1951-1988 and hospital separations for 1969-1988. The source of the data are mortality and morbidity statistics provided to Statistics Canada by the provinces. The age-standardized mortality rates (ASMR) for peptic ulcer disease decreased from 1951 to 1988 by 69.4% for men (8.5 to 2.6 per 100,000 population), and 31.8% for women (2.2 to 1.5). Separation rates from hospitals during 1969-1988 for peptic ulcer disease also decreased by 59.8% for men (242.7 to 97.6 per 100,000 population) and 35.6% for women (103.2 to 66.5). Age-specific rates for both mortality and hospital separations increased with age. Epidemiological studies indicate that the incidence of peptic ulcer disease is declining in the general population. The downward trends in mortality and hospitalization rates for peptic ulcer disease reflect this change in incidence, but additional factors probably contribute as well to this decline. Male rates for both mortality and hospital separations were much higher than female rates at the beginning of the study period; but toward the end, the gap between the sexes narrowed considerably, mainly because the male rates declined substantially while the female rates decline moderately. The slower decline in the rates for women may be related to such factors as the increasing labour force participation among women and the slower decline in the population of female smokers.

  13. Management of bleeding gastroduodenal ulcers

    DEFF Research Database (Denmark)

    Laursen, Stig Borbjerg; Jørgensen, Henrik Stig; Schaffalitzky de Muckadell, Ove B

    2012-01-01

    serious ulcer bleeding is suspected and blood found in gastric aspirate, endoscopy within 12 hours will result in faster discharge and reduced need for transfusions. Endoscopic hemostasis remains indicated for high-risk lesions. Clips, thermocoagulation, and epinephrine injection are effective......Description: A multidisciplinary group of Danish experts developed this guideline on management of bleeding gastroduodenal ulcers. Sources of data included published studies up to March 2011. Quality of evidence and strength of recommendations have been graded. The guideline was approved......-risk stigmata. Although selected patients can be discharged promptly after endoscopy, high-risk patients should be hospitalized for at least 3 days after endoscopic hemostasis. Patients with peptic ulcer bleeding who require secondary cardiovascular prophylaxis should start receiving acetylsalicylic acid (ASA...

  14. Management of bleeding gastroduodenal ulcers

    DEFF Research Database (Denmark)

    Laursen, Stig Borbjerg; Jørgensen, Henrik Stig; Schaffalitzky de Muckadell, Ove B

    2012-01-01

    serious ulcer bleeding is suspected and blood found in gastric aspirate, endoscopy within 12 hours will result in faster discharge and reduced need for transfusions. Endoscopic hemostasis remains indicated for high-risk lesions. Clips, thermocoagulation, and epinephrine injection are effective......Description: A multidisciplinary group of Danish experts developed this guideline on management of bleeding gastroduodenal ulcers. Sources of data included published studies up to March 2011. Quality of evidence and strength of recommendations have been graded. The guideline was approved......-risk stigmata. Although selected patients can be discharged promptly after endoscopy, high-risk patients should be hospitalized for at least 3 days after endoscopic hemostasis. Patients with peptic ulcer bleeding who require secondary cardiovascular prophylaxis should start receiving acetylsalicylic acid (ASA...

  15. [Peptic ulcer disease etiology, diagnosis and treatment].

    Science.gov (United States)

    Bak-Romaniszyn, Leokadia; Wojtuń, Stanisław; Gil, Jerzy; Płaneta-Małecka, Izabela

    2004-01-01

    Authors in this article present etiology, clinical manifestations, diagnostic procedures and treatment of peptic ulcer disease in children and adults. Increased gastric acid output, Helicobacter pylori, NSAIDs and stress are the basic risk factors in peptic ulcer disease. H. pylori infection is a widely known risk factor in peptic ulcer disease and influences diagnostic and treatment procedures. Primary ulcer disease concerns mainly duodenum and is accompanied by H. pylori infection. Gastroscopy and Helicobacter tests are the only reliable procedures to diagnose peptic ulcer disease. Nowadays the most important aim in peptic ulcer treatment is the H. pylori eradication. Therapy with two antibiotics and a protein pomp inhibitor eradicates the bacteria, treats the ulceration and lowers the number of ulcer recurrence. In non-infected H. pylori ulcers or in a long-term treatment protein pomp inhibitors and H2-inhibitors are effective as well in gastroprotective therapy.

  16. Peptic Ulcer Disease Different Pathogenesis of Duodenal and Gastric Ulcer

    Directory of Open Access Journals (Sweden)

    Hendra Koncoro

    2015-12-01

    Full Text Available Despite decrease frequency of Helicobacter pylori (H. pylori due to eradication therapy, peptic ulcer disease as a manifestation of this infection is still remain a health burden. Understanding the physiology of gastric acid secretion and its alteration by H. pylori induced inflammation will aid physician in differentiating peptic ulcer disease based on its location. Duodenal ulcer and gastric ulcer disease are two common condition that usually found in peptic ulcer. Recognition of symptoms and its pathogenesis may lead physician to understand the fate of each condition in the future. This article reviews concept of peptic ulcer pathogenesis according to ulcer etiology.

  17. Peptic Ulcer Disease Different Pathogenesis of Duodenal and Gastric Ulcer

    OpenAIRE

    Hendra Koncoro; I Dewa Nyoman Wibawa

    2015-01-01

    Despite decrease frequency of Helicobacter pylori (H. pylori) due to eradication therapy, peptic ulcer disease as a manifestation of this infection is still remain a health burden. Understanding the physiology of gastric acid secretion and its alteration by H. pylori induced inflammation will aid physician in differentiating peptic ulcer disease based on its location. Duodenal ulcer and gastric ulcer disease are two common condition that usually found in peptic ulcer. Recognition of symptoms ...

  18. Computed tomographic findings in penetrating peptic ulcer

    Energy Technology Data Exchange (ETDEWEB)

    Madrazo, B.L.; Halpert, R.D.; Sandler, M.A.; Pearlberg, J.L.

    1984-12-01

    Four cases of peptic ulcer penetrating the head of the pancreas were diagnosed by computed tomography (CT). Findings common to 3 cases included (a) an ulcer crater, (b) a sinus tract, and (c) enlargement of the head of the pancreas. Unlike other modalities, the inherent spatial resolution of CT allows a convenient diagnosis of this important complication of peptic ulcer disease.

  19. Association between ulcer site and outcome in complicated peptic ulcer disease

    DEFF Research Database (Denmark)

    Lolle, Ida; Møller, Morten Hylander; Rosenstock, Steffen Jais

    2016-01-01

    OBJECTIVE: Mortality rates in complicated peptic ulcer disease are high. This study aimed to examine the prognostic importance of ulcer site in patients with peptic ulcer bleeding (PUB) and perforated peptic ulcer (PPU). MATERIALS AND METHODS: Design: a nationwide cohort study with prospective...... and adjusted association between ulcer site (gastric and duodenal) and the outcome measures of interest were assessed by binary logistic regression analysis. RESULTS: Some 20,059 patients with PUB and 4273 patients with PPU were included; 90-d mortality was 15.3% for PUB and 29.8% for PPU; 30-d mortality...... was 10.2% and 24.7%, respectively. Duodenal bleeding ulcer, as compared to gastric ulcer (GU), was associated with a significantly increased risk of all-cause mortality within 90 and 30 d, and with re-intervention: adjusted odds ratio (OR) 1.47 (95% confidence interval 1.30-1.67); p 

  20. Management of NSAID-associated peptic ulcer disease.

    Science.gov (United States)

    Melcarne, Luigi; García-Iglesias, Pilar; Calvet, Xavier

    2016-06-01

    Non-steroidal anti-inflammatory drug (NSAID) use increases the risk of gastrointestinal complications such as ulcers or bleeding. The presence of factors like advanced age, history of peptic ulcer, Helicobacter pylori infection and the use of anticoagulants or antiplatelet agents increase this risk further. COX-2 inhibitors and antisecretory drugs, particularly proton pump inhibitors, help to minimize the risk of gastrointestinal complications in high-risk patients. This review presents a practical approach to the prevention and treatment of NSAID-associated peptic ulcer disease and examines the new advances in the rational use of NSAIDs.

  1. Refractory peptic ulcer disease.

    Science.gov (United States)

    Napolitano, Lena

    2009-06-01

    Refractory PUD is a diagnostic and therapeutic challenge. Optimal management of severe or refractory PUD requires a multidisciplinary team approach, using primary care providers, gastroenterologists, and general surgeons. Medical management has become the cornerstone of therapy. Identification and eradication of H pylori infection combined with acid reduction regimens can heal ulceration and also prevent recurrence. Severe, intractable or recurrent PUD and associated complications mandates a careful and methodical evaluation and management strategy to determine the potential etiologies and necessary treatment (medical or surgical) required.

  2. Acid-reducing vagotomy is associated with reduced risk of subsequent ischemic heart disease in complicated peptic ulcer

    OpenAIRE

    Wu, Shih-Chi; Fang, Chu-Wen; Chen, William Tzu-Liang; Muo, Chih-Hsin

    2016-01-01

    Abstract Persistent exacerbation of a peptic ulcer may lead to a complicated peptic ulcer (perforation or/and bleeding). The management of complicated peptic ulcers has shifted from acid-reducing vagotomy, drainage, and gastrectomy to simple local suture or non-operative (endoscopic/angiographic) hemostasis. We were interested in the long-term effects of this trend change. In this study, complicated peptic ulcer patients who received acid-reducing vagotomy were compared with those who receive...

  3. Drug-induced peptic ulcer disease

    OpenAIRE

    Vella, Valerie

    2005-01-01

    For more than a century, peptic ulcer disease has been a major cause of morbidity and mortality. Peptic ulcer disease is a heterogeneous group of disorders involving the gastrointestinal tract and results from an imbalance between the aggressive forces of gastric acid and pepsin and the defensive mechanisms of the gastric mucosa.

  4. Triple gastric peptic ulcer perforation.

    Science.gov (United States)

    Radojkovic, Milan; Mihajlovic, Suncica; Stojanovic, Miroslav; Stanojevic, Goran; Damnjanovic, Zoran

    2016-03-01

    Patients with advanced or metastatic cancer have compromised nutritional, metabolic, and immune conditions. Nevertheless, little is known about gastroduodenal perforation in cancer patients. Described in the present report is the case of a 41-year old woman with stage IV recurrent laryngeal cancer, who used homeopathic anticancer therapy and who had triple peptic ulcer perforation (PUP) that required surgical repair. Triple gastric PUP is a rare complication. Self-administration of homeopathic anticancer medication should be strongly discouraged when evidence-based data regarding efficacy and toxicity is lacking.

  5. Optimal management of peptic ulcer disease in the elderly.

    Science.gov (United States)

    Pilotto, Alberto; Franceschi, Marilisa; Maggi, Stefania; Addante, Filomena; Sancarlo, Daniele

    2010-07-01

    Recent data report that the incidence of peptic ulcer is decreasing in the general population; conversely, the rates of gastric and duodenal ulcer hospitalization and mortality remain very high in older patients. Two major factors that might explain this epidemiological feature in the elderly population are the high prevalence of Helicobacter pylori infection and the increasing prescriptions of gastroduodenal damaging drugs, including NSAIDs and/or aspirin (acetylsalicylic acid). The main goals for treating peptic ulcer disease in old age are to reduce recurrence of the disease and to prevent complications, especially bleeding and perforation. The available treatments for peptic ulcer are essentially based on gastric acid suppression with antisecretory drugs and the eradication of H. pylori infection. The aim of this article is to report the available data on clinical efficacy and tolerability of peptic ulcer treatments in elderly patients and provide recommendations for their optimal use in this special population. Proton pump inhibitor (PPI)-based triple therapies for 7 days are highly effective for the cure of H. pylori-positive peptic ulcers as well as for reducing ulcer recurrence. Antisecretory drugs are also the treatment of choice for NSAID- or aspirin-related peptic ulcers and are useful as preventive therapy in chronic users of NSAIDs and low-dose aspirin as antiplatelet therapy. Antisecretory PPI therapy has a favourable tolerability profile in geriatric patients; however, monitoring is suggested in older patients with frequent pulmonary infections, gastrointestinal malabsorption, unexplained chronic diarrhoea, osteoporosis or those taking concomitant cytochrome P450 2C19-metabolized medications. The overall approach to the geriatric patient should include a comprehensive geriatric assessment that ensures multidimensional evaluation of the patient in order to better define the clinical risk of adverse outcomes in the older patient with peptic ulcer and

  6. Management of bleeding gastroduodenal ulcers

    DEFF Research Database (Denmark)

    Laursen, Stig Borbjerg; Jørgensen, Henrik Stig; Schaffalitzky de Muckadell, Ove B.

    2012-01-01

    Description: A multidisciplinary group of Danish experts developed this guideline on management of bleeding gastroduodenal ulcers. Sources of data included published studies up to March 2011. Quality of evidence and strength of recommendations have been graded. The guideline was approved by the D......Description: A multidisciplinary group of Danish experts developed this guideline on management of bleeding gastroduodenal ulcers. Sources of data included published studies up to March 2011. Quality of evidence and strength of recommendations have been graded. The guideline was approved...... serious ulcer bleeding is suspected and blood found in gastric aspirate, endoscopy within 12 hours will result in faster discharge and reduced need for transfusions. Endoscopic hemostasis remains indicated for high-risk lesions. Clips, thermocoagulation, and epinephrine injection are effective......-risk stigmata. Although selected patients can be discharged promptly after endoscopy, high-risk patients should be hospitalized for at least 3 days after endoscopic hemostasis. Patients with peptic ulcer bleeding who require secondary cardiovascular prophylaxis should start receiving acetylsalicylic acid (ASA...

  7. Perforated peptic ulcer: How to improve outcome?

    DEFF Research Database (Denmark)

    Møller, Morten Hylander; Adamsen, Sven; Wøjdemann, Morten;

    2008-01-01

    Despite the introduction of histamine H(2)-receptor antagonists, proton-pump inhibitors and the discovery of Helicobacter pylori, both the incidence of emergency surgery for perforated peptic ulcer and the mortality rate for patients undergoing surgery for peptic ulcer perforation have increased...... with an emphasis on risks that are preventable. A systematic review including randomized studies was carried out. There are a limited number of studies of patients with peptic ulcer perforation. Most of these studies are of low evidential status. Only a few randomized, controlled trials have been published...... to improve the outcome of patients with peptic ulcer perforation, sepsis needs to be factored into the existing knowledge and treatment Udgivelsesdato: 2008/8/27...

  8. [Peptic ulcer disease. Clinical evaluation in 2006].

    Science.gov (United States)

    Malfertheiner, P; Bellutti, M

    2006-06-01

    Treatment of peptic ulcer disease has undergone a radical change due to the discovery of its main cause, the Helicobacter pylori infection. The management of the chronic infection is now the primary aim. Treatment of peptic ulcer essentially consists of eradicating H. pylori. A current problem is the resistance developed by H. pylori to the antibiotics used in eradication regimen. Ulcers that are induced by nonsteroidal antirheumatic (NSAR) agents and acetylsalicylic acid are gaining in importance. Optimized inhibition of acid secretion with proton pump inhibitors has made it possible to both prevent and cure ulcers in the stomach and duodenum caused by NSAR agents.

  9. 消化性溃疡出血患者76例临床诊治分析%Clinical analysis of diagnosis and treatment of 7 6 cases of patients with peptic ulcer bleeding

    Institute of Scientific and Technical Information of China (English)

    赵丽娟; 鲍斯琴

    2014-01-01

    peptic ulcer hemorrhage is the most common complication of peptic ulcer patients physical sign depends on the patients with hemorrhage parts,speed and the bleeding.Panxi tora thiazole is gastric acid secretion inhibitor,choice,they the stomach membrane proton pump H+-K+ atpase,thereby blocking the final steps of the gastric acid secretion,suppressing gastric acid secretion.On basis of gastric acid and hydrochloric acid in gastric juice and promote secretin and other stimulus are inhibition caused by gastric acid secretion,work quickly,function is strong and durable,can maintain stomach pH levels higher,build good environment for patients stop bleeding,the drug combination is better anti Hp treatment of peptic ulcer bleeding.%消化性溃疡出血是消化性溃疡患者最常见的并发症,体征表现取决于患者出血的部位,速度和出血量。泮托拉唑是胃酸分泌的抑制剂,可选择性、竞争性地抑制胃壁细胞膜上的质子泵 H+-K+-ATP 酶,从而阻断胃酸分泌的终末步骤,产生抑制胃酸分泌作用。对基础胃酸和胃酸促分泌素等各种刺激引起的胃酸分泌均有抑制作用,起效迅速,作用强而持久,可维持胃内 pH 较高水平,为患者止血造就良好的环境,该药联合抗 Hp 治疗消化性溃疡出血效果更好。

  10. Planned second look endoscopy in patients with bleeding duodenal or gastric ulcers

    DEFF Research Database (Denmark)

    Trap, R; Skarbye, M; Rosenberg, J

    2000-01-01

    INTRODUCTION: Preliminary studies have suggested a beneficial effect of second look endoscopy in patients with bleeding peptic ulcers. METHODOLOGY: We have performed a retrospective survey of seventy patients with bleeding peptic ulcers admitted to our unit in the period 1 September 1996-31 March...

  11. A Real World Report on Intravenous High-Dose and Non-High-Dose Proton-Pump Inhibitors Therapy in Patients with Endoscopically Treated High-Risk Peptic Ulcer Bleeding

    Directory of Open Access Journals (Sweden)

    Lung-Sheng Lu

    2012-01-01

    Full Text Available Background and Study Aims. The optimal dose of intravenous proton-pump inhibitor (PPI therapy for the prevention of peptic ulcer (PU rebleeding remains controversial. This study aimed to understand the real world experiences in prescribing high-dose PPI and non-high-dose PPI for preventing rebleeding after endoscopic treatment of high-risk PU. Patients and Methods. A total of 220 subjects who received high-dose and non-high-dose pantoprazole for confirmed acute PU bleeding that were successfully treated endoscopically were enrolled. They were divided into rebleeding (n=177 and non-rebleeding groups (n=43. Randomized matching of the treatment-control group was performed. Patients were randomly selected for non-high-dose and high-dose PPI groups (n=44 in each group. Results. Univariate analysis showed, significant variables related to rebleeding were female, higher creatinine levels, and higher Rockall scores (≧6. Before case-control matching, the high-dose PPI group had higher creatinine level, higher percentage of shock at presentation, and higher Rockall scores. After randomized treatment-control matching, no statistical differences were observed for rebleeding rates between the high-dose and non-high-dose groups after case-control matching. Conclusion. This study suggests that intravenous high-dose pantoprazole may not be superior to non-high-dose regimen in reducing rebleeding in high-risk peptic ulcer bleeding after successful endoscopic therapy.

  12. How to Diagnose and Treat Peptic Ulcer?

    Institute of Scientific and Technical Information of China (English)

    HU Xian-guo

    2009-01-01

    @@ Ulcer of the stomach and duodenum,also called ulcerative disease,is a sharply circumscribed loss of the tissue lining those parts of the digestive tract exposed to gastric juice containing acid and pepsin. Because its formation and development are closely related to the digestive effect of acidic gastric juice and pepsase,the disease is called peptic ulcer. It is a common disease,belonging to epigastric pain in TCM,mainly caused by cold attacking the stomach,stagnated liver-qi affecting the stomach,or spleen and stomach deficiency with deficiency and cold of the middle-jiao. Regulating qi to stop pain is the principle for its treatment. Peptic ulcer is usually differentiated as the following TCM syndromes.

  13. Peptic ulcer disease: a clinical study in 73 children

    Science.gov (United States)

    Deckelbaum, Richard J.; Roy, Claude C.; Lussier-Lazaroff, Jeannette; Morin, Claude L.

    1974-01-01

    Seventy-three children with peptic ulcer have been admitted to The Montreal Children's Hospital and l'Hôpital Sainte-Justine over the past 11 years. The primary ulcer group comprised 39 duodenal and nine gastric ulcers; repeat contrast studies were necessary to demonstrate a crater in 25%. Vomiting was especially prominent in the younger patients (1 month to 6 years). Pain was present in the majority of older patients (6 to 18 years) but was considered “typical” in no more than one third. Bleeding occurred more commonly in the older children but five had occult bleeding only. There was a positive family history in 11 children with primary duodenal ulcers but in none of those with gastric ulcers. Follow-up in 34 cases with primary ulcers showed that close to two thirds of the older children have had recurrent problems. Bleeding and/or perforation was the most common mode of presentation in 25 cases of secondary ulcers. Corticosteroids and increased intracranial pressure were the most frequently associated factors, the younger age group being at greater risk. PMID:4853569

  14. Symptoms and Causes of Peptic Ulcer Disease

    Science.gov (United States)

    ... pylori are spiral-shaped bacteria that can cause peptic ulcer disease by damaging the mucous coating that protects the lining of the stomach and duodenum. Once H. pylori have damaged the mucous coating, powerful stomach acid can get through to the sensitive lining. Together, ...

  15. Effects of Alanyl-glutamine Enriched Parenteral Nutrition Treatment on Peptic Ulcer Bleeding%丙氨酰谷氨酰胺辅助治疗消化性溃疡出血的临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    钟碧莹; 张国安; 汤茵

    2015-01-01

    目的:观察全肠外营养(total parenteral nutrition,TPN)添加丙氨酰谷氨酰胺治疗消化性溃疡所致上消化道出血的疗效。方法以2011年1月-2013年12月间入住该院的198例消化性溃疡出血患者为研究组,以2011年1月-2013年12月间入住该院的74例消化性溃疡出血患者为对照组,所有患者均于入院24 h内行急诊胃镜检查,明确诊断后两组均经常规治疗,根据病情给予禁食、补液、营养支持、抑酸、止血、保护胃粘膜等治疗。研究组给予丙氨酰谷氨酰胺(力太)20 g加入500 mL全肠外营养液中静脉输注Qd。对照组给予同样500 mL全肠外营养液但不加入力太。一周后复查胃镜,观察两组患者胃镜下的溃疡分期及再出血情况。结果272例消化性溃疡出血患者初次检查镜下溃疡均为活动期,其中研究组A1期182例(91.92%),A2期16例(8.08%);复查胃镜有142例(71.72%)患者进入愈合期,其中H期140例(70.70%),S期2例(1.01%),溃疡愈合率为71.72%。对照组初次检查镜下溃疡分期:A1期52例(70.27%),A2期22例(29.73%);复查胃镜有38例(51.35%)患者进入愈合期,其中H期26例(35.14%),S期12例(16.22%),溃疡愈合率为51.35%。两组愈合率比较差异有统计学意义。研究组一周内再出血18例(9.09%);对照组一周内再出血20例(27.03%);两组再出血率比较差异有统计学意义。结论对于消化性溃疡合并出血患者,常规治疗的同时加用含丙氨酰谷氨酰胺肠外营养可以促进溃疡愈合,降低再出血率。%Objective Efficacy of Alanyl Glutamine total parenteral nutrition treatment of upper gastrointestinal hemorrhage caused by peptic ulcer. Methods 198 cases of peptic ulcer bleeding in patients admitted to our hospital from Jan 2011 to Dec 2013 as the study group, 64 cases of peptic ulcer bleeding in patients admitted to our hospital from Jan 2011 to Dec 2013 as the control group, All patients were

  16. Update on Peptic Ulcers in the Pediatric Age

    Directory of Open Access Journals (Sweden)

    Graziella Guariso

    2012-01-01

    Full Text Available Background. Peptic ulcer disease (PUD in children is reported worldwide, although it is relatively rare as compared with adults. Helicobacter pylori (HP infection is a common cause of PUD in the pediatric age. Other risk factors include the use of nonsteroidal anti-inflammatory agents (NSAIDs, steroids, immunosuppressive drugs, and stressful events. Aim. To critically review the evidence on epidemiology, diagnostic management, and available treatments for PUD in the pediatric age. Methods. A MEDLINE search was performed indicating keywords as “Peptic Ulcer Disease,” “Epidemiology,” “Pediatric,” “Helicobacter pylori,” “Gastric ulcer,” “Bulbar Ulcer,” and “Upper Gastrointestinal Bleeding.” A selection of clinical trials, systematic reviews, and meta-analyses within the time period 2002–2012 was performed. Results. PUD in children is reported worldwide with an estimated frequency of 8.1% in Europe and of 17.4% in the US. When the underlying cause of PUD is addressed, the prognosis is excellent. Standard triple therapy, bismuth-based quadruple therapy, and the sequential therapy represent the current recommended treatments for HP related ulcers. NSAIDs related ulcers are treated by stopping the causative medications and by administration of proton-pump inhibitors or antisecretory drugs. Conclusions. PUD still represents a major concern in the paediatric age. A careful differential diagnosis and an adequate treatment constitute an excellent prognosis.

  17. Etiopathogenetic principles and peptic ulcer disease classification.

    Science.gov (United States)

    Tytgat, G N J

    2011-01-01

    Ulceration corresponds to tissue loss, breaching the muscularis mucosae. When ulcers develop in the acid-peptic environment of the gastroduodenum, they are traditionally called peptic ulcer (PUD). Ulcers never develop spontaneously in a healthy gastroduodenal mucosa. Ulceration is the ultimate consequence of a disequilibrium between aggressive injurious factors and defensive mucosa-protective factors. The dominant aggressors are strong acid and high proteolytic (pepsin) activity in gastric secretions. The dominant defensors are the phospholipid surfactant layer, covering the mucus bicarbonate gel, the mucus bicarbonate layer covering the epithelium, the tight junctional structures between the epithelial cells, restricting proton permeability, and the epithelial trefoil peptides, contributing to healing after injury. Initially, acid-peptic aggression was considered the overwhelming cause of PUD, supported by the pioneering work of Schwartz, launching the dictum 'no acid, no ulcer'. This led to the universal therapy directed against intragastric acidity, also interfering with peptic activity when the pH was >4. The therapeutic sequence went from large doses of antacids to H(2)-receptor antagonists and finally to proton pump inhibitors (PPIs). The longer the intragastric pH was >3, the quicker ulcer healing was seen. Unfortunately, ulcers often recurred after stopping therapy, demanding maintenance therapy to keep the ulcers healed and to prevent the need for surgery (vagotomy, partial gastric resection). Later on, the emphasis gradually shifted to weakening/failing of the defensive factors, raising the vulnerability of the gastroduodenal mucosa to luminal secretions. Leading injurious mechanisms jeopardizing the mucosal integrity are numerous: infections, especially Helicobacter pylori, drug-induced injury, particularly acetylsalicylic acid (ASA) and non-steroidal anti-inflammatory drugs (NSAIDs), physicochemical and caustic injury, vascular disorders, interfering

  18. Gastritis, dyspepsia and peptic ulcer disease.

    Science.gov (United States)

    Dore, M P; Graham, D Y

    2008-06-01

    Peptic ulcer disease remains a common problem and it most frequently due to the presence of an Helicobacter pylori infection or use of non-steroidal anti-inflammatory drugs (NSAIDs). Dyspepsia is neither sensitive or specific for diagnosing peptic ulcer disease. The approach to patients with dyspepsia is to arrive at a definitive diagnosis without unnecessary exposure to invasive or costly diagnostic procedures. Non-invasive testing is preferred with endoscopy being reserved for those with alarm markers or above a specified age (e.g., 55 years in Western countries). Patients negative for H. pylori infection should receive an empiric trial of acid suppression for 4 to 8 weeks and if beneficial it can be continued.

  19. Bronchial hypersecretion, chronic airflow limitation, and peptic ulcer.

    Science.gov (United States)

    Kauffmann, F; Brille, D

    1981-11-01

    Men with and men without a history of peptic ulcers were compared using respiratory symptoms and spirographic measurements taken from data recorded in an epidemiologic study. Among the 1,049 men examined, 7% reported a history of peptic ulcer. A clear relationship appeared between bronchial hypersecretion and peptic ulcers. It persisted after adjustment for age, smoking habits, social class, and country of origin. Men with ulcers inhaled tobacco smoke more often. Ulcers, smoking, and chronic phlegm were independently related to a lower body build index. It seems that the relationship between smoking and ulcers was greater among men with chronic phlegm, and it is postulated that peptic ulcers and "chronic bronchitis" might be related to a "common secretory disorder." After adjustment for age, men with a history of peptic ulcers had, not a lower FEV1, but a higher vital capacity. A slightly lower FEV1/VC ratio cannot in such cases be considered as an index of chronic airflow limitation.

  20. Renal Aspects of Peptic Ulcer Pharmacology

    Directory of Open Access Journals (Sweden)

    Daniel Muruve

    1992-01-01

    Full Text Available Medications to treat peptic ulcer disease are used widely and may have adverse effects on renal function. Similarly, renal dysfunction may alter the pharmacokinetics of this diverse group of medications resulting in dosage adjustments. The older agents, antacids and sucralfate, allow absorption of cations (calcium, magnesium and aluminum which may result in toxicity. Newer medications (H2 blockers and omeprazole appear to have fewer side effects and be better tolerated with appropriate dosage adjustments.

  1. Gastric schwannoma coexists with peptic ulcer perforation

    Directory of Open Access Journals (Sweden)

    Volkan İnce

    2011-09-01

    Full Text Available Gastric schwannoma is a benign neoplasm that originates from sheet of nerve cell in stomach. Differential diagnosis of gastrointestinal stromal tumors, (GISTs which have malign potential, than these tumors, which definite diagnosis is determined by histopathological and immunohistochemical methods have clinical significance due to gastric schwannomas have excellent progress after surgical resection. We presented a case of gastric schwannoma coexists with peptic ulcer perforation with guide of literature in this study.

  2. 老年患者消化性溃疡并出血或穿孔临床分析%The Clinical Analysis on Elderly Patients with Peptic Ulcer Bleeding or Perforation

    Institute of Scientific and Technical Information of China (English)

    向阳; 杨力

    2013-01-01

    目的:通过分析近十余年医院收治的232例老年消化性溃疡并出血或穿孔的临床资料,以加深对本病的认识,提高诊断及治疗水平。方法:采用回顾性研究的方法,对2000年1月-2012年6月收治的符合消化性溃疡并出血或穿孔诊断标准的老年患者进行分析。结果:232例老年消化性溃疡中198例合并出血,34例合并穿孔,212例幽门螺杆菌阳性,73例有服用NSAID类药物史,26例恶性溃疡。结论:老年性消化性溃疡的发病机制是综合,复杂的,出血及穿孔是常见的两个并发症。由于老年人胃黏膜防御因子减弱,动脉硬化,器官组织退行性变,服用NSAID类药物,加之合并有其他疾病如冠心病,高血压等,导致症状不典型,病变愈合慢,易复发,病情严重,复杂。临床医师对老年患者要高度重视,要加深对本病的认识,提高诊断及治疗水平。%Objective:To analyze the last ten years of 232 elderly patients admitted to hospital and peptic ulcer bleeding or perforation of the clinical data in order to deepen the understanding of the disease,improve diagnosis and treatment standards. Method:A retrospective study method of elderly patients who were treated by peptic ulcer bleeding or perforation meet diagnostic criteria from January 2000 to June 2012 were analyzed. Result:Two hundred and thirty-two cases of elderly peptic ulcer hemorrhaged in 198 cases,34 cases with perforation,212 cases of H. pylori positive,73 cases had history of NSAID use drugs,26 cases of malignant ulcers. Conclusion:The pathogenesis of senile peptic ulcer is a comprehensive,complex. Bleeding and perforation is common to both complications due to gastric mucosal defensive factors weakened the elderly,atherosclerosis,organ and tissue degeneration,taking NSAID drugs,coupled associated with other diseases such as coronary heart disease,high blood pressure,leading to atypical symptoms,lesions heal

  3. Misoprostol in peptic ulcer disease.

    Science.gov (United States)

    Watkinson, G; Akbar, F A

    1987-01-01

    Misoprostol, a synthetic prostaglandin E1 (PGE1) methyl ester analog has potent antisecretory and cytoprotective effects on the gastric and duodenal mucosa which should make it an effective drug in the treatment of gastric and duodenal ulcer. In two multicenter, randomised, double-blind, controlled studies involving over 900 patients with endoscopically proven benign gastric ulcer and in six similar studies involving over 2000 patients with active duodenal ulcers, differing doses of misoprostol have been compared with either placebo therapy or with conventional doses of cimetidine. In these studies misoprostol 800 mcg daily given as two or four divided doses has been shown to produce rates of complete ulcer healing and pain relief which were significantly superior to placebo therapy and comparable to those achieved with cimetidine. Drug related adverse effects were infrequent. A dose related diarrhea occurred in a small proportion of patients which seldom necessitated suspension of therapy. Because of the known uterotropic effect of prostaglandins the drug should not be used in pregnant women or women of child bearing age unless they are using adequate contraceptive measures. No clinically significant adverse, hematological or biochemical effects have been reported. Two studies suggested that misoprostol reduced the adverse effect of smoking on the healing of duodenal ulcer. In addition, misoprostol has been shown to protect the gastro-duodenal mucosa from the damaging effects of alcohol and non-steroidal anti-inflammatory drugs. This action may prove of value in the treatment of ulcer patients who are inveterate smokers, alcohol users or who are compelled to consume non-steroidal anti-inflammatory drugs for pain relief from rheumatic and allied diseases.

  4. Age Features Of Peptic And Duodenal Ulcer Disease

    Directory of Open Access Journals (Sweden)

    Е.А. Islamova

    2009-12-01

    Full Text Available Peptic ulcer disease is one of the most widespread diseases. 6-10 % of adult population in Russia suffer from it. Demographic processes in the Russian Federation determine the increase of patients' number aged over 60 with peptic ulcer disease. It counts 10-35 % of all patients with this disease. The modern views on pathogenesis of peptic ulcer disease, including factor of Helicobacter pylori, in patients of different age groups have been highlighted in the article. Pathogenetic features and clinical morphological manifestations of peptic ulcer disease in young and aged patients have been considered

  5. Gastric acid inhibition in the treatment of peptic ulcer hemorrhage.

    Science.gov (United States)

    Ghassemi, Kevin A; Kovacs, Thomas O G; Jensen, Dennis M

    2009-12-01

    Upper gastrointestinal bleeding from peptic ulcer disease is a common clinical event, resulting in considerable patient morbidity and significant health care costs. Inhibiting gastric acid secretion is a key component in improving clinical outcomes, including reducing rebleeding, transfusion requirements, and surgery. Raising intragastric pH promotes clot stability and reduces the influences of gastric acid and pepsin. Patients with high-risk stigmata for ulcer bleeding (arterial bleeding, nonbleeding visible vessels, and adherent clots) benefit significantly from and should receive high-dose intravenous proton pump inhibitors (PPIs) after successful endoscopic hemostasis. For patients with low-risk stigmata (flat spots or clean ulcer base), oral PPI therapy alone is sufficient. For oozing bleeding (an intermediate risk finding), successful endoscopic hemostasis and oral PPI are recommended. Using intravenous PPIs before endoscopy appears to reduce the frequency of finding high-risk stigmata on later endoscopy, but has not been shown to improve clinical outcomes. High-dose oral PPIs may be as effective as intravenous infusion in achieving positive clinical outcomes, but this has not been documented by randomized studies and its cost-effectiveness is unclear.

  6. Zinc compounds as therapeutic agents in peptic ulcer.

    Science.gov (United States)

    Baños, J E; Bulbena, O

    1989-01-01

    Zinc acexamate (ZAC) is the first zinc compound developed and marketed for use in the therapy of peptic ulcer. ZAC is active in several ulcer experimental models. This action is secondary to an effect on both aggressive and defensive mucosal factors. ZAC reduces acid and peptic secretion, increases mucus secretion, protects mucosa from disruption by aspirin and reverses the reduction of blood flow caused by noradrenaline. Clinically, ZAC has proven to be a useful drug in the healing of peptic ulcer. Reduction of inflammatory associated processes of peptic ulcer, which has not been seen with H2-blockers, suggests that ZAC may be highly effective in preventing ulcer relapse. These properties, together with its good safety profile, indicate that ZAC would be an interesting option in the treatment of peptic ulcer.

  7. Association studies of Helicobacter pylori and non-steroidal anti-inflammatory drugs in patients with bleeding peptic ulcer%幽门螺杆菌感染及非甾体抗炎药致消化性溃疡并出血的相关性研究

    Institute of Scientific and Technical Information of China (English)

    王莹; 王秀英; 王敏琴

    2011-01-01

    OBJECTIVE To explore the association studies of Helicobacter pylori and non-steroidal anti-inflammatory drug in patients with bleeding peptic ulcer. METHODS The clinical dates of 188 cases of peptic ulcer were reviewed retrospectively. Each parameters were evaluated with univariate and multivariate analysis.RESULTS Univariate analysis identified 4 statistically significant variables, including aged ≥60 years, the history of peptic ulcer, cardio cerebral vascular diseases and NSAIDs use(P<0.05). Logistic regression analysis showed that aged 60 years, the history of peptic ulcer, bleeding peptic ulcer and cardio cerebral vascular diseases, H. pylori infection alone, NSAIDs alone and combined H. pylori infection and NSAIDs were the risk factors of bleeding peptic ulcer(P<0. 01). CONCLUSION H. pylori infection is not a risk factor for bleeding peptic ulcer, but combination of aged 60 years, H. pylori, the history of peptic ulcer, bleeding peptic ulcer and cardio cerebral vascular diseases increases in risk factors of bleeding peptic ulcer.%目的 探讨服用非甾体抗炎药及幽门螺杆菌感染与消化性溃疡并出血的相关性.方法 对188例消化性溃疡患者的临床资料进行回顾性分析,将其所有的危险因素行单因素和多因素分析.结果 在单因素分析中,出血组中年龄≥60岁、既往有消化道出血史、心脑血管史、口服非甾体抗炎药所占比例高于未出血组,两组比较差异有统计学意义(P<0.05);进一步行多因素logistic回归分析,发现年龄≥60岁、既往有消化性溃疡史、消化道出血史、心脑血管病史、单纯Hp感染、单纯服用非甾体抗炎药及Hp感染+服用非甾体抗炎药均为消化性溃疡并出血的危险因素(P<0.01).结论 单纯Hp感染并不能增加消化性溃疡并出血的危险性,但若与年龄≥60岁、服用非甾体抗炎药、既往有消化性溃疡史、消化道出血史、心脑血管史等因素同时出现可增加其危险性.

  8. PEPTIC ULCER FREQUENCY DIFFERENCES RELATED TO H. PYLORI OR AINES

    Directory of Open Access Journals (Sweden)

    Diego Michelon de CARLI

    2015-03-01

    Full Text Available Background Peptic ulcer etiology has been changing because of H. pylori decline. Objectives To estimate peptic ulcer prevalence in 10 years-interval and compare the association with H. pylori and use of non-steroidal anti-inflammatory drugs. Methods Records assessment in two periods: A (1997-2000 and B (2007-2010, searching for peptic ulcer, H. pylori infection and non-steroidal anti-inflammatory drugs use. Results Peptic ulcer occurred in 30.35% in A and in 20.19% in B. H. pylori infection occurred in 73.3% cases in A and in 46.4% in B. Non-steroidal anti-inflammatory drugs use was 3.5% in A and 13.3% in B. Neither condition occurred in 10.4% and 20.5% in A and B respectively. Comparing both periods, we observed reduction of peptic ulcer associated to H. pylori (P=0.000, increase of peptic ulcer related to non-steroidal anti-inflammatory drugs (P=0.000 and idiopathic peptic ulcer (P=0.002. The concurrent association of H. pylori and non-steroidal anti-inflammatory drugs was also higher in B (P=0.002. Rates of gastric ulcer were higher and duodenal ulcer lower in the second period. Conclusions After 10 years, the prevalence of peptic ulcer decreased, as well as ulcers related to H. pylori whereas ulcers associated to non-steroidal anti-inflammatory drugs increased. There was an inversion in the pattern of gastric and duodenal ulcer and a rise of idiopathic peptic ulcer.

  9. Early outcome after emergency gastrectomy for complicated peptic ulcer disease.

    Science.gov (United States)

    Cheng, Mina; Li, W H; Cheung, M T

    2012-08-01

    OBJECTIVE. To analyse outcomes of patients who underwent emergency gastrectomy for complicated peptic ulcer disease. DESIGN. Prognostic study on a historical cohort. SETTING. A regional hospital in Hong Kong. PATIENTS. Patients who underwent emergency gastrectomy from 2000 to 2009 in our hospital. MAIN OUTCOME MEASURES. Primary outcome measures were in-hospital mortality and the predictors of such deaths. Secondary outcome measures were 7-day mortality, 30-day mortality, and morbidities. RESULTS. In all, 112 patients had emergency gastrectomies performed for complicated peptic ulcer disease during the study period. In-hospital mortality was 30%. In the univariate analysis, old age, duodenal ulcer, failed primary surgery, gastrojejunostomy anastomosis for reconstruction, hand-sewn technique for duodenal stump closure, use of a sump drain, low haemoglobin level, preoperative blood transfusion, prolonged prothrombin time, and high creatinine or bilirubin levels were associated with an increased risk of in-hospital mortality. In the multivariate analysis, failed primary surgery, old age, and high creatinine level turned out to be independent risk factors. CONCLUSIONS. Emergency gastrectomy should be considered seriously as the primary treatment option in appropriately selected elderly patients, instead of salvage procedures to repair a perforation or control bleeding by plication.

  10. Perforated peptic ulcer disease: A review of history and treatment

    NARCIS (Netherlands)

    M.J.O.E. Bertleff (Marietta); J.F. Lange (Johan)

    2010-01-01

    textabstractBackground: In the last one hundred years much has been written on peptic ulcer disease and the treatment options for one of its most common complications: perforation. The reason for reviewing the literature was evaluating most common ideas on how to treat perforated peptic ulcers (PPU)

  11. ETIOPATHOGENESIS OF PEPTIC ULCER: back to the past?

    Directory of Open Access Journals (Sweden)

    Mariana Barbosa ARAÚJO

    2014-04-01

    Full Text Available Objectives To review some aspects of the etiopathogenesis of peptic ulcerous disease especially on the basis of studies on its correlation with Helicobacter pylori (H. pylori. Methods A search was made in the data bases MEDLINE, LILACS and PubMed, and in Brazilian and foreign books, referring to the incidence and prevalence of infection by H. pylori and of peptic ulcerous disease in various populations of different countries. Results It was observed that the prevalence of H. pylori infection is similar in individuals with peptic ulcerous disease and the general population. There are differences between countries with respect to the prevalence of infection and of gastric or duodenal peptic ulcers. In many countries the prevalence of infection by H. pylori shows stability while the prevalence of peptic ulcerous disease is declining. The prevalence of peptic ulcerous disease without H. pylori infection varies between 20% and 56% in occidental countries. Discussion The observations might be suggestive of H. pylori being only one more factor to be summed together with other aggressive components in the genesis of peptic ulcerous disease. We would therewith be returning to the classic concept that peptic gastric and duodenal ulcers have multifactorial etiology and would result from imbalance between aggressive and defensive factors. The focus of studies should be enriched with the identification of the defensive factors and of other aggressive factors besides the well known H. pylori and non-steroidal anti-inflammatory drugs, since these two aggressors do not exhaust the full causal spectrum.

  12. Effect of Pantoprazole and Omeprazole in the treatment of olderly peptic ulcer bleeding%泮托拉唑与奥美拉唑治疗老年消化性溃疡出血疗效对比

    Institute of Scientific and Technical Information of China (English)

    万晓林

    2016-01-01

    Objective To investigate the clinical effect of pantoprazole and omeprazole on elderly peptic ulcer bleeding. Methods 52 cases of elderly patients with peptic ulcer hemorrhage were divided into pantoprazole group(28 cases, give pantoprazole)and omeprazole group (24 cases, give omeprazole), bleeding stop time, pH of gastric juice, the clinical efficacy of two groups was observed, and the cost-effectiveness was calculated. Results In pantoprazole group, bleeding stop time was shorter than that of omeprazole, and gastric juice pH value was higher than that of omeprazole group,the differences between groups were statistically significant (P<0.05).The total efficiency of pantoprazole group was 96.4% (27/28), and was91.7% in omeprazole group (22/24), cost of omeprazole group was significantly higher than that of pantoprazole group, C/E was 13.046, and △C/△E was 117.723. Conclusion Using pantoprazole in elderly patients with peptic ulcer bleeding has good curative effect with less adverse reaction and low cost of medical , it is worth of farther explore and promote to use.%目的:对比泮托拉唑和奥美拉唑对老年消化溃疡出血的临床疗效。方法将52例老年消化溃疡出血患者分为泮托拉唑组(28例,给予泮托拉唑)和奥美拉唑组(24例,给予奥美拉唑),观察2组出血停止时间、胃液 pH、临床疗效,并进行成本-效果分析。结果泮托拉唑组患者出血停止时间短于奥美拉唑组,胃液pH 值高于奥美拉唑组,组间比较差异均有统计学意义(P<0.05)。泮托拉唑组总有效率96.4%(27/28),奥美拉唑组91.7%(22/24),奥美拉唑组成本明显高于泮托拉唑组,C/E 为13.046,△C/△E 为117.723。结论泮托拉唑用于老年患者消化溃疡出血疗效较好,不良反应少,医疗费用低,值得临床进一步研究推广。

  13. [Clinical impact of dual antiplatelet therapy on peptic ulcer disease].

    Science.gov (United States)

    Ahn, Dae Geon; Kim, Beom Jin; Kim, Jeong Wook; Kim, Jae Gyu

    2014-08-01

    Increased incidence of coronary artery disease has led to the increased use of dual antiplatelet therapy composed of aspirin and clopidogrel. We investigated the incidence of gastrointestinal complications in patients who received single or dual antiplatelet therapy and analyzed their clinical characteristics in order to predict the prognostic factors. Between January 2009 and December 2011, we retrospectively reviewed the medical records of patients who underwent coronary angiography at Chung-Ang University Hospital (Seoul, Korea). One hundred and ninety-four patients were classified into two groups: aspirin alone group and dual antiplatelet group. Clinical characteristics, past medical history, and presence of peptic ulcer were analyzed. During the follow-up period, 11 patients had duodenal ulcer; the event rate was 2.02% in the aspirin alone group and 9.47% in the dual antiplatelet group (hazard ratio [HR] 5.24, 95% CI 1.03-26.55, pantiplatelet groups had a higher incidence of duodenal ulcers without significant bleeding compared with the aspirin alone group. In patients who received PPI, the dual antiplatelet therapy group had a higher incidence of gastric ulcers without significant bleeding compared with the aspirin alone group. Therefore, physicians must pay attention to high risk groups who receive dual antiplatelet therapy and aggressive diagnostic endoscopy should also be considered.

  14. Wernicke's Encephalopathy in a Patient with Peptic Ulcer Disease.

    Science.gov (United States)

    Uruha, Akinori; Shimizu, Toshio; Katoh, Tomoji; Yamasaki, Yasushi; Matsubara, Shiro

    2011-01-01

    We report a 74-year-old man with Wernicke's encephalopathy (WE) whose only prior illness was peptic ulcer disease. Upper gastrointestinal endoscopy demonstrated gastric ulcer scars accompanied by marked deformity, without pathologic evidence of malignancy. WE due to peptic ulcer disease in previous reports was substantially associated with thiamine deficiency due to recurrent vomiting or surgical procedures. In our case, however, there was no history of vomiting or gastrointestinal surgery. Besides, we thoroughly ruled out other known clinical settings related to WE. There is the possibility that peptic ulcer disease itself provoked thiamine deficiency due to malabsorption.

  15. PERFORATED PEPTIC ULCER: A CLINICAL ANALYSIS AND OUTCOME

    Directory of Open Access Journals (Sweden)

    Bijit

    2016-03-01

    Full Text Available BACKGROUND The incidence of perforated peptic ulcer is approximately 7-10 cases per one lakh population per year. Perforation is seen in about 7% of patients hospitalized for peptic ulcer disease. Peptic ulcer perforation, which can be gastric/duodenal perforation can be a serious life-threatening condition if not detected early and treated urgently. Peptic ulcer disease has decreased considerably worldwide with the advent of potent anti-ulcer medicines, but its complication like peptic ulcer perforation has not. Our study is to analyse the clinical, radiological and management related findings in influencing the outcome of patients of peptic ulcer perforation after surgery. MATERIALS AND METHODS A series of 47 patients of peptic ulcer perforation were evaluated. Patients expiring within six hours of admission were not included in this study. RESULTS Age of the patients ranged from 17-80 years. The incidence of perforation was highest in the age group of 41-50 years (31.9%. Out of 47 patients, 41 (87.2% survived. CONCLUSION The incidence of perforation was highest in the age group of 41-50 years. Prognosis becomes poor with age, delayed treatment, shock at admission and concomitant diseases. Direct repair of the perforation with pedicled omentum gave excellent results.

  16. Is herpes simplex virus associated with peptic ulcer disease?

    OpenAIRE

    Löhr, J M; Nelson, J. A.; Oldstone, M B

    1990-01-01

    To test the hypothesis that herpes simplex virus type 1 (HSV-1) may be associated with peptic ulcer disease, we examined ulcerative lesions of the distal stomach and proximal duodenum for the presence of nucleic acids and antibodies specific for HSV-1. Utilizing in situ hybridization, immunocytochemistry, and polymerase chain reaction with sequencing, gastric or duodenal tissues from 4 of 22 patients (18%) with documented peptic ulcer disease demonstrated the presence of both specific HSV-1 n...

  17. NSAID induced perforated peptic ulcer in a pediatric sickle cell patient

    Directory of Open Access Journals (Sweden)

    Crystal Johnson-Mann

    2016-11-01

    Full Text Available Peptic ulcer disease is a relatively rare entity in the pediatric population. Given the trend toward multimodal pain control for pain crises in Sickle Cell Disease patients, they are at an increased risk of developing complications secondary to peptic ulcer disease. We discuss a case of a Sickle Cell Disease patient on multimodal therapy that presented with a perforated peptic ulcer requiring emergent surgery. While multimodal therapy helps ease the dependency on narcotic pain medication, it does present other potential problems like potential bleeding or perforation. For those that can be categorized in this select group of patients, routine surveillance with esophagogastroduodenoscopy should be considered for those at highest risk to prevent devastating complications.

  18. Hypothalamic digoxin, hemispheric chemical dominance, and peptic ulcer disease.

    Science.gov (United States)

    Kurup, Ravi Kumar; Kurup, Parameswara Achutha

    2003-10-01

    The isoprenoid pathway produces three key metabolites--endogenous digoxin-like factor (EDLF) (membrane sodium-potassium ATPase inhibitor and regulator of neurotransmitter transport), ubiquinone (free radical scavenger), and dolichol (regulator of glycoconjugate metabolism). The pathway was assessed in peptic ulcer and acid peptic disease and its relation to hemispheric dominance studied. The activity of HMG CoA reductase, serum levels of EDLF, magnesium, tryptophan catabolites, and tyrosine catabolites were measured in acid peptic disease, right hemispheric dominant, left hemispheric dominant, and bihemispheric dominant individuals. All the patients with peptic ulcer disease were right-handed/left hemispheric dominant by the dichotic listening test. The pathway was upregulated with increased EDLF synthesis in peptic ulcer disease (PUD). There was increase in tryptophan catabolites and reduction in tyrosine catabolites in these patients. The ubiquinone levels were low and free radical production increased. Dolichol and glycoconjugate levels were increased and lysosomal stability reduced in patients with acid peptic disease (APD). There was increase in cholesterol:phospholipid ratio with decreased glyco conjugate levels in membranes of patients with PUD. Acid peptic disease represents an elevated EDLF state which can modulate gastric acid secretion and the structure of the gastric mucous barrier. It can also lead to persistence of Helicobacter pylori infection. The biochemical pattern obtained in peptic ulcer disease is similar to those obtained in left-handed/right hemispheric chemically dominant individuals. But all the patients with peptic ulcer disease were right-handed/left hemispheric dominant by the dichotic listen ing test. Hemispheric chemical dominance has no correlation with handedness or the dichotic listening test. Peptic ulcer disease occurs in right hemispheric chemically dominant individuals and is a reflection of altered brain function.

  19. Peptic ulcer in the gallbladder. A case report

    DEFF Research Database (Denmark)

    Larsen, E H; Diederich, P J; Sørensen, Flemming Brandt

    1985-01-01

    Gastric mucosa can be found in the gallbladder as a congenital heterotopia. A case of a perforated peptic ulcer in the gallbladder with concomitant hemorrhage in heterotopic gastric mucosa causing hematemesis and melena is presented.......Gastric mucosa can be found in the gallbladder as a congenital heterotopia. A case of a perforated peptic ulcer in the gallbladder with concomitant hemorrhage in heterotopic gastric mucosa causing hematemesis and melena is presented....

  20. Peptic ulcer in the gallbladder. A case report

    DEFF Research Database (Denmark)

    Larsen, E H; Diederich, P J; Sørensen, Flemming Brandt

    1985-01-01

    Gastric mucosa can be found in the gallbladder as a congenital heterotopia. A case of a perforated peptic ulcer in the gallbladder with concomitant hemorrhage in heterotopic gastric mucosa causing hematemesis and melena is presented.......Gastric mucosa can be found in the gallbladder as a congenital heterotopia. A case of a perforated peptic ulcer in the gallbladder with concomitant hemorrhage in heterotopic gastric mucosa causing hematemesis and melena is presented....

  1. PEPTIC ULCER: A REVIEW ON ETIOLOGY AND PATHOGENESIS

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    Kaur Amandeep

    2012-06-01

    Full Text Available A peptic ulcer is a sore on the lining of the stomach or duodenum. The two most common types of peptic ulcer are called “gastric ulcers” and “duodenal ulcers”. Peptic ulcers are found to be due to an imbalance between aggressive factors such as hydrochloric acid (HCL, pepsin, refluxed bile, leukotrienes (LTs, reactive oxygen species (ROS and defensive factors, which include the function of the mucus-bicarbonate barrier, prostaglandins (PGs, mucosal blood flow, cell renewal and migration, nonenzymatic and enzymatic antioxidants and some growth factors. H. pylori infection and the use of nonsteroidal anti-inflammatory drugs (NSAIDs are the predominant causes of peptic ulcer disease. Also, a numbers of factors are implicated in the pathogenesis of gastric ulcer, among which major factors involved are bacterial infection (Helicobacter pylori, certain medications (NSAID, chemicals (Hcl/ethanol ,gastric cancer and minor factors are stress, smoking, spicy food and nutritional deficiencies. The idea behind treating ulcers is to lower the amount of acid that your stomach makes, to neutralize the acid that is made and to protect the injured area so it can have time to heal. The main aim of this review article has to summarize the ulcerogenic mechanisms of various mediators involved in Peptic ulcer disease.

  2. Complex endoscopic treatment of acute gastrointestinal bleeding of ulcer origin

    Directory of Open Access Journals (Sweden)

    V. V. Izbitsky

    2013-06-01

    Full Text Available Gastrointestinal bleeding (GIB is determined in 20-30% of patients with peptic ulcer disease. Acute gastrointestinal bleeding is on the first place as the main cause of deaths from peptic ulcer ahead of the other complications. Rebleeding occurs in 30-38% of patients. Materials and Methods For getting of the objective endoscopic picture in patients with bleeding gastroduodenal ulcers we used the classification of J.A. Forrest in our study: Type I - active bleeding: • I a - pulsating jet; • I b - stream. Type II - signs of recent bleeding: • II a - visible (non-bleeding visible vessel; • II b - fixed thrombus - a clot; • II c - flat black spot (black bottom ulcers. Type III - ulcer with a clean (white down. Integrated endoscopic hemostasis included: irrigation of ulcer defect and area around it with 3% hydrogen peroxide solution in a volume of 10 - 30ml; Injection of 2-4 mL of diluted epinephrine (1:10000 for hemostasis; use of Argon plasma coagulation. Results and Discussion Integrated endoscopic stop of bleeding was performed in 57 patients who were examined and treated at the Department of Surgery from 2006 to 2012. In 16 patients bleeding was caused by gastric ulcer. Gastric ulcer type I localization according to classification (HD Johnson, 1965 was determined in 9 patients, type II - in 2 patients, type III – in 5 patients. In 31 patients bleeding was caused by duodenal peptic ulcer, in 4 patients - erosive gastritis, 1 - erosive esophagitis, and in 5 patients - gastroenteroanastomosis area peptic ulcer. Final hemostasis was achieved in 55 (96.5% patients. In 50 (87.7% patients it was sufficient to conduct a single session of complex endoscopic treatment. In 5 (8.8% patients – it was done two times. In 2 (3.5% cases operation was performed due to the recurrent bleeding. The source of major bleeding in these patients was: chronic, duodenal ulcer penetrating into the head of the pancreas in one case complicated by subcompensated

  3. [Guidelines of treatment for peptic ulcer disease in special conditions].

    Science.gov (United States)

    Kim, Ji Hyun; Moon, Jeong Seop; Jee, Sam Ryong; Shin, Woon Geon; Park, Soo-Heon

    2009-11-01

    The pathogenesis, incidence, complication rates, response to acid suppression and Helicobacter pylori (H. pylori) eradication therapy in peptic ulcer associated with chronic disease such as liver cirrhosis, chronic renal failure, diabetes mellitus, and critically ill conditions are different from those with general population, so that the management strategies also should be differentiated. The eradication of H. pylori are not so effective for preventing recurrence of peptic ulcer in liver cirrhosis patients as shown in general population, and conservative managements such as preventing deterioration of hepatic function and decrease in portal pressure are mandatory to reduce the risk of ulcer recurrence. The standard triple therapy for H. pylori eradication are as effective in chronic renal failure patients as in normal population, but the frequency of side effects of amoxicillin is higher in the patients not receiving dialysis therapy. Delay in eradication therapy until beginning of dialysis therapy or modification of eradication regimen should be considered in such cases. High prevalence of asymptomatic peptic ulcers and increased mortality in complicated peptic ulcer disease warrant regular endoscopic surveillance in diabetic patients, especially with angiopathy. The prolongation of duration of eradication therapy also should be considered in diabetic patients with angiopathic complication because of lower eradication rate with standard triple regimens as compared to normal population. Prophylactic acid suppressive therapy is highly recommended in critically ill patients with multiple risk factors. Herein, we propose evidence-based treatment guidelines for the management of peptic ulcer disease in special conditions based on literature review and experts opinion.

  4. [The clinical analysis of 51 taxi drivers with peptic ulcer].

    Science.gov (United States)

    Luo, Wen-wen; Zhao, Jie; Fu, Yun-xian; Ma, A-huo

    2012-02-01

    To explore the main pathogenic factor causing the peptic ulcer of taxi drivers, which provide the basis for its prevention. 98 taxi drivers were inspected by electronic endoscopy, according to the inspection all cases were divided into ulcers group and normal group. Then various factors were statuses by the logistic regression analysis according to the results of questionnaire. The prevalence of peptic ulcer of taxi drivers was 52.0%, and logistic regression analysis showed that dining time, taste spicy, meals temperature, smoking,alcohol, mental stress, HP infection and stomach health knowledge were statistically significant (P taxi drivers. By emphasis on diet and lifestyle adjustments, stress regulation on the basis of eradication of HP infection will help the prevention and treatment of peptic ulcer of the taxi driver.

  5. Psychosocial factors in peptic ulcer and inflammatory bowel disease.

    Science.gov (United States)

    Levenstein, Susan

    2002-06-01

    Over the past decade, while gastroenterologists' interest in mind-body interactions in organic disorders dwindled, stronger evidence has linked psychosocial factors with the incidence and recurrence of peptic ulcer and with the course of inflammatory bowel disease. Psychological-behavioral approaches to treatment continue to be disappointing. Psychosocial factors may affect ulcer by increasing duodenal acid load, altering local circulation or motility, intensifying Helicobacter pylori infection, stimulating corticosteroid secretion, and affecting health risk behaviors; possible mechanisms for inflammatory bowel disease include immune deregulation, gut permeability changes, and poor medication adherence. Both belong to the growing category of diseases thought to have an infectious component: for peptic ulcer the bacterium Helicobacter pylori, for inflammatory bowel disease an exaggerated immune response to gut bacteria. Peptic ulcer and inflammatory bowel disease, which present unique interactions among psychological, immunologic, endocrine, infectious, and behavioral factors, are splendid paradigms of the biopsychosocial model.

  6. Surgical perspectives in peptic ulcer disease and gastritis

    Institute of Scientific and Technical Information of China (English)

    Tamar Lipof; David Shapiro; Robert A Kozol

    2006-01-01

    For much of the twentieth century, surgery was frequently the solution for peptic ulcer disease. Our understanding of the pathophysiology of ulcers paralleled the development of potent pharmaceutical therapy. As the surgical world developed parietal cell vagotomy which would minimize the complications of surgery,patients failing medical therapy became rare. Emergent surgery for complicated peptic ulcers has not declined however. The development of proton pump inhibitors and the full understanding of the impact of H pylori has led to a trend towards minimalism in surgical therapy for complicated peptic ulcer disease. In addition to the changes in patient care, these developments have had an impact on the training of surgeons. This article outlines these trends and developments.

  7. Laparoscopic repair for perforated peptic ulcers with U-CLIP®

    Directory of Open Access Journals (Sweden)

    Fontana Diego

    2009-07-01

    Full Text Available Abstract Background The literature established that, in patients without Boey's risk factors, laparoscopic repair of perforated peptic ulcers, compared to open repair, is associated to lower wound infection rate, less analgesic use, reduction in post operative pain, shorter hospital stay. Some of the main drawbacks are length of operative time and laparoscopic surgeon's experience in intracorporeal knotting. We, for first, report our preliminary experience of perforated peptic ulcers' laparoscopic repair using Medtronic U-Clip®. Methods From January 2008 to June 2008 we performed laparoscopic repair of perforated peptic ulcers using Medtronic U-Clip® in 10 consecutive patients (6 men and 4 women, from 20 to 65 years-old of age. All the patients presented with iuxtapyloric perforated peptic ulcer, not greater than 10 mm, without signs of sepsis, free from major illnesses. The mini-invasive procedure was performed both by skilled and non-skilled laparoscopic surgeons under experts' surveillance. After it was recognized, perforation was sutured using U-Clip® in a full-thickness manner. Results and Discussion We reported no surgical complications in the peri-operative period. The clinical outcome and time needed to perform the intervention didn't change between skilled and non-skilled surgeons. The follow-up at 30 days was good. Conclusion In our experience, the anastomotic device U-Clip® simplifies laparoscopic repair of perforated peptic ulcer, avoiding the need to perform knots and making the procedure safe and easier.

  8. Systematic review of the symptom burden, quality of life impairment and costs associated with peptic ulcer disease.

    Science.gov (United States)

    Barkun, Alan; Leontiadis, Grigorios

    2010-04-01

    Management of peptic ulcer disease has improved over the past few decades. However, the widespread use of nonsteroidal anti-inflammatory drugs and low-dose acetylsalicylic acid means that the burden of peptic ulcer disease remains a relevant issue. We systematically searched PubMed and EMBASE for articles published 1966-2007 that reported symptoms, impairment of well-being or health-related quality of life, and costs associated with peptic ulcer disease. Thirty studies reported the prevalence of patient-reported gastrointestinal symptoms in individuals with endoscopically diagnosed symptomatic peptic ulcer disease. Average prevalence estimates, weighted by sample size, were 81% (95% confidence interval [CI], 77%-85%) for abdominal pain (11 studies), 81% (95% CI, 76%-85%) for pain specifically of epigastric origin (14 studies), and 46% (95% CI, 42%-50%) for heartburn or acid regurgitation (11 studies). On average, 29% (95% CI, 25%-34%) of patients with peptic ulcer disease presented with bleeding, often as the initial symptom (11 studies). Patients with peptic ulcer disease had significantly lower health-related quality of life than the general population, as measured by the Psychological General Well-Being index (P high costs for employers and health care systems.

  9. Role of dietary polyphenols in the management of peptic ulcer.

    Science.gov (United States)

    Farzaei, Mohammad Hosein; Abdollahi, Mohammad; Rahimi, Roja

    2015-06-07

    Peptic ulcer disease is a multifactorial and complex disease involving gastric and duodenal ulcers. Despite medical advances, the management of peptic ulcer and its complications remains a challenge, with high morbidity and death rates for the disease. An accumulating body of evidence suggests that, among a broad reach of natural molecules, dietary polyphenols with multiple biological mechanisms of action play a pivotal part in the management of gastric and duodenal ulcers. The current review confirmed that dietary polyphenols possess protective and therapeutic potential in peptic ulcer mediated by: improving cytoprotection, re-epithelialization, neovascularization, and angiogenesis; up-regulating tissue growth factors and prostaglandins; down-regulating anti-angiogenic factors; enhancing endothelial nitric oxide synthase-derived NO; suppressing oxidative mucosal damage; amplifying antioxidant performance, antacid, and anti-secretory activity; increasing endogenous mucosal defensive agents; and blocking Helicobacter pylori colonization associated gastric morphological changes and gastroduodenal inflammation and ulceration. In addition, anti-inflammatory activity due to down-regulation of proinflammatory cytokines and cellular and intercellular adhesion agents, suppressing leukocyte-endothelium interaction, inhibiting nuclear signaling pathways of inflammatory process, and modulating intracellular transduction and transcription pathways have key roles in the anti-ulcer action of dietary polyphenols. In conclusion, administration of a significant amount of dietary polyphenols in the human diet or as part of dietary supplementation along with conventional treatment can result in perfect security and treatment of peptic ulcer. Further well-designed preclinical and clinical tests are recommended in order to recognize higher levels of evidence for the confirmation of bioefficacy and safety of dietary polyphenols in the management of peptic ulcer.

  10. Acid-reducing vagotomy is associated with reduced risk of subsequent ischemic heart disease in complicated peptic ulcer: An Asian population study.

    Science.gov (United States)

    Wu, Shih-Chi; Fang, Chu-Wen; Chen, William Tzu-Liang; Muo, Chih-Hsin

    2016-12-01

    Persistent exacerbation of a peptic ulcer may lead to a complicated peptic ulcer (perforation or/and bleeding). The management of complicated peptic ulcers has shifted from acid-reducing vagotomy, drainage, and gastrectomy to simple local suture or non-operative (endoscopic/angiographic) hemostasis. We were interested in the long-term effects of this trend change. In this study, complicated peptic ulcer patients who received acid-reducing vagotomy were compared with those who received simple suture/hemostasis to determine the risk of ischemic heart disease (IHD).This retrospective cohort study analyzed 335,680 peptic ulcer patients recorded from 2000 to 2006 versus 335,680 age-, sex-, comorbidity-, and index-year matched comparisons. Patients with Helicobacter pylori (HP) infection were excluded. In order to identify the effect of vagus nerve severance, patients who received gastrectomy or antrectomy were also excluded. The incidence of IHD in both cohorts, and in the complicated peptic ulcer patients who received acid-reducing vagotomy versus those who received simple suture or hemostasis was evaluated.The overall incidence of IHD was higher in patients with peptic ulcer than those without peptic ulcer (17.00 vs 12.06 per 1000 person-years), with an adjusted hazard ratio (aHR) of 1.46 based on multivariable Cox proportional hazards regression analysis controlling for age, sex, Charlson's comorbidity index, and death (competing risk). While comparing peptic ulcer patients with acid-reducing vagotomy to those with simple suture/hemostasis or those without surgical treatment, the aHR (0.58) was the lowest in the acid-reducing vagotomy group.Patients with peptic ulcer have an elevated risk of IHD. However, complicated peptic ulcer patients who received acid-reducing vagotomy were associated with reduced risk of developing IHD.

  11. Clinical and morphological features of peptic ulcer at men and women

    OpenAIRE

    Islamova Е.А.; Lipatova Т.Е.

    2010-01-01

    The aim of research was to study clinical and morphological features of peptic ulcer at men and women of various age. 166 patients with duodenal peptic ulcer (80 men and 86 women) and 138 with stomach peptic ulcer (80 men and 58 women) were inspected. Clinical displays, morphometrical analysis of components of diffuse neuroendocrine system and stomach receptors of sexual hormones were studied. It is defined, that peptic ulcer at women under 40 years has more favorable clinical current, than a...

  12. Gastroretentive drug delivery systems for therapeutic management of peptic ulcer.

    Science.gov (United States)

    Garg, Tarun; Kumar, Animesh; Rath, Goutam; Goyal, Amit K

    2014-01-01

    A peptic ulcer, stomach ulcer, or gastric ulcer, also known as peptic ulcer disease (PUD), is a very common chronic disorder of the stomach which is mainly caused by damage or impairment of the stomach lining. Various factors such as pepsin, gastric acid, H. pylori, NSAIDs, prostaglandins, mucus, bicarbonate, and blood flow to mucosa play an important role in causing peptic ulcers. In this review article, our main focus is on some important gastroretentive drug delivery systems (GRDDS) (floating, bioadhesive, high density, swellable, raft forming, superporous hydrogel, and magnetic systems) which will be helpful in gastroretention of different dosage forms for treatment of peptic ulcer. GRDDS provides a mean for controlled release of compounds that are absorbed by active transport in the upper intestine. It also enables controlled delivery for paracellularly absorbed drugs without a decrease in bioavailability. The above approaches are specific for targeting and leading to a marked improvement in the quality of life for a large number of patients. In the future, it is expected that they will become of growing significance, finally leading to improved efficiencies of various types of pharmacotherapies.

  13. Risk factors in patients surgically treated for peptic ulcer perforation

    DEFF Research Database (Denmark)

    Møller, Morten Hylander; Shah, Kamran; Bendix, Jørgen;

    2009-01-01

    OBJECTIVE: The overall mortality for patients undergoing surgery for perforated peptic ulcer has increased despite improvements in perioperative monitoring and treatment. The objective of this study was to identify and describe perioperative risk factors in order to identify ways of optimizing...... the treatment and to improve the outcome of patients with perforated peptic ulcer. MATERIAL AND METHODS: Three hundred and ninety-eight patients undergoing emergency surgery in four university hospitals in Denmark were included in the study. Information regarding the pre-, intra- and postoperative phases were...... insufficiency upon admission and insufficient postoperative nutrition have been added to the list of independent risk factors for death within 30 days of surgery in patients with peptic ulcer perforation. Finding that shock upon admission, reduced albumin blood levels upon admission, renal insufficiency upon...

  14. Epidemiology of peptic ulcer disease in Wuhan area of China from 1997 to 2002

    Institute of Scientific and Technical Information of China (English)

    Wei-Guo Dong; Chun-Sheng Cheng; Shao-Ping Liu; Jie-Ping Yu

    2004-01-01

    AIM: To describe the epidemiological features of peptic ulcer disease in Wuhan area during 1997-2002, to analyze the sex, age and occupation characteristics, as well as the geographic distribution of peptic ulcer disease, and to determine the effective methods of preventing and controlling peptic ulcer disease.METHODS: In the early 1980s, the peptic ulcer disease registry system was established to collect the data of peptic ulcer disease in Wuhan area. Here we performed a statistically detailed analysis of 4876 cases of peptic ulcer disease during 1997-2002.RESULTS: The morbidity of peptic ulcer disease between males and females was significantly different (x2 = 337.9,P<0.001). The majority of peptic ulcer diseases were found at the age of 20 to 50 years. Because of different occupations,the incidence of peptic ulcer disease was different in different areas.CONCLUSION: The incidence of peptic ulcer disease is highly associated with sex, age, occupation and geographic environmental factors. By analyzing the epidemiological features of peptic ulcer disease, we can provide the scientific data for prevention and control of peptic ulcer disease.

  15. Peptic ulceration may be a hormonal deficiency disease.

    Science.gov (United States)

    Love, Jack W

    2008-01-01

    Evidence is reviewed that Helicobacter pylori infection may cause a deficiency of the hormone secretin that allows peptic ulcer disease to develop by impairing the body's defenses to gastric acid. Secretin is released into the circulation from the S-cells of the duodenal crypts in response to gastric acid entering the duodenum. Once in the circulation, secretin has five well-documented effects that protect the upper intestine from gastric acid: it stimulates secretion of bicarbonate rich exocrine pancreatic juice; it stimulates secretion of alkaline bile; it stimulates secretion of alkaline mucus from the duodenal submucosal glands of Brunner; it inhibits the humoral phase of gastric secretion; and it inhibits gastric motility, thereby delaying gastric emptying. Impaired secretin release and reduced duodenal S-cells have been documented in peptic ulcer patients compared with control patients. Clinical evidence that patients with H. pylori infection and peptic ulceration have increased gastric secretion and motility and decreased duodenal bicarbonate response to gastric acid, all of which normalize after eradication of the infection, could be explained by reversible impairment of the secretin mechanism. Gastric metaplasia in the duodenum with H. pylori infection is known to reduce the S-cell population. The fact that not all patients with H. pylori infection develop peptic ulceration suggests that degree of secretin deficiency determined by extent of the infection must reach a critical level for peptic ulceration to occur. Peptic ulceration may be a hormonal deficiency disease, a result of secretin deficiency caused by H. pylori infection. It may be the first example of a specific hormonal deficiency disease caused by a specific bacterial infection.

  16. Reassessment of the predictive value of the Forrest classification for peptic ulcer rebleeding and mortality: can classification be simplified?

    NARCIS (Netherlands)

    Groot, N.L. de; Oijen, M.G.H. van; Kessels, K.; Hemmink, M.; Weusten, B.L.; Timmer, R.; Hazen, W.L.; Lelyveld, N. van; Vermeijden, R.R.; Curvers, W.L.; Baak, B.C.; Verburg, R.; Bosman, J.H.; Wijkerslooth, L.R. de; Rooij, J van; Venneman, N.G.; Pennings, M.C.P.; Hee, K. van; Scheffer, B.C.; Eijk, R.L. van; Meiland, R.; Siersema, P.D.; Bredenoord, A.J.

    2014-01-01

    BACKGROUND AND STUDY AIMS: This study aimed to reassess whether the Forrest classification is still useful for the prediction of rebleeding and mortality in peptic ulcer bleedings and, based on this, whether the classification could be simplified. PATIENTS AND METHODS: Prospective registry data on

  17. [Non-Helicobacter pylori, Non-nonsteroidal Anti-inflammatory Drug Peptic Ulcer Disease].

    Science.gov (United States)

    Chang, Young Woon

    2016-06-25

    Non-Helicobacter pylori, non-NSAID peptic ulcer disease (PUD), termed idiopathic PUD, is increasing in Korea. Diagnosis is based on exclusion of common causes such as H. pylori infection, infection with other pathogens, surreptitious ulcerogenic drugs, malignancy, and uncommon systemic diseases with upper gastrointestinal manifestations. The clinical course of idiopathic PUD is delayed ulcer healing, higher recurrence, higher re-bleeding after initial ulcer healing, and higher mortality than the other types of PUD. Genetic predisposition, older age, chronic mesenteric ischemia, cigarette smoking, concomitant systemic diseases, and psychological stress are considered risk factors for idiopathic PUD. Diagnosis of idiopathic PUD should systematically explore all possible causes. Management of this disease is to treat underlying disease followed by regular endoscopic surveillance to confirm ulcer healing. Continuous proton pump inhibitor therapy is an option for patients who respond poorly to the standard ulcer regimen.

  18. [Diagnosis and Treatment of Peptic Ulcer Disease: Present and Future Perspective].

    Science.gov (United States)

    Kim, Byung Wook

    2016-06-25

    Peptic ulcer disease is one of the most commonly encountered diseases in gastroenterology clinics. After the discovery of Helicobacter pylori by Warren and Marshall, it has been identified as the most important cause of peptic ulcer. Eradication of H. pylori markedly reduces the post-treatment recurrence rate of peptic ulcer. However, as human populations age, the incidence of cardiovascular and musculoskeletal diseases increases and consequent use of aspirin and non-steroidal anti-in-flammatory drugs increases. Thus causes and presenting patterns of peptic ulcer have changed. In this review, I describe new diagnostic and therapeutic strategies for peptic ulcer disease and explore future perspectives.

  19. Rebleeding after initial endoscopic hemostasis in peptic ulcer disease.

    Science.gov (United States)

    Hong, Mi Jin; Lee, Sun-Young; Kim, Jeong Hwan; Sung, In-Kyung; Park, Hyung Seok; Shim, Chan Sup; Jin, Choon Jo

    2014-10-01

    Endoscopic hemostasis is the first-line treatment for upper gastrointestinal bleeding (UGIB). Although several factors are known to be risk factors for rebleeding, little is known about the use of antithrombotics. We tried to verify whether the use of antithrombotics affects rebleeding rate after a successful endoscopic hemostasis for peptic ulcer disease (PUD). UGIB patients who underwent successful endoscopic hemostasis were included. Rebleeding was diagnosed when the previously treated lesion bled again within 30 days of the initial episode. Of 522 UGIB patients with PUD, rebleeding occurred in 93 patients (17.8%). The rate of rebleeding was higher with aspirin medication (P=0.006) and after a long endoscopic hemostasis (P<0.001). Of all significant variables, procedure time longer than 13.5 min was related to the rate of rebleeding (OR, 2.899; 95% CI, 1.768-4.754; P<0.001) on the logistic regression analysis. The rate of rebleeding after endoscopic hemostasis for PUD is higher in the patients after a long endoscopic hemostasis. Endoscopic hemostasis longer than 13.5 min is related to rebleeding after a successful endoscopic hemostasis for PUD.

  20. 护理干预对治疗消化性溃疡伴上消化道出血的临床价值%Clinical value of peptic ulcer with upper gastrointestinal bleeding contributed by nursing intervention

    Institute of Scientific and Technical Information of China (English)

    叶玉华

    2014-01-01

    目的:对应用全面护理干预模式对合并出现上消化道出血症状的消化性溃疡疾病患者在治疗期间实施护理的临床效果进行研究。方法:2012年5月-2014年5月收治消化性溃疡疾病患者84例,随机分为对照组和观察组,每组42例。对照组采用常规消化科护理服务模式实施护理;观察组采用全面护理干预模式实施护理。结果:观察组消化功能恢复正常时间和临床治疗总时间明显短于对照组;观察组治疗期间护理服务的满意度明显高于对照组。结论:应用全面护理干预模式对合并出现上消化道出血症状的消化性溃疡疾病患者在治疗期间实施护理的临床效果非常明显。%Objective:To study the clinical effect by applying comprehensive nursing intervention mode to the patients with peptic ulcer disease appearing merging symptom of hemorrhage of upper digestive tract during the treatment with implementation of nursing.Methods:84 patients with peptic ulcer disease appearing merging symptom of hemorrhage of upper digestive tract were selected from May 2012 to May 2014,who randomly divided into the control group and the observation group,each are averages for 42 patients.The control group were given routine gastroenterology nursing service mode.The observation group were given comprehensive nursing intervention model.Results:Compared with the control group, the patients in the observation group were obviously shorter on the recovery time of gastrointestinal function and total time of clinical treatment were more satisfying on nursing service of peptic ulcer disease merging with hemorrhage of upper digestive tract during the treatment.Conclusion:The clinical effect of applying comprehensive nursing intervention mode to the patients with peptic ulcer disease appearing merging symptom of hemorrhage of upper digestive tract during the treatment with implementation of nursing is very obvious.

  1. Cisplatin-induced peptic ulcers, vagotomy, adrenal and calcium modulation.

    Science.gov (United States)

    Aggarwal, S K; San Antonio, J D; Sokhansanj, A; Miller, C

    1994-04-01

    Cytochemical and autoradiographic studies in Wistar rats [Crl:(WI)BR] show that cisplatin treatment (9 mg/kg) inhibits the release of acetylcholine from the axonal endings of the stomach smooth muscle resulting in bloating of the stomach and ulceration. Cisplatin also induces corticosteroid release from the adrenal gland stimulating peptic ulceration. Vagotomy helps ameliorate the effect but not eliminate it. Calcium supplementation restores normal neuromuscular function to gastric smooth muscle, thereby eliminating the gastro-intestinal toxicity due to cisplatin.

  2. Characterization of Patients with Helicobacter pylori-Negative Peptic Ulcers

    OpenAIRE

    Roberto Hernández Conde; Guillermo Noa Pedroso; Carlos Domínguez Álvarez; Isabel Mora Díaz; Marcos Félix Osorio Pagola; Yagén Pomares Pérez

    2013-01-01

    Background: the rate of Helicobacter pylori-negative ulcers is increasing. Treatment with nonsteroidal anti-inflammatory drugs and other ulcerogenic drugs plays a significant role.Objective: to characterize patients with Helicobacter pylori-negative peptic ulcer. Methods: a case series study of patients attended by the Gastroenterology Service of the Hermanos Ameijeiras Hospital was conducted in the year 2009. Demographic, epidemiological, clinical, endoscopic and histological variables were ...

  3. Peptic ulcer among urban bus drivers in Denmark

    DEFF Research Database (Denmark)

    Netterstrøm, Bo; Juel, K

    1990-01-01

    As part of a survey on the work environment of bus drivers, 2045 (83%) of 2465 male bus drivers in the three major cities in Denmark in 1978 answered a postal questionnaire on health and working conditions. In order to evaluate the relative occurrence of peptic ulcer among the bus drivers, a foll...

  4. The "stamp method" : a new treatment for perforated peptic ulcer?

    NARCIS (Netherlands)

    Bertleff, MJOE; Liem, RSB; Robinson, PH; Bonjer, HJ; Lange, JF; Bartels, H.; van der Werf, J.F.A.

    2006-01-01

    Background: The aim of this study was to develop a simple method for closure of a perforated peptic ulcer, making it more accessible for laparoscopic surgery. Methods: An experimental pilot study was performed using five male Wistar rats. The perforation was closed by a bioabsorbable patch made of l

  5. Perforated peptic ulcer following gastric bypass for obesity.

    Science.gov (United States)

    Macgregor, A M; Pickens, N E; Thoburn, E K

    1999-03-01

    Peptic ulcer in the excluded segment of a gastric bypass performed in the management of morbid obesity has only rarely been reported in the literature. The purpose of this study is to review our experience with the condition in a series of 4300 patients who underwent gastric-restrictive surgery between 1978 and 1997. Eleven patients presented with acute perforation of a peptic ulcer in the excluded gastric segment. Nine ulcers were duodenal, one was gastric, and one patient had both gastric and duodenal perforations. The time between primary gastric-restrictive surgery and ulcer perforation varied from 20 days to 12 years. All patients presented with upper abdominal pain. The classical radiological sign of perforated peptic ulcer, free air under the diaphragm, did not occur in any patient. Nine patients were initially treated by primary closure of the perforation with subsequent definitive ulcer therapy by vagotomy, pyloroplasty, or gastrectomy. One case, initially treated elsewhere, was managed by placement of a Malecot catheter through the duodenal perforation, gastrostomy, and peritoneal drainage. One recent case remains symptom-free on H2 blockers after simple closure. There was no mortality. Six cases were previously reported in the literature with a 33 per cent mortality rate.

  6. [Nonsteroidal Anti-inflammatory Drug and Aspirin-induced Peptic Ulcer Disease].

    Science.gov (United States)

    Shim, Young Kwang; Kim, Nayoung

    2016-06-25

    Despite decreasing Helicobacter pylori prevalence, the prevalence of peptic ulcer disease is increasing in the aged population, mainly due to increasing use of NSAIDs to manage pain and inflammation. In addition, low dose aspirin is employed as an anti-coagulant for those who have suffered or are at high risk of ischemic stroke and cardiovascular disease. However, NSAIDs and aspirin are injurious to mucosa of stomach and duodenum. NSAID-induced inhibition of mucosal prostaglandin synthesis is thought to be a major mechanism of gastrointestinal mucosal injury. The proportion of elderly has increased rapidly in Korea, with the proportion over 65 years old expected to be 24.3% in 2030. In this higher-risk population, the strategy to reduce the incidence of NSAID-related peptic ulcers and complications such as bleeding, obstruction and perforation is very important. Proton pump inhibitors (PPIs) with cyclooxygenase-2 inhibitor can be used for reducing the risk of NSAID-related ulcers and upper gastrointestinal (GI) complications. However, continuous use of PPI has several problems. In addition, NSAID-related problems in the lower GI tract have increased, in contrast to the decrease of NSAID-related upper GI disease. The aim of this review is to provide an evidence-based knowledge regarding the mechanism, complications of treatment, and prevention strategies for NSAID- or aspirin-related peptic ulcer disease in Korea.

  7. Managing peptic ulcer and gastroesophageal reflux disease in elderly Chinese patients – focus on esomeprazole

    Directory of Open Access Journals (Sweden)

    Tang RS

    2013-10-01

    Full Text Available Raymond SY Tang, Justin CY Wu Institute of Digestive Disease, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong Abstract: Peptic ulcer disease (PUD and gastroesophageal reflux disease (GERD are not uncommon in elderly patients. Clinical presentations of these acid-related disorders may be atypical in the geriatric population. Older individuals are at increased risk for poor outcomes in complicated PUD and for development of GERD complications. Multiple risk factors (eg, Helicobacter pylori [HP], use of nonsteroidal anti-inflammatory drugs [NSAIDs], aspirin contribute to the development of PUD. Recent data has shown that HP-negative, NSAID-negative idiopathic peptic ulcers are on the rise and carry a higher risk of recurrent ulcer bleeding and mortality. Effective management of PUD in the geriatric population relies on identification and modification of treatable risk factors. Elderly patients with GERD often require long-term acid suppressive therapy. Proton pump inhibitors (PPI including esomeprazole are effective in the treatment of reflux esophagitis, maintenance of GERD symptomatic control, and management of PUD as well as its complications. Potential safety concerns of long-term PPI use have been reported in the literature. Clinicians should balance the risks and benefits before committing elderly patients to long-term PPI therapy. Keywords: elderly patients, peptic ulcer disease, gastroesophageal reflux disease, proton pump inhibitor, esomeprazole

  8. Zinc compounds, a new treatment in peptic ulcer.

    Science.gov (United States)

    Escolar, G; Bulbena, O

    1989-01-01

    Effects of zinc in gastric ulcer have been reviewed through investigations carried out on zinc acexamate (ZAC). ZAC is an organic compound that has been shown to possess an experimental antiulcer effect and a wide therapeutic index, making it a useful drug in the treatment of peptic ulcer disease. ZAC protects from ulceration in several experimental models such as pylorus occlusion, reserpine-induced ulcer, necrotizing agents, PAF-induced ulcer and cold-restraint stress. ZAC first reduces the gastric acid output by inhibiting the mast cell degranulation, an action likely to be mediated through a membrane stabilizing action. Secondly, it enhances the mucosal protection factors by increasing mucus secretion, inhibiting the H+ retrodiffusion and improving microcirculation. ZAC is also effective in acetic acid-induced chronic ulcer, restoring the continuity of the damaged mucosa. Several clinical trials have shown the usefulness of ZAC in acute and maintenance treatment of both gastric and duodenal ulcers. Endoscopic studies showed that ZAC reduced the inflammatory processes (gastritis and duodenitis) associated with ulcer healing. This reduction was statistically significant and not observed with other comparative treatments (H2-antagonists). The observed side-effects were minimal and affected less than 2% of treated patients. The pharmacological profile, clinical effectiveness and good tolerance of ZAC suggest this compound as an interesting option in the treatment of peptic disease.

  9. The Peptic Ulcer Perforation (PULP) score: a predictor of mortality following peptic ulcer perforation. A cohort study

    DEFF Research Database (Denmark)

    Møller, M H; Engebjerg, M C; Adamsen, S;

    2012-01-01

    Accurate and early identification of high-risk surgical patients with perforated peptic ulcer (PPU) is important for triage and risk stratification. The objective of the present study was to develop a new and improved clinical rule to predict mortality in patients following surgical treatment...

  10. Sarcomas arising after radiotherapy for peptic ulcer disease

    Energy Technology Data Exchange (ETDEWEB)

    Lieber, M.R.; Winans, C.S.; Griem, M.L.; Moossa, R.; Elner, V.M.; Franklin, W.A.

    1985-06-01

    Therapeutic gastric irradiation has been used to reduce peptic juice secretion in patients with peptic ulcer disease. Between 1937 and 1968 a total of 2049 patients received such therapy at the University of Chicago. Three of these patients are known to have developed sarcomas in the field of radiation. Two gastric leiomyosarcomas of the stomach were diagnosed 26 and 14 years after treatment and a malignant fibrous histiocytoma of the anterior chest wall was removed six years after gastric irradiation. Of 743 peptic ulcer patients treated without irradiation and constituted as a control group for the study of therapeutic gastric radiation, none is known to have developed sarcoma. As the incidence of sarcoma in these patient groups is known only from the tumor registry of the University of Chicago, other cases of sarcoma may exist in the groups. While an increased incidence of sarcoma has not been proven to occur in patients who received therapeutic gastric irradiation for peptic ulcer disease, the possibility of such a risk should be borne in mind by physicians caring for such patients.

  11. Historical impact to drive research in peptic ulcer disease.

    Science.gov (United States)

    Banić, M; Malfertheiner, P; Babić, Z; Ostojić, R; Kujundzic, M; Fatović-Ferenčić, S; Plesko, S; Petričušić, L

    2011-01-01

    The story of gastric acid secretion began with early ideas on gastric secretion (Spallanzani and de Réaumur, 17th century) and with first descriptions of food digestion (Dupuytren and Bichat, Beaumont, early 18th century), followed by proof that gastric juice contained acid (Prout, early 18th century). The research continued with first descriptions of gastric glands as the source of gastric acid and its changes upon digestive stimulus (Purkinje and Golgi, mid and late 19th century). The theory of 'nervism' - the neuro-reflex stimulation of gastric secretion by vagal nerve (Pavlov, early 20th century) was contrasted by a histamine-mediated concept of gastric secretion (Popielski and Code, mid 20th century). Thus, gastric acid and pepsin (Schwann, early 19th century) were found to be essential for food digestion and studies also pointed to histamine, being the most potent final common chemostimulator of oxyntic cells. The discoveries in etiopathogenesis of mucosal injury were marked by the famous dictum: 'No acid, no ulcer' ('Ohne saueren Magensaft kein peptisches Geschwür', Schwarz, 1910) that later induced the term of 'mucosal defense' and the notion that the breaking of 'gastric mucosal barrier' represents the initial step in the process of mucosal injury (Davenport, Code and Scholer, mid 20th century). The prostaglandins were shown to influence all major components of gastric mucosal barrier, described with the term 'cytoprotection' (Vane, Robert and Jacobson, 1970s). Beginning in the latter half of 19th century, the studies on gastric bacteriology that followed enabled the discovery of association between Campylobacter (Helicobacter) pylori and peptic ulcers (Warren and Marshall, 1980s) that led to worldwide major interventions in treating peptic ulcer disease. The surgical approach to peptic ulcer had been outlined by resection procedures (Billroth, Pean, Moynihan, late 19 century) and vagotomy, with or without drainage procedures (Jaboulay, Latarjet

  12. Factors Associated with Peptic Gastroduodenal Ulcer Perforations in Adult patients at Muhimbili National Hospital

    OpenAIRE

    2011-01-01

    Peptic gastroduodenal ulcer disease results from an imbalance of acid secretion and mucosal defenses that resist acid digestion. Following developments in the medical treatment of peptic ulcer disease (PUD) in the last two decades, surgical intervention is currently confined to the treatment of complicated disease, namely, ulcer hemorrhage, perforation, penetration and obstruction. Simple closure or omental patch repair is the mainstay of treatment of perforated peptic ulcer (PPU), definitive...

  13. Evidence-based clinical practice guidelines for peptic ulcer disease 2015.

    Science.gov (United States)

    Satoh, Kiichi; Yoshino, Junji; Akamatsu, Taiji; Itoh, Toshiyuki; Kato, Mototsugu; Kamada, Tomoari; Takagi, Atsushi; Chiba, Toshimi; Nomura, Sachiyo; Mizokami, Yuji; Murakami, Kazunari; Sakamoto, Choitsu; Hiraishi, Hideyuki; Ichinose, Masao; Uemura, Naomi; Goto, Hidemi; Joh, Takashi; Miwa, Hiroto; Sugano, Kentaro; Shimosegawa, Tooru

    2016-03-01

    The Japanese Society of Gastroenterology (JSGE) revised the evidence-based clinical practice guidelines for peptic ulcer disease in 2014 and has created an English version. The revised guidelines consist of seven items: bleeding gastric and duodenal ulcers, Helicobacter pylori (H. pylori) eradication therapy, non-eradication therapy, drug-induced ulcer, non-H. pylori, non-nonsteroidal anti-inflammatory drug (NSAID) ulcer, surgical treatment, and conservative therapy for perforation and stenosis. Ninety clinical questions (CQs) were developed, and a literature search was performed for the CQs using the Medline, Cochrane, and Igaku Chuo Zasshi databases between 1983 and June 2012. The guideline was developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Therapy is initially provided for ulcer complications. Perforation or stenosis is treated with surgery or conservatively. Ulcer bleeding is first treated by endoscopic hemostasis. If it fails, surgery or interventional radiology is chosen. Second, medical therapy is provided. In cases of NSAID-related ulcers, use of NSAIDs is stopped, and anti-ulcer therapy is provided. If NSAID use must continue, the ulcer is treated with a proton pump inhibitor (PPI) or prostaglandin analog. In cases with no NSAID use, H. pylori-positive patients receive eradication and anti-ulcer therapy. If first-line eradication therapy fails, second-line therapy is given. In cases of non-H. pylori, non-NSAID ulcers or H. pylori-positive patients with no indication for eradication therapy, non-eradication therapy is provided. The first choice is PPI therapy, and the second choice is histamine 2-receptor antagonist therapy. After initial therapy, maintenance therapy is provided to prevent ulcer relapse.

  14. 老年患者消化性溃疡穿孔及出血后短期病死率的研究%Research for short-term case fatality rate in gerontal patient after peptic ulcer perforation and bleeding

    Institute of Scientific and Technical Information of China (English)

    梁艳斌; 符宏宇; 陈辉; 蒋晓渠

    2012-01-01

    目的 研究消化性溃疡穿孔和出血后短期病死率与年龄的关系,并确定合并症对此关系的影响.方法 收集2004年4月~2010年12月住院治疗并首次被诊断为消化性溃疡穿孔的患者295例和消化性溃疡合并出血患者1032例.根据住院病史及出院记录确定其诊断结果及是否死亡,溃疡的合并症及相关药物的使用信息通过住院病史获得.将两组患者分别分为65岁以下组、65 ~79岁组、80岁及以上组.计算年龄、性别和合并症与标准30天病死率的关系,用COX回归的方法评价老年患者与年轻患者30天死亡比值比(MRR).结果 295例消化性溃疡穿孔患者中年龄在65 ~79岁者107例(36.3%),80岁以上者73例(24.7%);<65岁的患者中标准30天病死率为3.5%,年龄在80岁以上的患者达到21.9%,校正MRR值达5.2(95% CI:4.3 ~6.8).在1032消化性溃疡出血患者中,年龄在80岁以上者338例(32.8%),<65岁患者的标准30天病死率为1.7%,年龄> 80岁的患者达8.3%,调整后的MRR为3.6% (95%CI:2.8 ~4.9).分层分析显示,老年患者的高MRR与合并症的严重程度无关.结论 衰老是一个独立于合并症、与消化性溃疡穿孔或出血预后不良存在强关联的预测因素.%Objective To study the correlation of age with short-term case fatality rate in peptic ulcer perforation and bleeding,and to evaluate the effect of complications on this correlation. Methods Those hospitalized patients with a first-time discharge diagnosis of perforated peptic ulcer(295 cases) or bleeding peptic ulcer(1032 cases) from April 1st,2004 to December 31st,2010 were recruited. Information about diagnosis, death, complications and medicine was obtained through the patient' s medical records. We devided peptic ulcer perforation and bleeding peptic ulcer patients in 2 groups and each group was divided into 3 groups according to the age;under 65,65 to 79 and above 80 years. We analyzed the

  15. Peptic ulcer pathophysiology: acid, bicarbonate, and mucosal function

    DEFF Research Database (Denmark)

    Højgaard, L; Mertz Nielsen, A; Rune, S J

    1996-01-01

    The previously accepted role of gastric acid hypersecretion in peptic ulcer disease has been modified by studies showing no correlation between acid output and clinical outcome of ulcer disease, or between ulcer recurrence rate after vagotomy and preoperative acid secretion. At the same time......, studies have been unable to demonstrate increased acidity in the duodenal bulb in patients with duodenal ulcer, and consequently more emphasis has been given to the mucosal protecting mechanisms. The existence of an active gastric and duodenal mucosal bicarbonate secretion creates a pH gradient from...... cell removal and repair regulated by epidermal growth factor. Sufficient mucosal blood flow, including a normal acid/base balance, is important for subepithelial protection. In today's model of ulcer pathogenesis, gastric acid and H. pylori work in concert as aggressive factors, with the open question...

  16. A case-control study on non-steroidal anti-inflammatory drugs(NSAIDs)induced and NSAIDs unrelated peptic ulcer with upper gastrointestinal bleeding%NSAIDs相关性消化性溃疡出血与非NSAIDs消化性溃疡出血的临床对照研究

    Institute of Scientific and Technical Information of China (English)

    宗晔; 赵海英; 王青釭; 吴咏冬; 张澍田

    2012-01-01

    目的 探讨非甾体类抗炎药(NSAIDs)相关性溃疡出血与非NSAIDs消化性溃疡出血的差异.方法 通过临床对照研究,比较46例NSAIDs相关性溃疡出血与88例非NSAIDs消化性溃疡出血的临床资料.结果 NSAIDs组年龄显著高于非NSAIDs组,女性患者比率高于非NSAIDs组;NSAIDs组具有心脑血管和/或风湿免疫性疾病的患者多于非NSAIDs组,而既往具有消化性溃疡病史的患者低于非NSAIDs组;NSAIDs组上腹痛症状显著低于非NSAIDs组;NSAIDs组发病时血糖高于非NSAIDs组;NSAIDs组胃溃疡比率显著高于非NSAIDs组.以上差异均有统计学意义(P<0.05).结论 NSAIDs相关性溃疡出血发病年龄、性别、临床表现及溃疡的发生部位与非NSAIDs溃疡患者均有差异,熟悉NSAIDs相关性溃疡出血的特点有利于临床诊治.%Objective To explore the difference in clinical characteristics between non - steroidal anti - inflammatory drugs ( NSAIDs ) induced and NSAIDs unrelated peptic ulcer with upper gastrointestinal bleeding. Methods The case - control study was used to analyze the clinical data of forty - six patients with NSAIDs induced and eighty - eight patients with NSAIDs unrelated peptic ulcer with upper gastrointestinal bleeding. Results The age range of patients in NSAIDs induced group was older than that of NSAIDs unrelated group. Female patients in NSAIDs induced group were more than those in NSAIDs unrelated group. More patients in NSAIDs induced group had the history of cardio - cerebral - vascular diseases or rheumatic diseases, fewer patients in NSAIDs induced group had the history of peptic ulcer and epigastric pain. The level of blood sugar in NSAIDs induced group was higher than that of NSAIDs unrelated group. The number of patients with gastric ulcer in NSAIDs induced group was more than that of NSAIDs unrelated group. Their difference was significant( P < 0. 05 ). Conclusion There was significant difference between NSAIDs induced group and

  17. Characterization of Patients with Helicobacter pylori-Negative Peptic Ulcers

    Directory of Open Access Journals (Sweden)

    Roberto Hernández Conde

    2013-10-01

    Full Text Available Background: the rate of Helicobacter pylori-negative ulcers is increasing. Treatment with nonsteroidal anti-inflammatory drugs and other ulcerogenic drugs plays a significant role.Objective: to characterize patients with Helicobacter pylori-negative peptic ulcer. Methods: a case series study of patients attended by the Gastroenterology Service of the Hermanos Ameijeiras Hospital was conducted in the year 2009. Demographic, epidemiological, clinical, endoscopic and histological variables were studied. Mean and standard deviation were analyzed; logistic regression, t-Student and Chi-square tests were used. Results: A total of 269 gastric ulcers, 239 duodenal ulcers and 41 combined were diagnosed; 115 cases were Helicobacter pylori-negative and 434 were positive. Nonsteroidal anti-inflammatory drugs were associated with 33,9 % of H. pylori-negative patients and 22.8% of the positive patients. Ulcerative syndrome occurred in 47 % and 45% in both groups. All H. pylori-negative duodenal ulcers were located in the duodenal bulb as well as 96, 6 % of the positive. The antrum was the most common location for gastric ulcerations (92.3% negative; 90.5% positive. Multiple ulcers predominated in the duodenum while double ulcers prevailed in the stomach, all negative for H.pylori. Antral gastritis predominated (73. 0 % H. pilory- negative, the level of activity was higher in the positive cases (97. 0 % and intestinal metaplasia was similar for both groups. Conclusions: in patients with H. pylori-negative peptic ulcer, non-steroidal anti-inflammatory drugs should be taken into consideration as one of the main factors associated with this entity.

  18. 消化性溃疡合并上消化道出血的相关危险因素分析%Analysis of related risk factors for the upper-gastrointestinal bleeding in peptic ulcer disease

    Institute of Scientific and Technical Information of China (English)

    向四国; 仰涢霞; 黄丽儿

    2015-01-01

    [目的]分析消化性溃疡合并上消化道出血的相关危险因素。[方法]将324例消化性溃疡患者,按是否合并上消化道出血分为观察组(75例)、对照组(249例),对2组临床资料中一般情况、生活习惯、饮食习惯和用药情况等进行回顾性分析。[结果]观察组性别、年龄、病程、职业以及有非甾体类抗炎药用药史和 Hp感染史患者比率均高于对照组,差异有统计学意义(P<0.05),而2组婚姻、家族史比较,差异无统计学意义(P>0.05)。观察组长期吸烟、嗜酒、喜食辛辣刺激食物、生活无规律患者比率均高于对照组,差异有统计学意义( P<0.05)。观察组溃疡直径≥20 mm、溃疡处于活动期、抑郁、失眠患者比率均高于对照组,差异有统计学意义(P<0.05),而2组溃疡部位比较,差异无统计学意义(P>0.05)。[结论]服用非甾体类抗炎药、有 H p感染及不良的生活习惯是消化性溃疡合并上消化道出血的危险因素。%Objective]To investigate the related risk factors for the upper‐gastrointestinal bleeding (UGIB)in peptic ulcer disease(PU).[Methods]A retrospective analysis was performed for 324 cases of PU patients in our hospital during 2010 January -2014 January ,in which 75 patients complicated with UGIB were considered as observation group(OG) ,and 249 patients without UGIB complication were considered as control group(CG).The clinical data of the general condition ,living habits ,diet and medication were competitively analyzed. [Results ] T he ratio of gender ,age ,disease duration ,occupation ,the history of NSAIDS intake and Hp positive rate in OG were significantly higher than those in CG(P0.05).Meanwhile ,the ratio of long‐term smoking ,drinking ,eating spicy food in OG were significantly higher than those in CG(P0.05).In an addition ,the ratio of depression ,insomnia and regular life were higher in OG than those in CG(P<0

  19. Tannins, peptic ulcers and related mechanisms.

    Science.gov (United States)

    de Jesus, Neyres Zinia Taveira; de Souza Falcão, Heloina; Gomes, Isis Fernandes; de Almeida Leite, Thiago Jose; de Morais Lima, Gedson Rodrigues; Barbosa-Filho, Jose Maria; Tavares, Josean Fechine; da Silva, Marcelo Sobral; de Athayde-Filho, Petrônio Filgueiras; Batista, Leonia Maria

    2012-01-01

    This review of the current literature aims to study correlations between the chemical structure and gastric anti-ulcer activity of tannins. Tannins are used in medicine primarily because of their astringent properties. These properties are due to the fact that tannins react with the tissue proteins with which they come into contact. In gastric ulcers, this tannin-protein complex layer protects the stomach by promoting greater resistance to chemical and mechanical injury or irritation. Moreover, in several experimental models of gastric ulcer, tannins have been shown to present antioxidant activity, promote tissue repair, exhibit anti Helicobacter pylori effects, and they are involved in gastrointestinal tract anti-inflammatory processes. The presence of tannins explains the anti-ulcer effects of many natural products.

  20. Tannins, Peptic Ulcers and Related Mechanisms

    Directory of Open Access Journals (Sweden)

    Leonia Maria Batista

    2012-03-01

    Full Text Available This review of the current literature aims to study correlations between the chemical structure and gastric anti-ulcer activity of tannins. Tannins are used in medicine primarily because of their astringent properties. These properties are due to the fact that tannins react with the tissue proteins with which they come into contact. In gastric ulcers, this tannin-protein complex layer protects the stomach by promoting greater resistance to chemical and mechanical injury or irritation. Moreover, in several experimental models of gastric ulcer, tannins have been shown to present antioxidant activity, promote tissue repair, exhibit anti Helicobacter pylori effects, and they are involved in gastrointestinal tract anti-inflammatory processes. The presence of tannins explains the anti-ulcer effects of many natural products.

  1. Relative Frequency of Peptic Ulcer and Erosion in Patients with Different Types of Cholestasis

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    F Joukar

    2008-04-01

    Full Text Available Introduction: Cholestasis is impairment of normal bile excretion into the duodenum and classified as mechanical and non mechanical cholestasis. Mechanical Cholestasis presents with increase in bile duct diameter or obstruction in bile duct in an ERCP. Cholestasis leads to different complications. One of these complications is mucosal peptic erosion leading to gastrointestinal bleeding, perforation and even obstruction due to stricture. We therefore carried out this study to assess the relative frequency of peptic ulcer and erosion in patients with different type of cholestasis. Methods: In a case control study, 170 patients with mechanical cholestasis on the basis of physical examination, liver function tests, radiologic and serologic assay were candidates for ERCP as final therapeutic and diagnostic test. Collected data was registered in questionnaire and evaluated by the Fisher Test. Later, sonography (common bile duct diameter in the two groups: mechanical (85 patients and non mechanical (85 patients and endoscopy was done for exact survey and location of mucosal erosions. Results: Frequency of mucosal peptic erosions in mechanical cholestatic groups was42.6% ( 36 patients and significantly more than frequency of mucosal peptic erosion in non mechanical cholestatic groups (15 patients, 17.6% (P=0.02. 51 patients (30% of the total patients with cholestasis had mucosal erosion. From these patients, 25 patients had peptic ulcer [frequency of duodenal ulcer was 17 patients (68% and gastric ulcer was 8 patients (32% ](P=0.01. There was significant difference in prevalence of duodenal ulcer in patients with mechanical (12 cases, 70.6% and non mechanical (5 cases, 29.4% cholestasis(P=0.01. There was a significant difference between prevalence of duodenal ulcer (12 cases, 70.6% and gastric ulcer(5 cases, 29.4% in patients with mechanical cholestasis (P=0.01 but this was not so in patients with non mechanical cholestasis. Conclusion: According to

  2. SOME EXPERIMENTALLY PROVED HERBS IN PEPTIC ULCER DISEASE

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    Javed Ahmad Khan et al

    2012-08-01

    Full Text Available Peptic ulcer is a worldwide health problem because of its high morbidity, mortality and enormous financial implication. An estimated 15,000 deaths per year occur as a consequence of complicated PUD. A large number of drugs for peptic ulcer disease are available in mainstream medicine but they are associated with numerous side effects like arrhythmias, impotence, gynaecomastia and haematopoietic changes and the recurrence is also very common. In recent times, focus on plant research has increased all over the world and a large body of evidence has been collected to show immense potential of medicinal plants used in various traditional systems. Here, an attempt is made to summarise experimentally proved herbs used in PUD during last decade.

  3. Survey of Research on Acupuncture Treatment of Peptic Ulcer

    Institute of Scientific and Technical Information of China (English)

    杨波; 高洋; 严兴科

    2008-01-01

    In reviewing and analyzing the study on the clinical selection of the acupoints for peptic ulcer in the recent ten years,it was found out that peptic ulcer was mostly treated by combination of multiple acupoints clinically,by the combination of Front-mu point and Back-shu point of the spleen and stomach,and the combination of Front-mu point and Back-shu point of the spleen and stomach with Lower He-sea point,indicating that Front-mu point and Back-shu point of the spleen and stomach and Lower He-sea point have the important functions in the treatment of peptic ulcer.%回顾分析了近10年针灸治疗消化性溃疡的临床选穴研究概况,发现临床治疗消化性溃疡以多穴配伍为主,多穴中以脾胃之俞募配穴及脾胃之俞募穴配下合穴为主.表明脾胃之背俞穴、募穴及下合穴对治疗消化性溃疡具有重要作用.

  4. A comparison of oral omeprazole and intravenous cimetidine in reducing complications of duodenal peptic ulcer

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    Khaleghian Farzaneh

    2006-01-01

    Full Text Available Abstract Background Gastrointestinal bleeding is a common problem and its most common etiology is peptic ulcer disease. Ulcer rebleeding is considered a perilous complication for patients. To reduce the rate of rebleeding and to fasten the improvement of patients' general conditions, most emergency departments in Iran use H2-blockers before endoscopic procedures (i.e. intravenous omeprazole is not available in Iran. The aim of this study was to compare therapeutic effects of oral omeprazole and intravenous cimetidine on reducing rebleeding rates, duration of hospitalization, and the need for blood transfusion in duodenal ulcer patients. Methods In this clinical trial, 80 patients with upper gastrointestinal bleeding due to duodenal peptic ulcer and endoscopic evidence of rebleeding referring to emergency departments of Imam and Sina hospitals in Tabriz, Iran were randomly assigned to two equal groups; one was treated with intravenous cimetidine 800 mg per day and the other, with 40 mg oral omeprazole per day. Results No statistically significant difference was found between cimetidine and omeprazole groups in regards to sex, age, alcohol consumption, cigarette smoking, NSAID consumption, endoscopic evidence of rebleeding, mean hemoglobin and mean BUN levels on admission, duration of hospitalization and the mean time of rebleeding. However, the need for blood transfusion was much lower in omeprazole than in cimetidine group (mean: 1.68 versus 3.58 units, respectively; p Conclusion This study demonstrated that oral omeprazole significantly excels intravenous cimetidine in reducing the need for blood transfusion and lowering rebleeding rates in patients with upper gastrointestinal bleeding. Though not statistically significant (p = 0.074, shorter periods of hospitalization were found for omeprazole group which merits consideration for cost minimization.

  5. Peptic ulcer disease in endogenous hypercortisolism: myth or reality?

    Science.gov (United States)

    Hatipoglu, Esra; Caglar, Asli Sezgin; Caglar, Erkan; Ugurlu, Serdal; Tuncer, Murat; Kadioglu, Pinar

    2015-11-01

    Many clinicians believe hypercortisolism is ulcerogenic. However, data from clinical studies show that prophylaxis for peptic ulcer disease is no longer recommended in patients receiving corticosteroid treatment. This has not yet been verified in endogenous hypercortisolism by controlled clinical studies. The purpose of the current study was to evaluate the relationship between endogenous Cushing's syndrome (CS) and peptic ulcer disease and Helicobacter pylori infection. The study group contained 20 cases with CS resulting from ACTH-dependent endogenous hypercortisolism. The control groups consisted of 14 age- and gender-matched cases receiving exogenous corticosteroid therapy and 100 cases of dyspepsia with non-cushingoid features. Upper gastrointestinal endoscopy was performed on all cases. Biopsies were taken from five different points: two samples from the antrum, two samples from the corpus, and one sample from the fundus. A histological diagnosis of Helicobacter pylori infection was also obtained from evaluation of biopsy specimens. The frequency of stomach and duodenal ulcers did not vary between the groups (p = 0.5 and p = 0.7). Antral gastritis was less frequent and pangastritis was more common in cases with CS compared to the healthy controls (p = 0.001 and p < 0.001). The incidence of Candida esophagitis was more frequent in cases with CS compared to cases with corticosteroid treatment and healthy controls (p = 0.03). Histopathological findings and frequency of Helicobacter pylori based on pathology results did not vary between the three groups. It is possible that neither exogenous nor endogenous corticosteroid excess directly causes peptic ulcer or Helicobacter pylori infection. Prophylactic use of proton pump inhibitors is not compulsory for hypercortisolism of any type.

  6. Perforated peptic ulcer and short-term mortality among tramadol users

    DEFF Research Database (Denmark)

    Tørring, Marie Louise; Riis, Anders; Christensen, Steffen

    2007-01-01

    AIM: Use of nonsteroidal anti-inflammatory drugs (NSAIDs) increases risk and worsens prognosis for patients with complicated peptic ulcer disease. Therefore, patients who are at high risk of peptic ulcer often use tramadol instead of NSAIDs. Tramadol's effect on peptic ulcer prognosis is unknown....... The aim was to examine mortality in the 30 days following hospitalization for perforated peptic ulcer among tramadol and NSAID users compared with non-users. METHODS: The study was based on data on reimbursed prescriptions and hospital discharge diagnoses for the 1993-2004 period, extracted from...... population-based healthcare databases. All patients with a first-time diagnosis of perforated peptic ulcer were identified, excluding those with previous ulcer diagnoses or antiulcer drug use. Cox regression was used to estimate 30-day mortality rate ratios for tramadol and NSAID users compared with non...

  7. Severe and refractory peptic ulcer disease: the diagnostic dilemma: case report and comprehensive review.

    Science.gov (United States)

    Guzzo, James L; Duncan, Mona; Bass, Barbara L; Bochicchio, Grant V; Napolitano, Lena M

    2005-11-01

    The recognition of Helicobacter pylori infection as a cause of peptic ulcer disease, medical regimens to eradicate the organism, and the widespread use of proton pump inhibition to suppress gastric acid secretion have revolutionized the management of peptic ulcer disease. As a result, successful medical management of peptic ulcer disease has largely supplanted the need for gastric surgery by general surgeons. Surgery is reserved for complications of the disease, refractory disease, or rare causes of ulcer disease such as gastrinoma and Zollinger-Ellison syndrome. In this report, we describe a case of intractable peptic ulcer disease that progressed to gastric outlet obstruction despite maximal medical therapy. We review the diagnostic studies utilized to evaluate the potential etiologies of peptic ulcer disease and the difficulty in diagnosing gastrinoma and Zollinger-Ellison in the setting of potent medical acid suppression therapy.

  8. Managing peptic ulcer and gastroesophageal reflux disease in elderly Chinese patients--focus on esomeprazole.

    Science.gov (United States)

    Tang, Raymond S Y; Wu, Justin C Y

    2013-01-01

    Peptic ulcer disease (PUD) and gastroesophageal reflux disease (GERD) are not uncommon in elderly patients. Clinical presentations of these acid-related disorders may be atypical in the geriatric population. Older individuals are at increased risk for poor outcomes in complicated PUD and for development of GERD complications. Multiple risk factors (eg, Helicobacter pylori [HP], use of nonsteroidal anti-inflammatory drugs [NSAIDs], aspirin) contribute to the development of PUD. Recent data has shown that HP-negative, NSAID-negative idiopathic peptic ulcers are on the rise and carry a higher risk of recurrent ulcer bleeding and mortality. Effective management of PUD in the geriatric population relies on identification and modification of treatable risk factors. Elderly patients with GERD often require long-term acid suppressive therapy. Proton pump inhibitors (PPI) including esomeprazole are effective in the treatment of reflux esophagitis, maintenance of GERD symptomatic control, and management of PUD as well as its complications. Potential safety concerns of long-term PPI use have been reported in the literature. Clinicians should balance the risks and benefits before committing elderly patients to long-term PPI therapy.

  9. Helicobacter Genotyping and Detection in Peroperative Lavage Fluid in Patients with Perforated Peptic Ulcer

    NARCIS (Netherlands)

    N.A.P. Komen (Niels); M.J.O.E. Bertleff (Marietta); J.F. Lange (Johan); P.W. de Graaf

    2008-01-01

    textabstractIntroduction and Objectives Certain Helicobacter pylori genotypes are associated with peptic ulcer disease; however, little is known about associations between the H. pylori genotype and perforated peptic ulcer (PPU). The primary aim of this study was to evaluate which genotypes are pre

  10. The management of peptic ulcer disease.

    Science.gov (United States)

    Louw, Japie A; Marks, I N Solly

    2003-11-01

    The period under review has seen little evolution in our understanding of the empiric management of dyspepsia. The role of Helicobacter pylori in this setting remains controversial, and a policy of risk stratification with the prudent use of test and treat and symptomatic therapy, with endoscopy for nonresponsive cases, seems to have some support from the literature in this period. The management of nonsteroidal antiinflammatory drug-associated and aspirin-associated complications has received a lot of attention in the period under review. The COX-2 selective agents have maintained their reputation as safer (but not "safe") options, although some of the original work with one of these agents has been rigorously interrogated and found wanting. Studies in the review period have focused our attention on the less than satisfactory protection of proton pump inhibitor cotherapy, the site-specific nature of ulcer recurrences (which may have therapeutic implications), lower gastroenterology complications associated with NSAID use, and the beneficial effect of proton pump inhibitor cotherapy for patients receiving low-dose aspirin. One should also expect a lot more information in the future with regard to the use of the nitric oxide donating class of nonsteroidal antiinflammatory drugs and aspirin. Findings are presented that suggest that the H.pylori stool antigen test is not as reliable as the urea breath test, while the most promising "new therapy" for H. pylori is not new, but rather an amalgam of some older drugs combined in a new "quadruple" therapy strategy, which shows some promise.

  11. [Peptic Ulcer Disease Associated with Helicobacter pylori Infection].

    Science.gov (United States)

    Yeo, Se-Hwan; Yang, Chang-Hun

    2016-06-25

    Although the global prevalence of peptic ulcer disease (PUD) is decreasing, PUD is still one of the most common upper gastrointestinal diseases in the world due to Helicobacter pylori infection and increased use of non-steroidal anti-inflammatory drugs. In Korea, the prevalence of H. pylori infection is also declining, but it is still the major cause of PUD. The outcomes of H. pylori infection are caused by imbalances between bacterial virulence factors, host factors, and environmental influences. In this review, we describe the prevalence trends of H. pylori infection in Korea, the mechanism of H. pylori infection-related PUD, and treatment strategies.

  12. Benign duodenocolic fistula as a complication of peptic ulcer disease.

    Science.gov (United States)

    Kamani, Fereshteh; Hessami, Reza; Abrishami, Alireza

    2014-01-01

    A 44-year-old man with upper abdominal pain, diarrhea and 25 kg weight loss since 3 months ago was admitted. He had a history of dyspepsia and peptic ulcer disease 4 months before admission. Gastroduodenal endoscopy and upper gastrointestinal series with barium study were done. Biopsies and CT-scan ruled out malignancies. Endoscopy and radiology studies revealed a duodenocolic fistula. He underwent right hemicolectomy, fistula en bloc excision, and distal gastrectomy surgery with gastrojejunostomy and ileocolic anastomosis. Radiologic modalities are necessary before surgery. Surgery is the only curative treatment in benign cases and reconstruction method is dependent on patient's situation.

  13. To drain or not to drain in perforated peptic ulcer

    Directory of Open Access Journals (Sweden)

    Zafer Kilbas

    2012-02-01

    Full Text Available In their study, published in the current issue of the Journal of Experimental and Integrative Medicine, Ansari et al investigated the role of prophylactic abdominal drain usage in perforated peptic ulcer (PPU, a frequently performed surgical procedure in the emergency departments. Surgical treatment of PPU has not changed much, i.e. primary closure of the perforation and careful cleansing of the abdominal cavity, since it was described by Johann von Mikulicz-Radecki (1850-1905. There have been different applications related to drain usage and drain numbers in different centers. While a single drain... [J Exp Integr Med 2012; 2(1.000: 45-46

  14. Route of children at ulcerative gastroduodenal bleedings

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    Сергій Олександрович Сокольник

    2015-07-01

    Full Text Available Aim. To elaborate the step-by-step differential algorithm of the motion of children with ulcerative gastroduodenal bleedings. Methods. There were examined 45 patients with gastroduodenal bleeding of ulcerative genesis using clinical, sociometric, genealogic, immune-enzyme, biochemical, endoscopic, functional methods. In the complex treatment for stop bleeding 13 patients underwent argon-plasma coagulation and the other – irrigation with aminocapronic acid. An efficiency of treatment was evaluated using epidemiologic and statistical methods.Results. At presence of an appropriate clinical symptomatology, burdened genealogic anamnesis, laboratory changes it is necessary to carry out an emergency endoscopic examination. In the case of continuing bleeding or instable homeostasis it is recommended to carry out an endoscopic hemostasis using argon-plasma coagulation, in conditions of the high risk of relapse of bleeding – the repeated course of argon-plasma coagulation. After stabilization - an examination for helicobacter infection, conservative therapy and dynamic observation with detection of risk of relapse of bleeding and elaboration of individualized medioprophylactic program.Conclusions. The use of step-by-step differentiated diagnostic and treatment algorithm of the motion in patients with ulcerative disease complicated with gastroduodenal bleeding allows detect the main spectrum of diagnostic researches faster and choose the tactics of treatment and therefore improve an efficiency of medical help for patient and shorten the term of inpatient treatment. 

  15. [Peptic ulcer disease in liver cirrhosis: role of Helicobacter pylori infection and therapeutic approach].

    Science.gov (United States)

    Mitrică, Dana; Constantinescu, R; Drug, V L; Stanciu, C

    2011-01-01

    Peptic ulcer has frequently been associated with liver cirrhosis. The death rate for peptic ulcer in cirrhotics has been reported to be five times higher than in general population. The underlying mechanisms are poorly understood. Different factors have been claimed to be involved, such as alterations in serum gastrin level, gastric acid secretions, mucosal blood flow and decreased prostaglandin production in gastric mucosa. Moreover, Helicobacter pylori infection, when accurately assessed, is detectable in most peptic ulcer cirrhotics. Since the H. pylori infection strongly correlates with peptic ulcer in general population, it is necessary to clarify the role of H. pylori in the pathogenesis of peptic ulcer in cirrhosis before eradication can be proposed as a preventive measure.

  16. Risk factors for peptic ulcer in patients with acute pancreatitis

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    LIAO Juan

    2013-07-01

    Full Text Available ObjectiveTo investigate the clinical characteristics of acute pancreatitis (AP associated with peptic ulcer (PU and to analyze the risk factors for PU in AP patients. MethodsA retrospective analysis was performed on the clinical data of 156 AP patients who were admitted to our hospital from January 2008 to January 2012. All patients underwent gastroscopy within 48 h after admission to detect PU and Helicobacter pylori (Hp infection. The severity of AP was assessed by Ranson score, APACHE Ⅱ score, and CT severity index. The clinical characteristics of AP patients with or without PU were statistically analyzed using independent samples t-test and chi-square test. The univariate and multivariate logistic regression analyses were used to determine the risk factors for PU in AP patients. ResultsAmong the 156 AP patients, 88 (56.4% had PU, but only 28 (31.8% of the 88 cases were infected with Hp. Of the 28 patients, 22 had gastric ulcer, and 6 had both gastric ulcer and duodenal ulcer. Of the 60 PU patients not infected with Hp, 25 had gastric ulcer, 26 had duodenal ulcer, and 9 had both gastric ulcer and duodenal ulcer. The univariate logistic regression analysis showed that male gender, alcohol-induced pancreatitis, smoking, alcohol consumption, high triglyceride level, high C-reactive protein level, and APACHE Ⅱ score ≥8 were significantly associated with PU in AP patients. However, the multivariate logistic regression analysis showed that APACHE Ⅱ score ≥8 was the independent risk factor for PU in AP patients (OR=8.54, 95% CI: 4.52-16.15, P<0.01. ConclusionAP patients are susceptible to PU, but the infection rate of Hp is low. APACHE Ⅱ score ≥8 is the independent risk factor for PU in AP patients.

  17. Helical CT findings of gastric wall thickening by peptic ulcer : compared with gastric adenocarcinoma with ulcer

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Won Jung; Choi, Jong Chul; Seo, Keum Soo; Koo, Bon Sik; Park, Byeong Ho; Kim, Chung Ku; Lee, Ki Nam; Nam, Kyung Jin [College of Medicine, Dong A University, Pusan (Korea, Republic of)

    2000-02-01

    To compare on the basis of helical CT findings gastric wall thickening of peptic gastric ulcer with that of gastric adenocarcinoma with ulcer. Thirty-eight patients with pathologically proven gastric lesion (17 cases of peptic ulcer and 21 cases of ulcerative or ulceroinfiltrative gastric cancer (Borrman type II, III)) underwent helical CT, and the findings were retrospectively reviewed in terms of maximum abnormal wall thickness, preservation of the inner enhancing layer, the presence three discriminate layers of gastric wall, and enhancement pattern. The enhancement pattern of abnormally thick wall was compared with that of the portal phase of back muscle, and was defined as low, iso, or high. The Chi-square test and Student t test were used for statistical analysis. In cases of peptic ulcer and gastric cancer with ulceration, maximum abnormal wall thickness was 7-30 (mean, 16.1)mm, and 11-33 (mean, 21.8)mm, respectively. The inner enhancing layer was preserved in 15 of 17 patients (88.2%) and one of 21 (4.8%); three discriminate layers of gastric wall were observed in 8 of 17 patients (47.0%), and one of 21 (4.8%). The enhancement pattern was low in 12 of 17 patients (70.5%), and 3 of 21 (14.3%); iso in 4 of 17 (23.5%), and 4 of 21 (19.0%), and high in one of 17 (5.9%), and 14 of 21 (66.7%). All figures refer, respectively, to the two distinct conditions. In terms of preservation of the inner enhancing layer, three discriminate layers of gastric wall, and a low enhancement pattern, there were statistically significant differences between peptic ulcer and gastric adenocarcinoma with ulcer. Where the enhancement was high, however, the statistically significant difference between the two conditions was even greater. There was no statistically significant difference in terms of gastric wall thickness or iso-attenuation of thickened gastric. Helical CT findings of gastric wall thickening, preservation of the inner enhancing layer, and three discriminate layers of

  18. A Contribution to the Study of the Association of Pulmonary Emphysema and Peptic Ulcer

    Directory of Open Access Journals (Sweden)

    A. T. Nafici

    1958-01-01

    Full Text Available This is a short survey on association of pulmonary emphysema and peptic ulcer in 680 hospitalized and 1218 private patients. The incidence of peptic ulcer in emphysemateous patient has been approximately evaluated as 38,80 /0 in hospital and 99% in private patients especially studied for this purpose. The probable cause or causes that may enhance the production of peptic ulcer in emphysemateous persons is discussed. A special constitution has been found in most cases of peptic ulcer; the result of which will .be published later en. In view of the fact that Some of the ernphysernateous ulcer patients had bronchial asthma in their history, and as such patients may develop no pathognomonic symptoms or signs of peptic ulcer steroid hormones are likely to be unduly prescribed for them which may result in the appearance of some of the complica ti ons of peptic ulcer such as hemorrhage or perforation. So we recommend that before making quite certain of the absence of the clinical and radiological signs or symptoms of peptic ulcer, any prescription of steroid hormones should strictly be avoided.

  19. An Overview of History, Pathogenesis and Treatment of Perforated Peptic Ulcer Disease with Evaluation of Prognostic Scoring in Adults

    OpenAIRE

    Prabhu, V; Shivani, A

    2014-01-01

    Peptic ulcer disease including both gastric and duodenal ulcer form a substantial part of patients seeking surgical opinion world-wide. The concept of acid in peptic ulcer disease, which was the basis of treatment of peptic ulcer was revolutionized by the discovery of H2-receptor antagonists, that led to the principle of acid suppression therapy for duodenal ulcer which followed decades of preference for surgical interventions in the form of gastric resections, vagotomy etc., After the discov...

  20. Anatomical distribution of peptic ulcer in high incidence gastric cancer area

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    Anuar Alonso Cedeño-Burbano

    2014-12-01

    Full Text Available Background: Peptic ulcer makes reference to the solution of continuity of gastric or duodenal wall beyond muscularis mucosae. Previously, duodenal location was more common than gastric, in a ratio ranging from 2:1 to 4:1. Despite this, after the discovery of the association between peptic ulcer and Helicobacter pylori, relationship between gastric and duodenal ulcer has spread to the equality. However, in areas with high incidence of gastric cancer, peptic ulcer seems to have a different behavior, existing predominance of gastric ulcer. Department of Cauca is have the highest incidence of gastric cancer in Colombia, with an annual rate of 42.5 /100,000 for males and 28.6 / 100,000 for women; however, it is unknown how peptic ulcer anatomically are distributed. Objective: To determine the anatomical distribution of peptic ulcer at endoscopy service of San José University Hospital of Popayán-Cauca, Colombia 2006-2012. Methods: A descriptive cross-sectional study was realized. Database of endoscopy service of San José University Hospital of Popayán was reviewed and reports with diagnosis of peptic ulcer were studied. Data were analyzed using SPSS-15. Results: Gastric ulcer was more common than duodenal ulcer. Gastric ulcer was more common in men (gastric and duodenal ulcer 1:1. In women duodenal ulcer is 1:1. Conclusion: At endoscopy service of San José University Hospital, gastric ulcer is more common than duodenal ulcer, with differences in gender, as in other areas with high incidence of gastric cancer. That fact are suggests in current literature could be related with the presence of stumps of Helicobacter pylori with combined virulence for cancer and ulcer at gastric level seems to be related to the presence in the medium of common virulence strains of Helicobacter pylori for stomach cancer and ulcer gastric, although the current literature is unclear about it, and still needs more validations.

  1. Xanthogranulomatous pseudotumor of stomach induced by perforated peptic ulcer mimicking a stromal tumor.

    Science.gov (United States)

    Lai, Hsin-Yi; Chen, Jeon-Hor; Chen, Chi-Kuan; Chen, Yung-Fang; Ho, Yung-Jen; Yang, Mei-Due; Shen, Wu-Chung

    2006-10-01

    Perforation is a serious complication of peptic ulcer disease occurring in 5% of such patients. Occasionally, the perforation may be sealed off by the omentum or the adjacent organs. Sealed perforated ulcer with pseudotumor formation is very rarely encountered. Here we present a case of gastric pseudotumor induced by perforation of a peptic ulcer. The imaging features in a barium sulfate study and computed tomography mimic an intramural tumor of the stomach.

  2. ENDOSCOPIC THERAPY OF SEVERE ULCER BLEEDING

    Science.gov (United States)

    Kovacs, Thomas O.G.; Jensen, Dennis M.

    2013-01-01

    Upper gastrointestinal (UGI) bleeding secondary to ulcer disease occurs commonly and results in significant patient morbidity and medical expense. After initial resuscitation, carefully performed endoscopy provides an accurate diagnosis of the source of the UGI hemorrhage and can reliably identify those high-risk subgroups that may benefit most from endoscopic hemostasis. Large channel therapeutic endoscopes are recommended. Endoscopists should be very experienced in management of patients with UGI hemorrhage including the use of various hemostatic devices. For patients with major stigmata of ulcer hemorrhage – active arterial bleeding, non-bleeding visible vessel and adherent clot – combination therapy with epinephrine injection and either thermal coaptive coagulation (with multipolar or heater probe), or endoclips is recommended. High dose intravenous proton pump inhibitors are recommended as concomitant therapy with endoscopic hemostasis of major stigmata. Patients with minor stigmata or clean-based ulcers will not benefit from endoscopic therapy and should be triaged to less intensive care and be considered for early discharge. Effective endoscopic hemostasis of ulcer bleeding can significantly improve outcomes by reducing rebleeding, transfusion requirement, and need for surgery, as well as reduce cost of medical care. PMID:21944418

  3. Role of phenolic compounds in peptic ulcer: An overview

    Directory of Open Access Journals (Sweden)

    Sabiha Sumbul

    2011-01-01

    Full Text Available Peptic ulcer is the most common gastrointestinal tract (GIT disorder in clinical practice, which affects approximately 5-10% of the people during their life. The use of herbal drugs for the prevention and treatment of various diseases is constantly developing throughout the world. This is particularly true with regard to phenolic compounds that probably constitute the largest group of plants secondary metabolites. Phenolic compounds have attracted special attention due to their health-promoting characteristics. In the past ten years a large number of the studies have been carried out on the effects of phenolic compounds on human health. Many studies have been carried out that strongly support the contribution of polyphenols to the prevention of cardiovascular diseases, cancer, osteoporosis, neurodegenerative diseases, and diabetes mellitus, and suggest a role in the prevention of peptic ulcer. Polyphenols display a number of pharmacological properties in the GIT area, acting as antisecretory, cytoprotective, and antioxidant agents. The antioxidant properties of phenolic compounds have been widely studied, but it has become clear that their mechanisms of action go beyond the modulation of oxidative stress. Various polyphenolic compounds have been reported for their anti-ulcerogenic activity with a good level of gastric protection. Besides their action as gastroprotective, these phenolic compounds can be an alternative for the treatment of gastric ulcers. Therefore, considering the important role of polyphenolic compounds in the prevention or reduction of gastric lesions induced by different ulcerogenic agents, in this review, we have summarized the literature on some potent antiulcer plants, such as, Oroxylum indicum, Zingiber officinale, Olea europaea L., Foeniculum vulgare, Alchornea glandulosa, Tephrosia purpurea, and so on, containing phenolic compounds, namely, baicalein, cinnamic acid, oleuropein, rutin, quercetin, and tephrosin

  4. Role of phenolic compounds in peptic ulcer: An overview.

    Science.gov (United States)

    Sumbul, Sabiha; Ahmad, Mohd Aftab; Mohd, Asif; Mohd, Akhtar

    2011-07-01

    Peptic ulcer is the most common gastrointestinal tract (GIT) disorder in clinical practice, which affects approximately 5-10% of the people during their life. The use of herbal drugs for the prevention and treatment of various diseases is constantly developing throughout the world. This is particularly true with regard to phenolic compounds that probably constitute the largest group of plants secondary metabolites. Phenolic compounds have attracted special attention due to their health-promoting characteristics. In the past ten years a large number of the studies have been carried out on the effects of phenolic compounds on human health. Many studies have been carried out that strongly support the contribution of polyphenols to the prevention of cardiovascular diseases, cancer, osteoporosis, neurodegenerative diseases, and diabetes mellitus, and suggest a role in the prevention of peptic ulcer. Polyphenols display a number of pharmacological properties in the GIT area, acting as antisecretory, cytoprotective, and antioxidant agents. The antioxidant properties of phenolic compounds have been widely studied, but it has become clear that their mechanisms of action go beyond the modulation of oxidative stress. Various polyphenolic compounds have been reported for their anti-ulcerogenic activity with a good level of gastric protection. Besides their action as gastroprotective, these phenolic compounds can be an alternative for the treatment of gastric ulcers. Therefore, considering the important role of polyphenolic compounds in the prevention or reduction of gastric lesions induced by different ulcerogenic agents, in this review, we have summarized the literature on some potent antiulcer plants, such as, Oroxylum indicum, Zingiber officinale, Olea europaea L., Foeniculum vulgare, Alchornea glandulosa, Tephrosia purpurea, and so on, containing phenolic compounds, namely, baicalein, cinnamic acid, oleuropein, rutin, quercetin, and tephrosin, respectively, as active

  5. Epidemiological Clinical Features and Evolution of Gastroduodenal Ulcer Bleeding in a Tertiary Care Hospital in Spain, during the Last Seven Years

    OpenAIRE

    2013-01-01

    Background. Gastroduodenal ulcer bleeding is a common medical emergency. The aim of this study was to analyze the characteristics of bleeding episodes and to identify changes in the clinical trends over seven years. Methods. Retrospective observational clinical study on a cohort of 272 consecutive adult patients with peptic ulcer bleeding, during the 2006–2012 period. Results. Mean annual admission rate was 12.8 per 100.000 inhabitants. Men were predominant (71%), with a mean age of 66.6 year...

  6. Peptic ulcer disease and other complications in patients receiving dexamethasone palliation for brain metastasis

    Energy Technology Data Exchange (ETDEWEB)

    Penzner, R.D.; Lipsett, J.A.

    1982-11-01

    A retrospective analysis was done of 106 patients who received radiation therapy for brain metastasis. Dexamethasone therapy was instituted in 97 patients. Peptic ulcer disease developed in 5 of 89 patients (5.6 percent) who received a dosage of at least 12 mg a day, but did not occur in patients who received a lower dose or in those who did not receive steroids. The interval between institution of dexamethasone therapy and the development of peptic ulcer disease ranged from three to nine weeks. Two patients had perforated ulcers, one of whom required surgical resection. Peptic ulcer disease contributed to the general deterioration and death of three of the five patients. Overall, in 14 of the 89 patients (15.7 percent) a complication of steroid therapy developed in the form of peptic ulcer disease, steroid myopathy or diabetes mellitus (or a combination of these).

  7. A FUZZY INFERENCE SYSTEM FOR ASSESSMENT OF THE SEVERITY OF THE PEPTIC ULCERS

    Directory of Open Access Journals (Sweden)

    Kianaz Rezaei

    2014-05-01

    Full Text Available Peptic ulcer disease is the most common ulcer of an area of the gastro- intestinal tract. The aim of this study is to utilize soft computing techniques to manage uncertainty and imprecision in measurements related to the size, shape of the abnormality. For this, we designed a fuzzy inference system (FIS which emulates the process of human experts in detection and analysis of the peptic ulcer. The proposed approach models the vagueness and uncertainty associated to measurements of small objects in low resolution images In this study, for the first time, we applied soft computing technique based upon fuzzy inference system (FIS for assessment of the severity of the peptic ulcer. Performance results reveal the FIS with maximum accuracy of 98.1%, which reveals superiority of the approach. The intelligent FIS system can help medical experts as a second reader for detection of the peptic ulcer in the decision making process and consequently, improves the treatment process.

  8. Peptic ulcers after the Great East Japan earthquake and tsunami: possible existence of psychosocial stress ulcers in humans.

    Science.gov (United States)

    Kanno, Takeshi; Iijima, Kastunori; Abe, Yasuhiko; Koike, Tomoyuki; Shimada, Norihiro; Hoshi, Tatsuya; Sano, Nozomu; Ohyauchi, Motoki; Ito, Hirotaka; Atsumi, Tomoaki; Konishi, Hidetomo; Asonuma, Sho; Shimosegawa, Tooru

    2013-04-01

    Societal stress derived from an event that affects the whole society, e. g., a natural disaster, provides a unique, indirect way of determining the relationship between psychological stress and peptic ulcer disease in humans. In this study, we investigated the changing patterns of the incidence of peptic ulcers before and after the Great East Japan earthquake, which occurred on 11 March, 2011. Clinical data of patients with peptic ulcers were retrospectively collected during the 3 months after the earthquake (2011) from 7 major hospitals in the middle of the stricken area, and were compared with the data for the same period of the previous year (2010). The eligible subjects were classified into four groups according to Helicobacter pylori infection status and intake of nonsteroidal anti-inflammatory drugs (NSAIDs). The incidence of all types of peptic ulcers was 1.5-fold increased after the earthquake, and in particular, the incidence of hemorrhagic ulcers was 2.2-fold increased; the gastric ulcer/duodenal ulcer ratio in hemorrhagic ulcers was also significantly increased (p psychological stress alone induced peptic ulcers in humans independently of H. pylori infection and NSAID intake.

  9. A systematic approach for the diagnosis and treatment of idiopathic peptic ulcers.

    Science.gov (United States)

    Chung, Chen-Shuan; Chiang, Tsung-Hsien; Lee, Yi-Chia

    2015-09-01

    An idiopathic peptic ulcer is defined as an ulcer with unknown cause or an ulcer that appears to arise spontaneously. The first step in treatment is to exclude common possible causes, including Helicobacter pylori infection, infection with other pathogens, ulcerogenic drugs, and uncommon diseases with upper gastrointestinal manifestations. When all known causes are excluded, a diagnosis of idiopathic peptic ulcer can be made. A patient whose peptic ulcer is idiopathic may have a higher risk for complicated ulcer disease, a poorer response to gastric acid suppressants, and a higher recurrence rate after treatment. Risk factors associated with this disease may include genetic predisposition, older age, chronic mesenteric ischemia, smoking, concomitant diseases, a higher American Society of Anesthesiologists score, and higher stress. Therefore, the diagnosis and management of emerging disease should systematically explore all known causes and treat underlying disease, while including regular endoscopic surveillance to confirm ulcer healing and the use of proton-pump inhibitors on a case-by-case basis.

  10. Activity of Alkaloids on Peptic Ulcer: What’s New?

    Directory of Open Access Journals (Sweden)

    Raphaela Francelino do Nascimento

    2015-01-01

    Full Text Available Peptic ulcer is a common disease characterized by lesions that affect the mucosa of the esophagus, stomach and/or duodenum, and may extend into the muscular layer of the mucosa. Natural products have played an important role in the process of development and discovery of new drugs, due to their wide structural diversity and present, mostly specific and selective biological activities. Among natural products the alkaloids, biologically active secondary metabolites, that can be found in plants, animals or microorganisms stand out. The alkaloids are compounds consisting of a basic nitrogen atom that may or may not be part of a heterocyclic ring. This review will describe 15 alkaloids with antiulcer activity in animal models and in vitro studies.

  11. Epinephrine plus argon plasma or heater probe coagulation in ulcer bleeding

    Institute of Scientific and Technical Information of China (English)

    Ahmet Karaman; Mevlut Baskol; Sebnem Gursoy; Edip Torun; Alper Yurci; Banu Demet Ozel; Kadri Guven; Omer Ozbakir; Mehmet Yucesoy

    2011-01-01

    AIM: To compare the effectiveness of argon plasma coagulation (APC) and heater probe coagulation (HPC) in non-variceal upper gastrointestinal bleeding. METHODS: Eighty-five (18 female, 67 male) patients admitted for acute gastrointestinal bleeding due to gastric or duodenal ulcer were included in the study. Upper endoscopy was performed and HPC or APC were chosen randomly to stop the bleeding. Initial hemostasis and rebleeding rates were primary and secondary end-points of the study. RESULTS: Initial hemostasis was achieved in 97.7% (42/43) and 81% (36/42) of the APC and HPC groups, respectively (P 0.05). CONCLUSION: APC is an effective hemostatic method in bleeding peptic ulcers. Larger multicenter trials are necessary to confirm these results.

  12. Changes in birth-cohort pattern of peptic ulcer mortality in England and Wales.

    OpenAIRE

    Katschinski, B. D.; Logan, R. F.

    1991-01-01

    Previous epidemiological studies have described the secular trends in peptic ulcer mortality in England and Wales as being characteristic of a cohort phenomenon. The most recent data on ulcer mortality, however, show increasing mortality rates from duodenal ulcer in women over 65 and from gastric ulcer in women over 75 years. While the rise in mortality rates in the oldest age groups is partly explained by their greater life expectancy, the increase in mortality from duodenal ulcer in older w...

  13. Perforation of a gastric tube peptic ulcer into the thoracic aorta.

    Science.gov (United States)

    Katsoulis, I E; Veloudis, G; Exarchos, D; Yannopoulos, P

    2001-01-01

    We present a case of a 52-year-old male patient who died from massive hematemesis as a result of perforation of a benign peptic ulcer into the descending thoracic aorta, 1 year after esophagectomy for esophageal cancer and gastric tube interposition. We also review the literature for mechanisms of ulceration in intrathoracic gastric grafts and for complications of such ulcers.

  14. Assessment of risk factors of helicobacter pylori infection and peptic ulcer disease.

    Science.gov (United States)

    Mhaskar, Rahul S; Ricardo, Izurieta; Azliyati, Azizan; Laxminarayan, Rajaram; Amol, Bapaye; Santosh, Walujkar; Boo, Kwa

    2013-04-01

    Helicobacter pylori (H. pylori) infection is a risk factor for peptic ulcer. There have been no studies addressing environmental and dietary risk factors in western India. We conducted a case control study enrolling peptic ulcer patients in Pune, India. Risk factors for peptic ulcer and H. pylori infection were assessed in a participant interview. H. pylori status was assessed from stool by monoclonal antigen detection. We enrolled 190 peptic ulcer, 35 stomach cancer patients, and 125 controls. Fifty-one percent (180/350) of the participants were infected with H. pylori. Lower socioeconomic status (SES) [odds ratio (OR): 1.10, 95% confidence interval (CI): 1.02-1.39], meat consumption (OR: 2.35, 95% CI: 1.30-4.23), smoking (OR: 2.23, 95% CI: 1.24-4.02), eating restaurant food (OR: 3.77, 95% CI: 1.39-10.23), and drinking nonfiltered or nonboiled water (OR: 1.05, 95% CI: 1.01-1.23) were risk factors for H. pylori infection. H. pylori infection (OR: 1.70, 95% CI: 1.03-2.89), meat (OR: 1.10, 95% CI: 1.02-1.75), fish (OR: 1.05, 95% CI: 1.02-1.89) consumption, and a family history of ulcer (OR: 1.20, 95% CI: 1.08-1.60) were risk factors for peptic ulcer. Consumption of chili peppers (OR: 0.20, 95% CI: 0.10-0.37) and parasite infestation (OR: 0.44, 95% CI: 0.24-0.80) were protective against H. pylori infection. H. pylori infection is associated with peptic ulcer. Lower SES, consumption of restaurant food, meat, nonfiltered water, and smoking are risk factors for H. pylori. Consumption of meat, fish, and a family history of peptic ulcer are risk factors for peptic ulcer. Consumption of chili peppers and concurrent parasite infestation appear to be protective against H. pylori.

  15. Clinical and endoscopic aspects in the evolution of patients with bleeding peptic ulcer: a cohort study Aspectos clínicos e endoscópicos na evolução de pacientes com úlcera péptica sangrante: um estudo de coorte

    Directory of Open Access Journals (Sweden)

    Fábio SEGAL

    2000-07-01

    Full Text Available Background - Bleeding ulcers are a major problem in public health and represent approximately half of all the cases of upper gastrointestinal hemorrhage in the United States. This study aims to determine the prognostic value of factors such as clinical history, laboratory and endoscopic findings in the occurrence of new episodes of bleeding in patients who have upper gastrointestinal hemorrhage caused by gastric or duodenal peptic ulcer. Methods - A cohort study with 94 patients was designed to investigate prognostic factors to the occurrence of new episodes of bleeding. Results - From the 94 patients studied, 88 did not present a new bleeding episode in the 7 days following hospital admission. The incidence of rebleeding was significantly higher in those patients with hemoglobin Introdução - Úlceras sangrantes constituem um grave problema de saúde pública e representam cerca da metade de todos os casos de hemorragia gastrointestinal nos Estados Unidos. O objetivo deste estudo foi determinar o valor prognóstico dos achados clínicos, laboratoriais e endoscópicos no ressangramento de pacientes com úlceras gástricas e duodenais sangrantes. Pacientes e Métodos - Foi realizado um estudo de coorte com 94 pacientes para avaliar fatores prognósticos no ressangramento por úlceras pépticas. Resultados - Dos 94 pacientes estudados, 88 não apresentaram novo episódio de sangramento durante os 7 dias de internação. A incidência de ressangramento foi significativamente maior nos pacientes com hemoglobina <6 g/dL na admissão (P = 0.03, RR=6.2. O grupo com ressangramento necessitou mais transfusão de sangue (P = 0,03 e o tempo de internação foi significativamente maior (P = 0,0349 que no grupo com hemostasia. Nas variáveis endoscópicas, a localização da úlcera no duodeno esteve associada positivamente com o ressangramento (P = 0,03. Conclusão - A identificação de paciente de risco de mortalidade por úlcera sangrante permanece um

  16. Endoscopic View of Gastroduodenal Artery Coils at the Base of Duodenal Ulcer in Case of Recurrent Massive Upper Gastrointestinal Bleed.

    Science.gov (United States)

    Ebrahem, Rawaa; Kadhem, Salam; Frey, John W; Salyers, William

    2017-04-13

    Helicobacter pylori (H. pylori) infection is one of the major causes of bleeding peptic ulcer disease, which is associated with serious complications; therefore, the eradication of H. pylori is essential to prevent these devastating complications. Post-treatment follow-up is crucial to guarantee the eradication of the organism and may be conducted via the urea breath test, the stool antigen test, or a gastric biopsy. Acute massive upper gastrointestinal (UGI) bleeding is one of the most common complications of peptic ulcer disease. Aggressive treatment with early endoscopic hemostasis is essential for a favorable outcome. Recurrent massive nonvariceal UGI bleeding remains a challenge. Optimal management requires a multidisciplinary team of skilled endoscopists, intensivists, experienced UGI surgeons, and interventional radiologists. Endoscopy is the first-line treatment after hemodynamic stability is achieved. The role of early elective surgery or angiographic embolization in selected high-risk patients to prevent re-bleeding remains controversial.

  17. Laparoscopic correction of perforated peptic ulcer: First choice? A review of literature

    NARCIS (Netherlands)

    M.J.O.E. Bertleff (Marietta); J.F. Lange (Johan)

    2010-01-01

    textabstractBackground Perforated peptic ulcer (PPU), despite antiulcer medication and Helicobacter eradication, is still the most common indication for emergency gastric surgery associated with high morbidity and mortality. Outcome might be improved by performing this procedure laparoscopically, bu

  18. Laparoscopic correction of perforated peptic ulcer: First choice? A review of literature

    NARCIS (Netherlands)

    M.J.O.E. Bertleff (Marietta); J.F. Lange (Johan)

    2010-01-01

    textabstractBackground Perforated peptic ulcer (PPU), despite antiulcer medication and Helicobacter eradication, is still the most common indication for emergency gastric surgery associated with high morbidity and mortality. Outcome might be improved by performing this procedure laparoscopically, bu

  19. Association of mortality with out-of-hours admission in patients with perforated peptic ulcer

    DEFF Research Database (Denmark)

    Knudsen, N V; Møller, M H

    2015-01-01

    surgically treated for benign gastric or duodenal perforated peptic ulcer in Denmark between September 1, 2011 and August 31, 2013 were included. Patients were identified through The Danish Clinical Register of Emergency Surgery. The association between 90-day mortality and time and day of admission......BACKGROUND: Perforated peptic ulcer is a serious emergency surgical condition. The aim of the present nationwide cohort study was to evaluate the association between mortality and out-of-hours admission in patients surgically treated for perforated peptic ulcer. METHODS: All Danish patients...... with the primary analysis. The overall 90-day mortality rate was 25.6% (186/726). CONCLUSION: No statistically significant adjusted association between 90-day mortality and out-of-hours admission was found in patients surgically treated for perforated peptic ulcer....

  20. Increased numbers of Foxp3-positive regulatory T cells in gastritis, peptic ulcer and gastric adenocarcinoma

    Science.gov (United States)

    Cheng, Hsin-Hung; Tseng, Guan-Ying; Yang, Hsiao-Bai; Wang, Hung-Jung; Lin, Hwai-Jeng; Wang, Wen-Ching

    2012-01-01

    AIM: To determine the number of regulatory T cells (Tregs) in gastric mucosa of patients with gastritis, peptic ulcers and gastric cancer. METHODS: This study was a retrospective analysis of gastric antrum biopsy specimens from healthy controls (n = 22) and patients with gastritis (n = 30), peptic ulcer (n = 83), or gastric cancer (n = 32). Expression of CD4, CD25 and Foxp3 was determined by immunohistochemistry in three consecutive sections per sample. RESULTS: Compared with healthy controls, there was an increased number of CD25+ and Foxp3+ cells in patients with gastritis (P = 0.004 and P = 0.008), peptic ulcer (P gastritis (P gastritis and peptic ulcer groups. PMID:22228968

  1. [Clinical-immunological and microbiological parallels in chronic generalized parodontitis and peptic ulcer of the stomach].

    Science.gov (United States)

    Orekhova, L Iu; Neĭzberg, D M; Stiuf, I Iu

    2006-01-01

    Clinical, immunological and DNA diagnostic examinations of 101 patients with chronic generalized parodontitis and peptic ulcer have revealed similar features of immunological disorders of gastric and oral mucosa and the role of Helicobacter pylori.

  2. A study of psychiatric morbidity in patients of peptic ulcer diseases

    Directory of Open Access Journals (Sweden)

    Jagpal Singh Klair

    2012-01-01

    Full Text Available Aims and Objectives: To study the prevalence of psychiatric morbidity among patients of peptic ulcer disease and to study the patients of peptic ulcer disease with psychiatric morbidity in comparison to patients of peptic ulcer disease without psychiatric morbidity on following variables: sociodemographic variables and attributes/risk factors of peptic ulcer disease. Materials and Methods: Fifty cases of clinically proven acid peptic diseases and 30 cases of the control group were screened in department of General Medicine, outdoor as well as indoor patients. Instruments applied for the purpose of the study were Personal Bio-data Performa (Appendix-I, (SCL- 80 (Appendix-II, Hamilton rating scale for anxiety and depression, (P.S.L.E.; clinical diagnosis of psychiatric disorders was made as per ICD- 10 criteria. Data collected shall be subjected to statistical analysis. Results and Findings: The psychiatric morbidity was significantly (P10 years, compared to 23.80% in patients without psychiatric morbidity. Lastly, 48.27% of patients with psychiatric morbidity had significantly (P<0.01 stronger family history of acid peptic disease compared to 9.52% in patients without psychiatric morbidity. Conclusions: There is a significant relationship between the peptic ulcer disease and the various psychiatric morbidity factors as illustrated from the findings of this study.

  3. Multicentre trial of a perioperative protocol to reduce mortality in patients with peptic ulcer perforation

    DEFF Research Database (Denmark)

    Møller, M H; Adamsen, S; Thomsen, R W;

    2011-01-01

    Morbidity and mortality rates in patients with perforated peptic ulcer (PPU) remain substantial. The aim of the present study was to evaluate the effect of a multimodal and multidisciplinary perioperative care protocol on mortality in patients with PPU.......Morbidity and mortality rates in patients with perforated peptic ulcer (PPU) remain substantial. The aim of the present study was to evaluate the effect of a multimodal and multidisciplinary perioperative care protocol on mortality in patients with PPU....

  4. Double Pylorus After a Peptic Ulcer in the Gastric Antrum: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Song, Jang hyeon; Shin, Sang Soo; Heo, Young Hoe [Chonnam National University Medical School, Gwangju (Korea, Republic of); Kim, Jin Woong; Jeong, Yong Yeon; Heo, Suk Hee; Kang, Heoung Keun [Chonnam National University Hwasun Hospital, Hwasun (Korea, Republic of)

    2010-06-15

    Double pylorus is an accessory channel between the gastric antrum and duodenal bulb with a normal pyloric canal. It is understood that the etiology of double pylorus is a congenital anomaly or an acquired complication after the occurrence of peptic ulcer disease. We report the CT findings with CT gastrography of double pylorus as a complication after a previous peptic ulcer in the gastric antrum

  5. Investigating the Effect of Kelussia Odoratissima on the Rate of Improvement in Patients with Peptic Ulcer

    OpenAIRE

    Asgari P; Mahmoudi M.; Bahramnezhad F; Mokhtarii R; Rafiei F

    2016-01-01

    Introduction: The studies on animal models have shown positive effects of Kelussia odoratissima on different health problem cases including digestive disorders. However, there has been no research on the effectiveness of Kelussia odoratissima on peptic ulcers in humans. In this study, "the effect of Kelussia odoratissima on the rate of improvement in patients with peptic ulcer" has been investigated. Methods: The present study was a Randomized clinical trial which is done in March- Septemb...

  6. Epstein-Barr Virus Association with Peptic Ulcer Disease

    Directory of Open Access Journals (Sweden)

    María G. Cárdenas-Mondragón

    2015-01-01

    Full Text Available Background. Helicobacter pylori (HP infection and nonsteroidal anti-inflammatory drugs (NSAID use are considered the main risk to develop peptic ulcer disease (PUD. However, PUD also occurs in the absence of HP infection and/or NSAID use. Recently, we have found evidence that Epstein-Barr virus (EBV reactivation increases the risk to develop premalignant and malignant gastric lesions. Objective. To study a possible association between EBV and PUD. Methods. Antibodies against an EBV reactivation antigen, HP, and the HP virulence factor CagA were measured in sera from 207 Mexican subjects, controls (healthy individuals, n = 129, and PUD patients (n = 78, 58 duodenal and 20 gastric ulcers. Statistical associations were estimated. Results. Duodenal PUD was significantly associated with high anti-EBV IgG titers (p = 0.022, OR = 2.5, while anti-EBV IgA was positively associated with gastric PUD (p = 0.002, OR = 10.1. Conclusions. Our study suggests that EBV reactivation in gastric and duodenal epithelium increases the risk to develop PUD.

  7. Epstein-Barr virus association with peptic ulcer disease.

    Science.gov (United States)

    Cárdenas-Mondragón, María G; Torres, Javier; Flores-Luna, Lourdes; Carreón-Talavera, Ricardo; Camorlinga-Ponce, Margarita; Fuentes-Pananá, Ezequiel M

    2015-01-01

    Background. Helicobacter pylori (HP) infection and nonsteroidal anti-inflammatory drugs (NSAID) use are considered the main risk to develop peptic ulcer disease (PUD). However, PUD also occurs in the absence of HP infection and/or NSAID use. Recently, we have found evidence that Epstein-Barr virus (EBV) reactivation increases the risk to develop premalignant and malignant gastric lesions. Objective. To study a possible association between EBV and PUD. Methods. Antibodies against an EBV reactivation antigen, HP, and the HP virulence factor CagA were measured in sera from 207 Mexican subjects, controls (healthy individuals, n = 129), and PUD patients (n = 78, 58 duodenal and 20 gastric ulcers). Statistical associations were estimated. Results. Duodenal PUD was significantly associated with high anti-EBV IgG titers (p = 0.022, OR = 2.5), while anti-EBV IgA was positively associated with gastric PUD (p = 0.002, OR = 10.1). Conclusions. Our study suggests that EBV reactivation in gastric and duodenal epithelium increases the risk to develop PUD.

  8. Epstein-Barr Virus Association with Peptic Ulcer Disease

    Science.gov (United States)

    Cárdenas-Mondragón, María G.; Torres, Javier; Flores-Luna, Lourdes; Carreón-Talavera, Ricardo; Camorlinga-Ponce, Margarita; Fuentes-Pananá, Ezequiel M.

    2015-01-01

    Background. Helicobacter pylori (HP) infection and nonsteroidal anti-inflammatory drugs (NSAID) use are considered the main risk to develop peptic ulcer disease (PUD). However, PUD also occurs in the absence of HP infection and/or NSAID use. Recently, we have found evidence that Epstein-Barr virus (EBV) reactivation increases the risk to develop premalignant and malignant gastric lesions. Objective. To study a possible association between EBV and PUD. Methods. Antibodies against an EBV reactivation antigen, HP, and the HP virulence factor CagA were measured in sera from 207 Mexican subjects, controls (healthy individuals, n = 129), and PUD patients (n = 78, 58 duodenal and 20 gastric ulcers). Statistical associations were estimated. Results. Duodenal PUD was significantly associated with high anti-EBV IgG titers (p = 0.022, OR = 2.5), while anti-EBV IgA was positively associated with gastric PUD (p = 0.002, OR = 10.1). Conclusions. Our study suggests that EBV reactivation in gastric and duodenal epithelium increases the risk to develop PUD. PMID:26199856

  9. Water-soluble vitamin deficiencies in complicated peptic ulcer patients soon after ulcer onset in Japan.

    Science.gov (United States)

    Miyake, Kazumasa; Akimoto, Teppei; Kusakabe, Makoto; Sato, Wataru; Yamada, Akiyoshi; Yamawaki, Hiroshi; Kodaka, Yasuhiro; Shinpuku, Mayumi; Nagoya, Hiroyuki; Shindo, Tomotaka; Ueki, Nobue; Kusunoki, Masafumi; Kawagoe, Tetsuro; Futagami, Seiji; Tsukui, Taku; Sakamoto, Choitsu

    2013-01-01

    We investigated over time whether contemporary Japanese patients with complicated peptic ulcers have any water-soluble vitamin deficiencies soon after the onset of the complicated peptic ulcers. In this prospective cohort study, fasting serum levels of water-soluble vitamins (vitamins B1, B2, B6, B12, C, and folic acid) and homocysteine were measured at 3 time points (at admission, hospital discharge, and 3 mo after hospital discharge). Among the 20 patients who were enrolled in the study, 10 consecutive patients who completed measurements at all 3 time points were analyzed. The proportion of patients in whom any of the serum water-soluble vitamins that we examined were deficient was as high as 80% at admission, and remained at 70% at discharge. The proportion of patients with vitamin B6 deficiency was significantly higher at admission and discharge (50% and 60%, respectively, ppeptic ulcers may have a deficiency of one or more water-soluble vitamins in the early phase of the disease after the onset of ulcer complications, even in a contemporary Japanese population.

  10. Life threatening bleeding from duodenal ulcer after Roux-en-Y gastric bypass: Case report and review of the literature

    Institute of Scientific and Technical Information of China (English)

    Arpad; Ivanecz; Marko; Sremec; Davorin; ?erani?; Stojan; Potr?; Pavel; Skok

    2014-01-01

    Acute upper gastrointestinal bleeding is a rare, but serious complication of gastric bypass surgery. The inaccessibility of the excluded stomach restrains postoperative examination and treatment of the gastric remnant and duodenum, and represents a major challenge, especially in the emergency setting. A 59-year-old patient with previous history of peptic ulcer disease had an upper gastrointestinal bleeding from a duodenal ulcer two years after having a gastric bypass procedure for morbid obesity. After negative upper endoscopy finding, he was urgently evaluated for gastrointestinal bleeding. At emergency laparotomy, the bleeding duodenal ulcer was identified by intraoperative endoscopy through gastrotomy. The patient recovered well after surgical hemostasis, excision of the duodenal ulcer and completion of the remnant gastrectomy. Every general practitioner, gastroenterologist and general surgeon should be aware of growing incidenceof bariatric operations and coherently possible complications after such procedures, which modify patient’s anatomy and physiology.

  11. Peptic Ulcer at the End of the 20th Century: Biological and Psychological Risk Factors

    OpenAIRE

    1999-01-01

    The prevailing concept of peptic ulcer etiology has swung over entirely in just a few years from the psychological to the infectious, yet the rich literature documenting an association between psychosocial factors and ulcer is not invalidated by the discovery of Helicobacter pylori. Physical and psychological stressors interact to induce ulcers in animal models, concrete life difficulties and subjective distress predict the development of ulcers in prospective cohorts, shared catastrophes suc...

  12. The р53 expression in cells of marginal zone of duodenal ulcers during acute bleeding

    Directory of Open Access Journals (Sweden)

    Sulayeva O.N.

    2009-01-01

    Full Text Available The aim of the work was to estimate the intensity and tissue distribution of proapoptogen p53 expression in duodenal mucosa in patients with acute bleeding caused by peptic ulcers. In 31 patients (1st group the healing of ulcer was detected after effective endoscopic hemostasis and in 15 patients rebleeding took place (2nd group. Performed immunocytochemical investigation allow to determine that acute ulcer bleeding was associated with activation of marginal zone cells apoptosis which was maximal in covering epithelium, vascular endothelium and regions infiltrated by lymphocytes. In patients with rebleeding the higher values of р53 expression were detected in crypts epithelium and in endothelium of dilatating vessels accompanied with intensive edema and lymphocytes infiltration of lamina propria and muscularis mucosae with perifocal activation of cells death. Additionally to apoptosis in 2nd group duodenum the necrosis of cells and epithelium desquamation were found, reflecting the tissue disintegration of duodenal mucosa.

  13. Endoscopic laser Doppler flowmetry in the experiment and in the bleeding gastric and duodenal ulcer clinic

    Science.gov (United States)

    Kapralov, S. V.; Shapkin, Y. G.; Lychagov, V. V.; Tuchin, V. V.

    2007-05-01

    One of the most complex problems of emergency surgery is the choice of surgical tactics to deal with bleeding peptic ulcer. Endoscopic hemostasis is prescribed to patients with continuing bleedings and prerelapse syndrome. But till nowdays the objective verification of the prerelapse condition had not been worked out. What is more there are no objective criteria to judge the effectiveness of the carried endohemostasis. The aim of the study was to work out a new objective diagnostic method of pre-recurrence syndrome that can be able to make prognosis for possible gastroduodenal ulcer bleeding recurrence more precise. Laser Doppler flowmetry was the method of studies the regional perfusion. The device used in this work was made at the Optics and Biophysics Department of Saratov State University.

  14. Surgical outcomes for perforated peptic ulcer: A prospective case series at an academic hospital in Monrovia, Liberia

    Directory of Open Access Journals (Sweden)

    J. Fallah Moses

    2015-06-01

    Conclusion: Peptic ulcer disease and its treatment represent a potentially substantial source of morbidity and mortality in limited-resource settings. In this case series, surgical treatment for perforated peptic ulcer disease carried a high mortality, and the results highlight the potential for public health systems strengthening to prevent poor health outcomes. Peptic ulcer disease in low- and middle-income countries presents unique epidemiology and treatment challenges that may differ significantly from evidence-based guidelines in high-income countries.

  15. Determination of the Risk of Recurrent Gastroduodenal Ulcer Bleeding

    OpenAIRE

    2016-01-01

    Despite the advances in endoscopic haemostasis, the incidence of recurrent ulcer bleeding remains to be high. It necessitates further search for its prognosis and methods of treatment.The objective of the research was to analyse risk factors for recurrent gastroduodenal ulcer bleeding.Materials and methods. The study included 203 patients with gastroduodenal ulcer bleeding. There were 135 (66.5%) males and 68 (33.3%) females. All the patients were examined and received conservative treatment ...

  16. Association between acute pancreatitis and peptic ulcer disease

    Institute of Scientific and Technical Information of China (English)

    Kang-Moon Lee; Chang-Nyol Paik; Woo Chul Chung; Jin Mo Yang

    2011-01-01

    AIM:To evaluate the relationship between peptic ulcer disease (PUD) and acute pancreatitis.METHODS:A cohort of 78 patients with acute pancreatitis were included in this study.The presence of PUD and the Helicobacter pylori (H.pylori ) status were assessed by an endoscopic method.The severity of acute pancreatitis was assessed using Ranson's score, the Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ score,computed tomography severity index and the clinical data during hospitalization,all of which were compared between the patients with and without PUD.The risk factors for PUD were also evaluated. RESULTS:Among 78 patients,41 patients (52.6%) with acute pancreatitis suffered from PUD,but only 13 (31.7%) patients with PUD were infected by H.pylori .On univariate analysis,male gender,an etiology of alcohol-induced pancreatitis,a history of smoking or alcohol consumption, elevated triglyceride and C-reactive protein levels, and high APACHE Ⅱ score were significantly associated with PUD.However,on multivariate logistic regression analysis,the APACHE Ⅱ score (odds ratio:7.69; 95% confidence interval:1.78-33.33; P < 0.01) was found to be the only independent risk factor for PUD.CONCLUSION:Patients with acute pancreatitis are liable to suffer from PUD.PUD is associated with severe acute pancreatitis according to the APACHE Ⅱ score, and treatment for PUD should be considered for patients with severe acute pancreatitis.

  17. Pharmacoeconomics of Helicobacter pylori : eradication versus maintenance therapy in controlling peptic ulcer disease

    NARCIS (Netherlands)

    Klok, R M; Brouwers, J R; Postma, Maarten

    2001-01-01

    We performed an electronic search in Medline and EMBASE for papers comparing Helicobacter pylori eradication and H(2)RA-maintenance therapy in peptic ulcer. Treatment to eradicate H. pylori in patients with a proven ulcer has a favorable cost-effectiveness compared with maintenance therapy, with ben

  18. Risk factors and therapeutic response in Chinese patients with peptic ulcer disease

    Institute of Scientific and Technical Information of China (English)

    Shou-Wu; Lee; Teng-Yu; Lee; Hong-Zen; Yeh; Chun-Fang; Tung; Yen-Chun; Peng

    2010-01-01

    AIM:To assess the risk factors and the eff icacy of medications of patients with gastric and duodenal ulcers among Chinese patients in Taiwan.METHODS:Patients with peptic ulcers,diagnosed by upper endoscopy,were retrospectively collected between January 2008 and December 2008.The differences were compared.RESULTS:Among all 448 cases,254(56.6%) and 194(43.4%) patients had gastric ulcers and duodenal ulcers respectively.Patients with gastric ulcers were younger than those with duodenal ulcers.Although more me...

  19. Perforation of the Peptic Ulcer Localized in the Proximal Jejunum – Case Report

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    Żyluk Andrzej Ż

    2016-09-01

    Full Text Available Non-traumatic perforation of the digestive tract occurs most often in the duodenum and stomach (peptic ulcer, as well as the colon (diverticulitis, cancer or ischemic lesions. Perforation of the small bowel is very rare. The Authors of the study presented a case of proximal jejunum perforation, which occurred in a patient with a history of duodenal peptic ulcer disease. Diagnosis posed no difficulties, and treatment included the excision of the ulceration and suturing of the bowel. The patient recovered without complications and the histological examination failed to reveal the nature of the ulcer. However, based on the medical history, one may suppose that it might be of peptic etiology, which makes this case exceptional.

  20. Historic changes of occupational work load and mortality from peptic ulcer in Germany.

    Science.gov (United States)

    Sonnenberg, A; Sonnenberg, G S; Wirths, W

    1987-09-01

    The occurrence of peptic ulcer disease appears to be associated with the amount of occupational work load. Worldwide the number of hospital admissions, surgical operations, and death rates from gastric and duodenal ulcer have declined during recent decades. This communication examines the probability of a correlation between the time trends of gastric and duodenal ulcer mortality in Germany and changes in the occupational work load between 1870 and 1984. Lifetime cumulative hours of work declined for all consecutive cohorts of the population born between 1840 and 1955. The fall occurred similarly in all age groups. However, lifetime cumulative energy expenditure originating from industrial blue collar work showed a peak for the cohorts born during the last quarter of the 19th century. A marked decline occurred in all cohorts born after 1905. A similar birth-cohort pattern was found for mortality from peptic ulcer disease, with those born at the turn of the century showing a higher risk of dying from peptic ulcer disease than any previous or subsequent generation. The coincidence of the birth-cohort patterns of both mortality from peptic ulcer and occupational energy expenditure suggests that birth-cohort pattern of peptic ulcer may be related to the trends of occupational work load that occurred during the industrial revolution. The amount of work hours appears to be a less sensitive measure for the occupational work load. The superimposition of two counteracting historic changes, namely the increased industrial work force and the decreased occupational work load due to legislative regulations, industrial automation, and mechanization may have shaped the rise and fall in the occurrence of peptic ulcer disease.

  1. Accuracy of Helicobacter pylori serology in two peptic ulcer populations and in healthy controls

    Institute of Scientific and Technical Information of China (English)

    Rolv-Ole Lindsetmo; Roar Johnsen; Tor Jac Eide; Tore Gutteberg; Hanne Haukland Husum; Arthur Revhaug

    2008-01-01

    AIM: To estimate the test characteristics of Helicobacter pylori (H pylori) serology and of C14-urea breath test (C14-UBT) in two different peptic ulcer populations and in community controls. Second, the aim was to explore the association between the level of Hpylori IgG antibodies and severity of inflammation as to active peptic ulceration in the same populations.METHODS: Vagotomized (n = 83), medically treated peptic ulcer patients (n = 73) and one reference group of community controls (n = 88) were gastroscoped.H pylori status was determined by histology, bacterial growth, C14-UBT and serology. Based on the updated Sydney System, cumulative scores from biopsies from the prepyloruos, incisura angularis, corpus and fundus were calculated.RESULTS: The prevalence of Hpylori infection varied from 70% to 79%. The C14-UBT had high accuracy compared to the serology test. The sensitivity of the serology test was good, but the specificity was low (41%-71%). The association between H pylori IgG antibodies and scores of gastric mucosal inflammation and current or previous peptic ulcer were weak.CONCLUSION: The accuracy of C14-UBT to diagnose Hpylori infection was good, and the clinical utility of a negative H pylori serology test was substantial, while the gain in clinical information of a positive test was meagre. Positive H pylori titres could not distinguish between subjects with or those without active peptic ulceration.

  2. Secreted and membrane-bound mucins and idiopathic peptic ulcer disease.

    Science.gov (United States)

    Niv, Yaron; Boltin, Doron

    2012-01-01

    The incidence of Helicobacter pylori and non-steroidal anti-inflammatory drug (NSAID)-negative peptic ulcer disease has increased over the last two decades, especially in the Western world and in countries with low H. pylori infection rates. Idiopathic peptic ulcer disease is a recently described entity which relates to peptic ulcers not caused by H. pylori, NSAID/aspirin therapy, other ulcerogenic organisms and drugs, or other rare malignant and benign diseases. Structural and secreted mucins create the unstirred gastric mucus layer and maintain a stable pH above the gastric mucosa. This mucous layer prevents enzymatic attack by acid and pepsin. Inhibition of cyclooxygenase by NSAID and aspirin inhibits prostaglandin production, inhibits mucin and bicarbonate secretion, and exposes the mucosa to the toxic effects of acid and intragastric enzymes. There is also a complex relationship between H. pylori and different mucin subtypes which on one hand facilitates mucin invasion but on the other hand protects the gastric mucosa. Genetic and epigenetic changes in the mucin molecule may be responsible for idiopathic peptic ulcer disease, but this hypothesis must be further investigated. Herein, the mucin hypothesis of idiopathic peptic ulcer disease is explored.

  3. Lewis blood genotypes of peptic ulcer and gastric cancer patients in Taiwan

    Institute of Scientific and Technical Information of China (English)

    Chi-Jung Yei; Jan-Gowth Chang; Mu-Chin Shih; Sheng-Fung Lin; Chao-Sung Chang; Fu-Tsong Ko; Kuang-Yang Lin; Ta-Chin Liu

    2005-01-01

    AIM: The Lewis b (Leb) antigen has been implicated as a possible binding site for attachment of Helicobacter pylori (H pylori)to gastric mucosa. However, studies both supporting and denying this association have been reported in the literature. Differences in secretor (Se)genotype have been suggested as a possible reason for previous discrepancies. Therefore, we investigated the relationship between Le and Se genotypes and H pylori infection rates in people with peptic ulcer or gastric cancer.METHODS: Peripheral blood samples were obtained from 347 patients with endoscopic evidence of peptic ulcer disease (235 cases of duodenal ulcer, 62 of gastric ulcer,and 50 of combined duodenal ulcer/gastric ulcer) and 51patients with gastric cancer on endoscopy. Peripheral blood specimens from 101 unrelated normal volunteers were used as controls. Lewis phenotype was determined using an antibody method, whereas Le and Se genotypes were determined by DNA amplification and restriction enzyme analysis. Gastric or duodenal biopsies taken from patients with endoscopic evidence of peptic ulcer or gastric cancer were cultured for H pylori. Isolates were identified as H pylori by morphology and production of urease and catalase. The H pylori infection status was also evaluated by rapid urease test (CLO test), and urea breath test (13C-UBT). Results of studies were analyzed by chi-square test (taken as significant).RESULTS: H pyloriwas isolated from 83.7% (303/347)of patients with peptic ulcer disease. Statistical analysis did not show any significant difference in Lewis phenotype or genotype between patients with and without H pylori infection. No significant association was found between Lewis genotype and peptic ulcer or gastric cancer.CONCLUSION: Lewis blood genotype or phenotype may not play a role in the pathogenesis of H pyloriinfection.However, bacterial strain differences and the presence of more than one attachment mechanism may limit the value of epidemiological studies in

  4. Assessment of risk factors of helicobacter pylori infection and peptic ulcer disease

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    Rahul S Mhaskar

    2013-01-01

    Full Text Available Background: Helicobacter pylori (H. pylori infection is a risk factor for peptic ulcer. There have been no studies addressing environmental and dietary risk factors in western India. We conducted a case control study enrolling peptic ulcer patients in Pune, India. Materials and Methods: Risk factors for peptic ulcer and H. pylori infection were assessed in a participant interview. H. pylori status was assessed from stool by monoclonal antigen detection. Results: We enrolled 190 peptic ulcer, 35 stomach cancer patients, and 125 controls. Fifty-one percent (180/350 of the participants were infected with H. pylori. Lower socioeconomic status (SES [odds ratio (OR: 1.10, 95% confidence interval (CI: 1.02-1.39], meat consumption (OR: 2.35, 95% CI: 1.30-4.23, smoking (OR: 2.23, 95% CI: 1.24-4.02, eating restaurant food (OR: 3.77, 95% CI: 1.39-10.23, and drinking nonfiltered or nonboiled water (OR: 1.05, 95% CI: 1.01-1.23 were risk factors for H. pylori infection. H. pylori infection (OR: 1.70, 95% CI: 1.03-2.89, meat (OR: 1.10, 95% CI: 1.02-1.75, fish (OR: 1.05, 95% CI: 1.02-1.89 consumption, and a family history of ulcer (OR: 1.20, 95% CI: 1.08-1.60 were risk factors for peptic ulcer. Consumption of chili peppers (OR: 0.20, 95% CI: 0.10-0.37 and parasite infestation (OR: 0.44, 95% CI: 0.24-0.80 were protective against H. pylori infection. Conclusion: H. pylori infection is associated with peptic ulcer. Lower SES, consumption of restaurant food, meat, nonfiltered water, and smoking are risk factors for H. pylori. Consumption of meat, fish, and a family history of peptic ulcer are risk factors for peptic ulcer. Consumption of chili peppers and concurrent parasite infestation appear to be protective against H. pylori.

  5. Pathogenicity island cag, vacA and IS605 genotypes in Mexican strains of Helicobacter pylori associated with peptic ulcers

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    Tabche-Barrera María L

    2011-05-01

    Full Text Available Abstract Background Helicobacter pylori is associated with chronic gastritis, peptic ulcers, and gastric cancer. Two major virulence factors of H. pylori have been described: the pathogenicity island cag (cag PAI and the vacuolating cytotoxin gene (vacA. Virtually all strains have a copy of vacA, but its genotype varies. The cag PAI is a region of 32 genes in which the insertion of IS605 elements in its middle region has been associated with partial or total deletions of it that have generated strains with varying virulence. Accordingly, the aim of this work was to determine the cag PAI integrity, vacA genotype and IS605 status in groups of isolates from Mexican patients with non-peptic ulcers (NPU, non-bleeding peptic ulcers (NBPU, and bleeding peptic ulcers (BPU. Methods The cag PAI integrity was performed by detection of eleven targeted genes along this locus using dot blot hybridization and PCR assays. The vacA allelic, cag PAI genotype 1 and IS605 status were determined by PCR analysis. Results Groups of 16-17 isolates (n = 50 from two patients with NPU, NBPU, and BPU, respectively, were studied. 90% (45/50 of the isolates harbored a complete cag PAI. Three BPU isolates lacked the cag PAI, and two of the NBPU had an incomplete cag PAI: the first isolate was negative for three of its genes, including deletion of the cagA gene, whereas the second did not have the cagM gene. Most of the strains (76% had the vacA s1b/m1 genotype; meanwhile the IS605 was not present within the cag PAI of any strain but was detected elsewhere in the genome of 8% (4/50. Conclusion The patients had highly virulent strains since the most of them possessed a complete cag PAI and had a vacA s1b/m1 genotype. All the isolates presented the cag PAI without any IS605 insertion (genotype 1. Combined vacA genotypes showed that 1 NPU, 2 NBPU, and 1 BPU patients (66.6% had a mixed infection; coexistence of H. pylori strains with different cag PAI status was observed in 1 NBPU

  6. Peptic ulcer and childhood adversities experienced by working-aged people

    Institute of Scientific and Technical Information of China (English)

    Markku PT Sumanen; Markku J Koskenvuo; Lauri H Sillanm.ki; Kari J Mattila

    2009-01-01

    AIM: To study the association between self-reported peptic ulcer and childhood adversities.METHODS: The Health and Social Support Study (HeSSup) population consisted of a stratified random sample drawn from the Finnish Population Register in four age groups: 20-24, 30-34, 40-44 and 50-54. The survey was carried out by postal questionnaire during 1998, with a response rate of 40.0%. A follow-up questionnaire was sent during 2003 to all those who responded to the first.Altogether 19 626 individuals returned the follow-up questionnaire; a response rate of 75.8%. The subjects were asked whether a doctor had told them that they have or have had peptic ulcer. The analyses covered those who responded affirmatively to both the baseline and the follow-up enquiries ( n = 718). Those not reporting a peptic ulcer in either of the two questionnaires ( n = 17 677) were taken as controls. The subjects were further requested (through six questions) to think about their childhood adversities.RESULTS: The most common adversities mentioned were long-lasting financial difficulties in the family,serious conflicts in the family, and a family member seriously or chronically ill. All the adversities reported,except parental divorce, were more common among peptic ulcer patients than among controls ( Pvaried values between < 0.001 and 0.003). Age- and sexadjusted odds ratios (OR) of childhood adversities in the multivariate logistic analysis for self-reported peptic ulcer varied between 1.45 and 2.01. Adjusting for smoking, heavy drinking, stress and nonsteroidal antiinflammatory drug use had no further influence (ORsbetween 1.22 and 1.73).CONCLUSION: Our findings suggest that childhood adversities maintain a connection with and have a predictive role in the development of peptic ulcer.

  7. Peptic ulcer as a risk factor for postherpetic neuralgia in adult patients with herpes zoster.

    Science.gov (United States)

    Chen, Jen-Yin; Lan, Kuo-Mao; Sheu, Ming-Jen; Tseng, Su-Feng; Weng, Shih-Feng; Hu, Miao-Lin

    2015-02-01

    Postherpetic neuralgia is the most common complication of herpes zoster. Identifying predictors for postherpetic neuralgia may help physicians screen herpes zoster patients at risk of postherpetic neuralgia and undertake preventive strategies. Peptic ulcer has been linked to immunological dysfunctions and malnutrition, both of which are predictors of postherpetic neuralgia. The aim of this retrospective case-control study was to determine whether adult herpes zoster patients with peptic ulcer were at greater risk of postherpetic neuralgia. Adult zoster patients without postherpetic neuralgia and postherpetic neuralgia patients were automatically selected from a medical center's electronic database using herpes zoster/postherpetic neuralgia ICD-9 codes supported with inclusion and exclusion criteria. Consequently, medical record review was performed to validate the diagnostic codes and all pertaining data including peptic ulcer, Helicobacter pylori (H. pylori) infection and ulcerogenic medications. Because no standard pain intensity measurement exists, opioid usage was used as a proxy measurement for moderate to severe pain. In total, 410 zoster patients without postherpetic neuralgia and 115 postherpetic neuralgia patients were included. Multivariate logistic regressions identified 60 years of age and older, peptic ulcer and greater acute herpetic pain as independent predictors for postherpetic neuralgia. Among etiologies of peptic ulcer, H. pylori infection and usage of non-selective nonsteroidal anti-inflammatory drugs were significantly associated with the increased risk of postherpetic neuralgia; conversely, other etiologies were not significantly associated with the postherpetic neuralgia risk. In conclusion, 60 years of age and older, peptic ulcer and greater acute herpetic pain are independent predictors for postherpetic neuralgia in adult herpes zoster patients.

  8. Herpes simplex virus type 1 in peptic ulcer disease: An inverse association with Helicobacter pylori

    Institute of Scientific and Technical Information of China (English)

    Klisthenis Tsamakidis; Efstathia Panotopoulou; Dimitrios Dimitroulopoulos; Dimitrios Xinopoulos; Maria Christodoulou; Alexandra Papadokostopoulou; Ioannis Karagiannis; Elias Kouroumalis; Emmanuel Paraskevas

    2005-01-01

    AIM: To assess the frequency of herpes simplex virus type Ⅰ in upper gastrointestinal tract ulcers and normal mucosa with the modern and better assays and also with a larger number of well characterized patients and controls and its relationship to Helicobacter pylori(H pylori).METHODS: Biopsy specimens from 90 patients (34 with gastric ulcer of the prepyloric area and 56 with duodenal ulcer) were evaluated. Biopsies from 50 patients with endoscopically healthy mucosa were considered as the control group. The method used to identify herpes simplex virus-1 (HSV-1) was polymerase chain reaction.H pylori was detected by the CLO-test and by histological method.RESULTS: Herpes simplex virus-1 was detected in 28 of 90 patients with peptic ulcer (31%) [11 of 34 patients with gastric ulcer (32.4%) and 17 of 56 with duodenal ulcer (30.4%)] exclusively close to the ulcerous lesion.All control group samples were negative for HSV-1.The likelihood of H pylori negativity among peptic ulcer patients was significantly higher in HSV-1 positive cases than in HSV-1 negative cases (P = 0.009). Gastric ulcer patients with HSV-1 positivity were Strongly associated with an increased possibility of Helicobacter pylori negativity compared to duodenal ulcer patients (P= 0.010).CONCLUSION: HSV-1 is frequent in upper gastrointestinal tract ulcers but not in normal gastric and duodenal mucosa. There is an inverse association between HSV-1 and H pylori infection.

  9. Serum positive cagA in patients with non-ulcer dyspepsia and peptic ulcer disease from two centers in different regions of Turkey

    Institute of Scientific and Technical Information of China (English)

    Ender Serin; U()ur Yilmaz; Ganiye Künefeci; Birol Ozer; Yüksel Gümürdülü; Mustafa Güclü; Fazilet Kayaselcuk; Sedat Boyacio( )lu

    2003-01-01

    AIM: To investigate and compare frequencies of serum positive cagA in patients from two separate regions of Turkey who were grouped according to the presence of peptic ulcer disease or non-ulcer dyspepsia.METHODS: One hundred and eighty Helicobacter pyloripositive patients with peptic ulcer disease or non-ulcer dyspepsia were included in the study. One hundred and fourteen patients had non-ulcer dyspepsia and 66 had peptic ulcer disease (32 with gastric ulcers and/or erosions and 34with duodenal ulcers). Each patient was tested for serum antibody to H. pylori cagA protein by enzyme immunoassay.RESULTS: The total frequency of serum positive cagA in the study group was 97.2 %. The rates in the patients with peptic ulcers and in those with non-ulcer dyspepsia were 100% and 95.6%, respectively. These results were similar to those reported in Asian studies, but higher than those that have been noted in other studies from Turkey and Western countries.CONCLUSION: The high rates of serum positive cagA in these patients with peptic ulcer disease and non-ulcer dyspepsia were similar to results reported in Asia. The fact that there was high seroum prevalence regardless of ulcer status suggests that factors other than cagA might be responsible for ulceration or other types of severe pathology in H. pylori-positive individuals.

  10. Meta-analysis of efficacy of zinc acexamate in peptic ulcer.

    Science.gov (United States)

    Jiménez, E; Bosch, F; Galmés, J L; Baños, J E

    1992-01-01

    Zinc acexamate (ZAC) is a new drug for the treatment of peptic ulcer. The present study was performed in order to evaluate the clinical efficacy of ZAC in peptic ulcer, using a meta-analysis of all randomized clinical trials performed with this drug. Eighteen studies were reviewed, but only 13 were considered in the final analysis. The total number of patients was 757. Control groups included placebo or H2 receptor antagonist drugs. Healing rate, assessed by endoscopy, was selected as the criterion for evaluating drug efficacy. The meta-analysis was performed using a modified version of the Mantel-Haenszel method. ZAC proved to be better than placebo in the treatment of peptic ulcer (pooled odds ratio: POR = 5.55; 95% confidence interval: 95% CI = 2.20-14.04) and not different from H2 receptor antagonist drugs when compared in patients with gastric (POR = 1.14; 95% CI = 0.47-2.72), duodenal (POR = 0.97; 95% CI = 0.13-7.33) or both ulcer types (POR = 1.10; 95% CI = 0.74-1.64). The present results show that ZAC is an effective drug for the treatment of peptic ulcer.

  11. Significant factors associated with fatal outcome in emergency open surgery for perforated peptic ulcer

    Institute of Scientific and Technical Information of China (English)

    Mario Testini; Piero Portincasa; Giuseppe Piccinni; Germana Lissidini; Fabio Pellegrini; Luigi Greco

    2003-01-01

    AIM: To evaluate the main factors associated with mortality in patients undergoing surgery for perforated peptic ulcer referred to an academic department of general surgery in a large southern Italian city.METHODS: One hundred and forty-nine consecutive patients (M:F ratio=110:39, mean age 52 yrs, range 16-95) with peptic ulcer disease were investigated for clinical history (including age, sex, previous history of peptic ulcer, associated diseases, delayed abdominal surgery, ulcer site, operation type, shock on admission, postoperative general complications,and intra-abdominal and/or wound infections), serum analyses and radiological findings.RESULTS: The overall mortality rate was 4.0%. Among all factors, an age above 65 years, one or more associated diseases, delayed abdominal surgery, shock on admission,postoperative abdominal complications and/or wound infections, were significantly associated (χ2) with increased mortality in patients undergoing surgery (0.0001<P<0.03).CONCLUSION: Factors such as concomitant diseases, shock on admission, delayed surgery, and postoperative abdominal and wound infections are significantly associated with fatal outcomes and need careful evaluation within the general workup of patients admitted for perforated peptic ulcer.

  12. Relationship between onset of peptic ulcer and meteorological factors

    Institute of Scientific and Technical Information of China (English)

    Da-Yun Liu; Zhong-Hui Liang; An-Ning Gao; Guo-Du Tang; Wang-Yue Yang; Jiang Qin; Xin-Guo Wu; Dong-Cai Zhu; Gui-Ning Wang; Jin-Jiang Liu

    2006-01-01

    AIM: To discuss the relationship between onset of peptic ulcer (PU) and meteorological factors (MFs).METHODS: A total of 24 252 Patients were found with active PU in 104 121 samples of gastroscoic examination from 17 hospitals in Nanning from 1992 to 1997. The detectable rate of PU (DRPU) was calculated every month,every ten days and every five days. An analysis of DRPU and MFs was made in the same period of the year. A forecast model based on MFs of the previous month was established. The real and forecast values were tested and verified.RESULTS: During the 6 years, the DRPU from November to April was 24.4 -28.8%. The peak value (28.8%)was in January. The DRPU from May to October was 20.0 -22.6%, with its low peak (20.0%) in June. The DRPU decreased from winter and spring to summer and autumn (P < 0.005). The correlated coefficient between DRPU and average temperature value was -0.8704,-0.6624, -0.5384 for one month, ten days, five days respectively (P < 0.01). The correlated coefficient between DRPU and average highest temperature value was -0.8000, -0.6470,-0.5167 respectively (P <0.01). The correlated coefficient between DRPU and average lowest temperature value was -0.8091, -0.6617, -0.5384 respectively (P <0.01). The correlated coefficient between DRPU and average dew point temperature was -0.7812,-0.6246, -0.4936 respectively (P <0.01). The correlated coefficient between DRPU and average air pressure value was 0.7320, 0.5777, 0.4579 respectively (P <0.01). The average temperature, average highest and lowest temperature, average air pressure and average dew point temperature value of the previous month, ten days and five days could forecast the onset of PU, with its real and forecast values corresponding to 71.8%, 67.9% and 66.6% respectively.CONCLUSION: DRPU is closely related with the average temperature, average highest and lowest temperature,average air pressure and average dew point temperature of each month, every ten days and every five

  13. Peptic Ulcer at the End of the 20th Century: Biological and Psychological Risk Factors

    Directory of Open Access Journals (Sweden)

    Susan Levenstein

    1999-01-01

    Full Text Available The prevailing concept of peptic ulcer etiology has swung over entirely in just a few years from the psychological to the infectious, yet the rich literature documenting an association between psychosocial factors and ulcer is not invalidated by the discovery of Helicobacter pylori. Physical and psychological stressors interact to induce ulcers in animal models, concrete life difficulties and subjective distress predict the development of ulcers in prospective cohorts, shared catastrophes such as war and earthquakes lead to surges in hospitalizations for complicated ulcers, and stress or anxiety can worsen ulcer course. Many known ulcer risk factors, including smoking, nonsteroidal anti-inflammatory drug use, heavy drinking, loss of sleep and skipping breakfast, can increase under stress; the association of low socioeconomic status with ulcer is also accounted for in part by psychosocial factors. Among possible physiological mechanisms, stress may induce gastric hypersecretion, reduce acid buffering in the stomach and the duodenum, impair gastroduodenal blood flow, and affect healing or inflammation through psychoneuroimmunological mechanisms. Psychosocial factors seem to be particularly prominent among idiopathic or complicated ulcers, but they are probably operative in run of the mill H pylori disease as well, either through additive effects or by facilitating the spread of the organism across the pylorus, while gastrointestinal damage by nonsteroidal anti-inflammatory drugs can also be potentiated by stress. Although the clinical importance of peptic ulcer is fading along with the millenium, due to secular trends and new therapies, it remains worthy of study as a splendid example of the biopsychosocial model.

  14. Bleeding gastroduodenal ulcers in patients without Helicobacter pylori infection and without exposure to non-steroidal anti-inflammatory drugs

    Directory of Open Access Journals (Sweden)

    Smolović Brigita

    2014-01-01

    Full Text Available Background/Aim. A high risk of bleeding in Helicobacter pylori (H.pylori-negative, non-steroidal anti-inflammatory drugs (NSAID-negative ulcers highlights the clinical importance of analysis of the changing trends of peptic ulcer disease. The aim of the study was to investigate the risk factors for ulcer bleeding in patients with non-H. pylori infection, and with no NSAIDs use. Methods. A prospective study included patients with endoscopically diagnosed ulcer disease. The patients were without H. pylori infection (verified by pathohistology and serology and without exposure to NSAIDs and proton pump inhibitors (PPI within 4 weeks before endoscopy. After endoscopy the patients were divided into 2 groups: the study group of 48 patients with bleeding ulcer and the control group of 47 patients with ulcer, but with no bleeding. Prior to endoscopy they had completed a questionnaire about demographics, risk factors and habits. The platelet function, von Willebrand factor (vWF and blood groups were determined. Histopathological analysis of biopsy samples were performed with a modified Sydney system. The influence of bile reflux was analyzed by Bile reflux index (BRI. Results. Age, gender, tobacco and alcohol use did not affect the bleeding rate. The risk of bleeding did not depend on concomitant diseases (p = 0.509 and exposure to stress (p = 0.944. Aspirin was used by 16/48 (33.3% patients with bleeding ulcer, as opposed to 7/47 (14.9% patients who did not bleed (p = 0.036. Abnormal platelet function had 12/48 (25.0% patients who bled, as opposed to 2/47 (4.3% patients who did not bleed (p = 0.004. Patients with BRI < 14 bled in 79.2%, and did not bleed in 57.4% of the cases (p = 0.023. There was no statistical difference between groups in regards to blood groups and range of vWF. Antrum atrophy was found in 14/48 (29.2% patients with bleeding ulcer and in only 5/47 (10.6% patients who had ulcer without bleeding (p = 0.024. Conclusion. Abnormal

  15. Diagnostic indicators for peptic ulcer perforation at a tertiary care hospital in Thailand

    Directory of Open Access Journals (Sweden)

    Suriya C

    2011-12-01

    Full Text Available Chutikarn Suriya1, Nongyao Kasatpibal2, Wipada Kunaviktikul2, Toranee Kayee31Clinical Epidemiology, Faculty of Medicine, Chiang Mai University, 2Faculty of Nursing, Chiang Mai University, 3Department of Surgery, Nakornping Hospital, Chiang Mai, ThailandIntroduction: Limited data currently exists regarding the diagnostic indicators of peptic ulcer perforation for early detection among patients in Thailand. Delayed diagnosis and treatment for an ulcer can be life-threatening, resulting in shock or death.Objective: To determine the diagnostic indicators of peptic ulcer perforation.Material and methods: A cohort study was conducted in a tertiary care hospital in Thailand from 2005 to 2009. Peptic ulcer patients aged 15 years and over admitted to the surgical department were included. The diagnostic indicators used criteria of the patients' final diagnoses and operations, coded according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, which included patient profiles, gender, age, coexisting illnesses, personal habits, signs and symptoms, laboratory investigations, radiological finding, and treatment role. Exponential risk regression analyses to obtain relative risk (RR estimates for diagnostic indicators were analyzed using Stata® statistical software package, version 11 (StataCorp LP, College Station, TX.Results: The study included 1290 patients. Of these, 57% reported perforated peptic ulcer. Multivariate analysis showed five diagnostic indicators: signs and symptoms including intense abdominal pain (RR = 1.53, 95% confidence interval [CI] 1.14–2.06, tenderness (RR = 1.94, 95% CI 1.17–3.21, and guarding (RR = 1.52, 95% CI 1.05–2.20; X-ray with free air (RR = 2.80, 95% CI 2.08–3.77; and referral from other hospitals (RR = 1.37, 95% CI 1.03–1.82.Conclusion: Five diagnostic indicators for peptic ulcer perforation monitoring were suggested from this study. Improving diagnostic

  16. Diagnosis and Treatment of Peptic Ulcer Disease and H. pylori Infection.

    Science.gov (United States)

    Fashner, Julia; Gitu, Alfred C

    2015-02-15

    The most common causes of peptic ulcer disease (PUD) are Helicobacter pylori infection and use of nonsteroidal anti-inflammatory drugs (NSAIDs). The test-and-treat strategy for detecting H. pylori is appropriate in situations where the risk of gastric cancer is low based on age younger than 55 years and the absence of alarm symptoms. Most other patients should undergo upper endoscopy to rule out malignancy and other serious causes of dyspepsia. Urea breath tests and stool antigen tests are most accurate for identifying H. pylori infection and can be used to confirm cure; serologic tests are a convenient but less accurate alternative and cannot be used to confirm cure. Treatment choices include standard triple therapy, sequential therapy, quadruple therapy, and levofloxacin-based triple therapy. Standard triple therapy is only recommended when resistance to clarithromycin is low. Chronic use of NSAIDs in patients with H. pylori infection increases the risk of PUD. Recommended therapies for preventing PUD in these patients include misoprostol and proton pump inhibitors. Complications of PUD include bleeding, perforation, gastric outlet obstruction, and gastric cancer. Older persons are at higher risk of PUD because of high-risk medication use, including antiplatelet drugs, warfarin, selective serotonin reuptake inhibitors, and bisphosphonates.

  17. Indigenous anti-ulcer activity of Musa sapientum on peptic ulcer

    Directory of Open Access Journals (Sweden)

    P Prabha

    2011-01-01

    Full Text Available Background: Peptic ulcer disease (PUD, encompassing gastric and duodenal ulcers is the most prevalent gastrointestinal disorder. The pathophysiology of PUD involves an imbalance between offensive factors like acid, pepsin and defensive factors like nitric oxide and growth factors. The clinical evaluation of antiulcer drugs showed tolerance, incidence of relapses and side-effects that make their efficacy arguable. An indigenous drug like Musa sapientum possessing fewer side-effects is the major thrust area of present day research, aiming at a better and safer approach for the management of PUD. Material and Methods: The unripe plantain bananas (Musa sapientum were shade-dried, powdered and used for phytochemical analysis and as antiulcer drug. In our present study Group I rats served as control and were treated with saline, Group II was indomethacin-induced ulcerated rats, Group III received aqueous extract of Musa sapientum along with indomethacin and Group IV received esomeprazole along with indomethacin for 21 days. The anti-ulcerogenic activity was investigated by performing hematological, mucosal, antioxidant profile in comparison with the standard drug esomeprazole. Results: Our findings from High - Performance Thin Layer Chromatography (HPTLC analysis showed that Musa sapientum has an active compound a monomeric flavonoid (leucocyanidin with anti-ulcerogenic activity. Results were expressed as mean ± SD. All our results are in congruous with the results of standard drug esomeprazole. Conclusion: It could be clearly concluded that administration of the aqueous extract of Musa sapientum at the dose used in this study tends to ameliorate ulcers. Its use in indigenous medicine should be scientifically scrutinized with further research.

  18. Evaluation of a poly-herbal preparation for the treatment of peptic ulcer

    Directory of Open Access Journals (Sweden)

    Zaman Hayat

    2017-06-01

    Full Text Available The aim of this study was to validate the traditional uses of ulcerene, a poly-herbal formulation in ethanol, aspirin and stress-induced gastric ulcer model of rat. The extent of gastric ulcer formation was studied, using ulcer score, ulcer index, percentage cure through gross examination and histopathological evaluation. A significant (p<0.001 dose-dependent anti-ulcerant effect was observed in ulcerene (50 and 100 mg/kg-treated group with highest effectiveness against ethanol-induced ulcer. The concentration-dependent spasmolytic effect was seen in spontaneously contracting, high K+ (80 mM and carbachol (1 µM-induced jejunum contractions (10, 0.3 and 1 mg/mL, similar to dicyclomine (10, 1 and 3 µM, indicated non-specific spasmolytic mechanism behind the effect. By considering these results, ulcerene can be suggested for the treatment of peptic ulcer.

  19. Quality-of-care initiative in patients treated surgically for perforated peptic ulcer

    DEFF Research Database (Denmark)

    Møller, M H; Larsson, H J; Rosenstock, S;

    2013-01-01

    Mortality and morbidity are considerable after treatment for perforated peptic ulcer (PPU). Since 2003, a Danish nationwide quality-of-care (QOC) improvement initiative has focused on reducing preoperative delay, and improving perioperative monitoring and care for patients with PPU. The present...

  20. Surgical delay is a critical determinant of survival in perforated peptic ulcer

    DEFF Research Database (Denmark)

    Buck, Daniel; Vester-Andersen, M; Møller, M H

    2013-01-01

    Morbidity and mortality following perforated peptic ulcer (PPU) remain substantial. Surgical delay is a well established negative prognostic factor, but evidence derives from studies with a high risk of bias. The aim of the present nationwide cohort study was to evaluate the adjusted effect...

  1. Preoperative prognostic factors for mortality in peptic ulcer perforation: a systematic review

    DEFF Research Database (Denmark)

    Møller, Morten Hylander; Adamsen, S.; Thomsen, R.W.;

    2010-01-01

    Objective. Mortality and morbidity following perforated peptic ulcer (PPU) is substantial and probably related to the development of sepsis. During the last three decades a large number of preoperative prognostic factors in patients with PPU have been examined. The aim of this systematic review...

  2. Penetrating ectopic peptic ulcer in the absence of Meckel's diverticulum ultimately presenting as small bowel obstruction

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    We report here how a heterotopic penetrating peptic ulcer progressed to cause small bowel obstruction in a patient with multiple previous negative investigations. The clinical presentation, radiographic features and pathological findings of this case are described, along with the salient lessons learnt. The added value of wireless capsule endoscopy (WCE) in such circumstances is debated.

  3. [Perforated peptic ulcer: is the form of methamphetamine known as "crystal meth" a new risk factor?].

    Science.gov (United States)

    Martínez-Aguirre, A E; Romero-Mejía, C; Chacón-Cruz, E

    2012-01-01

    The emergence of new synthetic drugs related to peptic ulcer perforation has been reported. Recently an increase in the use of inhaled methamphetamine has been observed and we have described an association of frequent use with peptic disease symptomatology and perforation. To determine whether methamphetamine use is a factor related to peptic acid disease and perforation and to establish its demographic variables. A retrospective, comparative, descriptive, and observational study was carried out through the evaluation of medical records of patients admitted to the Surgery Service with perforated ulcer, within the time frame of January 2002 to March 2005. A descriptive analysis was carried out, along with the Z test, odds ratio, confidence interval, p value and the Student's t test. Forty-two patients were divided into 2 groups: methamphetamine users (n=25) and nonusers (n=17). There was a statistically significant difference in relation to age, which was lower in the methamphetamine user group (38,7 years vs 58,88 years, p=0.0001). In addition, there was a trend in the user group to develop peptic ulcer perforation at earlier ages compared with the nonuser group (p=0.0001). There were no statistically significant differences between the two groups in regard to clinical presentation. Methamphetamine use is related to ulcer perforation in age groups of younger patients when compared with nonuser patients. Copyright © 2011. Published by Masson Doyma México S.A.

  4. Accuracy of clinical prediction rules in peptic ulcer perforation: an observational study

    DEFF Research Database (Denmark)

    Buck, David Levarett; Vester-Andersen, Morten; Møller, Morten Hylander

    2012-01-01

    Abstract Objective. The aim of the present study was to compare the ability of four clinical prediction rules to predict adverse outcome in perforated peptic ulcer (PPU): the Boey score, the American Society of Anesthesiologists (ASA) score, the Acute Physiology and Chronic Health Evaluation (APA...

  5. Penetrating ectopic peptic ulcer in the absence of Meckel's diverticulum ultimately presenting as small bowel obstruction.

    LENUS (Irish Health Repository)

    Hurley, Hilary

    2012-02-03

    We report here how a heterotopic penetrating peptic ulcer progressed to cause small bowel obstruction in a patient with multiple previous negative investigations. The clinical presentation, radiographic features and pathological findings of this case are described, along with the salient lessons learnt. The added value of wireless capsule endoscopy (WCE) in such circumstances is debated.

  6. Does Ramadan fasting contribute to the increase of peptic ulcer perforations?

    Science.gov (United States)

    Kocakusak, A

    2017-01-01

    Medical treatment has been widely used in peptic ulcer disease, however perforation is a severe complication. The rationale of this study was to evaluate the effect of Islamic Ramadan fasting on peptic ulcer perforation. Patients (No. 2311) who were operated on due to peptic ulcer perforation in a teaching and reference Hospital of a State University from January 1979 to January 2016 were analyzed. Patients were divided into two groups. Group I (No. 1805) included patients who were operated during other periods of the years without Ramadan fasting (396 months), while Group II (No. 506) constituted of patients who were operated on during the fasting periods (36 months). There was no significant difference in the mean ages between the groups (38 vs. 42 years). The mean monthly number of surgical intervention rates was higher in Group II (14.05 vs. 4.55, p 0.05). We could not detect any seasonal differences, although hot summer days constituted the longest fasting durations (19 hours) in the country. This study suggested that the occurrence of peptic ulcer perforation was significantly high during Ramadan fasting months due to the long fasting periods especially with significant male predominance.

  7. Randomized Clinical Trial of Laparoscopic Versus Open Repair of the Perforated Peptic Ulcer: The LAMA Trial

    NARCIS (Netherlands)

    M.J.O.E. Bertleff; J.A. Halm; W.A. Bemelman; A.C. van der Ham; E. van der Harst; H.I. Oei; J.F. Smulders; E.W. Steyerberg; J.F. Lange

    2009-01-01

    Laparoscopic surgery has become popular during the last decade, mainly because it is associated with fewer postoperative complications than the conventional open approach. It remains unclear, however, if this benefit is observed after laparoscopic correction of perforated peptic ulcer (PPU). The goa

  8. Surgical complications after open and laparoscopic surgery for perforated peptic ulcer in a nationwide cohort

    DEFF Research Database (Denmark)

    Wilhelmsen, M.; Møller, M H; Rosenstock, S

    2015-01-01

    BACKGROUND: Surgery for perforated peptic ulcer (PPU) is associated with a risk of complications. The frequency and severity of reoperative surgery is poorly described. The aims of the present study were to characterize the frequency, procedure-associated risk and mortality associated...

  9. A Five-Year Review of Perforated Peptic Ulcer Disease in Irrua, Nigeria

    Directory of Open Access Journals (Sweden)

    A. E. Dongo

    2017-01-01

    Full Text Available Background. Peptic ulcer perforation is a common cause of emergency admission and surgery. This is the first study that documents the presentation and outcome of management in Irrua, Nigeria. Patients and Method. This is a prospective study of all patients operated on for perforated peptic ulcer between April 1, 2010, and March 31, 2015. A structured questionnaire containing patients’ demographics, operation findings, and outcome was filled upon discharge or death. Results. There were 104 patients. 81 males and 23 females (M : F = 3.5 : 1. The age range was between 17 years and 95 years. The mean age was 48.99 years ± SD 16.1 years. The ratio of gastric to duodenal perforation was 1.88 : 1. Perforation was the first sign of peptic ulcer disease in 62 (59.6%. Pneumoperitoneum was detectable with plain radiographs in 95 (91% patients. 72 (69.2% had Graham’s Omentopexy. Death rate was 17.3%. Conclusion. We note that gastric perforation is a far commoner disease in our environment. Perforation is often the first sign of peptic ulcer disease. We identify fasting amongst Christians as a risk factor for perforation.

  10. Randomized Clinical Trial of Laparoscopic Versus Open Repair of the Perforated Peptic Ulcer: The LAMA Trial

    NARCIS (Netherlands)

    Bertleff, M.J.O.E.; Halm, J.A.; Bemelman, W.A.; van der Ham, A.C.; van der Harst, E.; Oei, H.I.; Smulders, J.F.; Steyerberg, E.W.; Lange, J.F.

    2009-01-01

    Laparoscopic surgery has become popular during the last decade, mainly because it is associated with fewer postoperative complications than the conventional open approach. It remains unclear, however, if this benefit is observed after laparoscopic correction of perforated peptic ulcer (PPU). The

  11. Prescribing Practices and Cost of Drugs for Peptic Ulcer in a Primary ...

    African Journals Online (AJOL)

    Pharmacotherapy Group, Faculty of Pharmacy, University of Benin, Benin ... Convenience sampling was used to include 100 peptic ulcer patients. ... adverse effects, this may be a cost-effective strategy, but the benefits of ranitidine in terms of ... The documentation involved: .... an economic and safety, particularly in light of.

  12. Peptic ulcerations are related to systemic rather than local effects of low-dose aspirin.

    NARCIS (Netherlands)

    Oijen, M.G.H. van; Dieleman, J.P.; Laheij, R.J.F.; Sturkenboom, M.C.; Jansen, J.B.M.J.; Verheugt, F.W.A.

    2008-01-01

    BACKGROUND & AIMS: Effervescent calcium carbasalate is a calcium-salt of acetylsalicylic acid causing less local gastric damage than acetylsalicylic acid at high doses in healthy controls. The aim of the study was to investigate the incidence of peptic ulcers in a population-based cohort using bioeq

  13. Prescription patterns of traditional Chinese medicine for peptic ulcer disease in Taiwan: A nationwide population-based study.

    Science.gov (United States)

    Huang, Chin-Ying; Lai, Wan-Yu; Sun, Mao-Feng; Lin, Che-Chen; Chen, Bor-Chyuan; Lin, Hung-Jen; Chang, Ching-Mao; Yang, Chung-Hsien; Huang, Kuo-Chin; Yen, Hung-Rong

    2015-12-24

    Peptic ulcer disease is a common digestive disease. There is a lack of large-scale survey on the use of traditional Chinese medicine (TCM) for the treatment of peptic ulcer disease. This study aimed to investigate the utilization of TCM for the treatment of peptic ulcer disease in Taiwan. We analyzed a random sample comprised of one million individuals with newly diagnosed peptic ulcer disease between 2001 and 2010 from the National Health Insurance Research Database in Taiwan. Demographic characteristics and TCM usage, including Chinese herbal formulas and the single herbs prescribed for patients with peptic ulcer disease, were analyzed. A total of 96,624 newly diagnosed subjects with peptic ulcer disease were included. 14,983 (15.5%) patients were TCM users. People residing in highly urbanized areas, younger people and female (compared with male) were more likely to use TCM. With regard to the comorbidities, TCM users had a lower prevalence of coronary artery disease, chronic obstructive lung disease, diabetes mellitus and liver cirrhosis and stroke. The average time between onset of peptic ulcer disease and the first visit to a TCM clinic was 4.7 months. Majority of the patients (n=14,449; 96.4%) received only Chinese herbal remedies. The most frequently prescribed Chinese herbal formula and single herb was Ban-Xia-Xie-Xin-Tang (Pinelliae Decoction to Drain the Epigastrium) and Hai-Piao-Xiao (Os Sepiae), respectively. The core pattern analysis showed that combination of Ban-Xia-Xie-Xin-Tang, Hai-Piao-Xiao (Os Sepiae), Yan-Hu-Suo (Rhizoma Corydalis), Bei-Mu (Bulbus Fritillariae Thunbergii) and Chuan-Lian-Zi (Fructus Toosendan) was most frequently used for peptic ulcer disease. Our study identified the core prescription patterns of TCM for patients with peptic ulcer disease in Taiwan. Further basic and clinical studies are necessary to elucidate the efficacy and mechanisms. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  14. Changing prevalence of Helicobacter pylori infection and peptic ulcer among dyspeptic Sardinian patients.

    Science.gov (United States)

    Dore, Maria Pina; Marras, Giuseppina; Rocchi, Chiara; Soro, Sara; Loria, Maria Francesca; Bassotti, Gabrio; Graham, David Y; Malaty, Hoda M; Pes, Giovanni M

    2015-10-01

    Over the past 50 years, the prevalence of Helicobacter pylori infection has fallen as standards of living improved. The changes in the prevalence of infection and its manifestations (peptic ulcer disease and gastric mucosal lesions) were investigated in a large cohort of Sardinians undergoing upper endoscopy for dyspepsia. A retrospective observational study was conducted involving patients undergoing endoscopy for dyspepsia from 1995 to 2013. H. pylori status was assessed by histology plus the rapid urease test or 13C-UBT. Gastric mucosal lesions were evaluated histologically. Data including non-steroidal anti-inflammatory drugs (NSAIDs) use and the presence of peptic ulcers were collected. The prevalence of H. pylori was calculated for each quartile and for each birth cohort from 1910 to 2000. 11,202 records were retrieved for the analysis (62.9% women). The overall prevalence of H. pylori infection was 43.8% (M: 46.6% vs. F: 42.0%; P = 0.0001). A dramatic decrease in the prevalence of infection occurred over the 19-year observation period. The birth cohort effect was evident in each category (quartile) reflecting the continuous decline in H. pylori acquisition. Over time, the prevalence of peptic ulcers also declined, resulting in an increase in the proportion of H. pylori negative/NSAID positive and H. pylori negative/NSAID negative peptic ulcers. The prevalence of gastric mucosal changes also declined despite aging. The decline in H. pylori prevalence over time likely reflects the improvement in socioeconomic conditions in Sardinia such that H. pylori infection and its clinical outcomes including peptic ulcer are becoming less frequent even among dyspeptic patients.

  15. ACUTE PERFORATED PEPTIC ULCER: A CLINICAL, DIAGNOSTIC AND MANAGEMENT ANALYSIS IN A TERTIARY HOSPITAL OF TELANGANA

    Directory of Open Access Journals (Sweden)

    Boda

    2015-12-01

    Full Text Available Treatment of Peptic Ulcer Disease in major hospitals is now limited to managing their complications like perforations of stomach or duodenum. This is also a common cause of peritonitis and remains a challenge to the surgeon. Diagnosis is based on clinical parameters like pain in the abdomen, shock, abdominal guarding/rigidity and abdominal distension. The diagnosis is confirmed by ultrasound examination of the abdomen, x-ray abdomen in erect posture. The predisposing factors include the age, smoking, alcohol intake, steroids and NSAIDs usage. The risk factors of mortality are presence of shock and pre-existing medical conditions and time of arrival to the casualty. The mortality and morbidity may be predicted using different scoring systems like ASA scoring and Boey’s scoring. AIM To analyze the different risk factors, clinical features and surgical treatment options of Acute Peptic Ulcer perforation in patients attending a Tertiary Hospital. To evaluate the prognostic factors causing death and complications in this condition. MATERIALS AND METHODS One hundred and sixty five patients attending with signs and symptoms of Acute Perforation of Peptic Ulcer were included. Males were predominantly affected than females with a 1.94:1 ratio. The median duration of illness was 9.64 days. History of smoking in 93.5%, NSAIDs in 78%, alcohol intake in 93.8% and steroids in 84% of the patients was present. Previous history of peptic ulcer disease was reported in 90% of the patients. Gastric ulcers were more common than with duodenal ulcer with a ratio of 1.32:1. The mortality rate was 6.66%. Among the complications wound infection was highest with 26% followed by paralytic ileus 23%. ASA and Boey’s scoring showed statistical significance in predicting the mortality with a P value of 0.00003. RESULTS The incidence of APPU was 0.35% of the total 46080 emergency surgical patients in a 4-year period. The incidence was high among the manual laborers and in

  16. Usefulness of anti-ulcer drugs for the prevention and treatment of peptic ulcers induced by low doses of aspirin

    Institute of Scientific and Technical Information of China (English)

    Sayaka Nakashima; Shinichi Ota; Shin Arai; Kiyoko Yoshino; Mie Inao; Keiko Ishikawa; Nobuaki Nakayama; Yukinori Imai; Sumiko Nagoshi; Satoshi Mochida

    2009-01-01

    AIM: To investigate the usefulness of anti-ulcer drugs for the prevention and treatment of low-dose aspirininduced peptic ulcer. METHODS: Upper gastrointestinal endoscopy was performed in 68 patients receiving daily low-dose aspirin (81 or 100 mg/day). The endoscopic findings were classified according to the Lanza score, and the scores were compared between groups categorized according to the concomitant use of anti-ulcer drugs and the types of drugs used. In another study, 31 hemorrhagic peptic ulcer patients who had been receiving low-dose aspirin were enrolled. The patients were randomly classified into the proton pump inhibitor (PPI)-treated group and the H2 receptor antagonist (H2RA)-treated group. The administration of low-dose aspirin was continued concomitantly, and endoscopic examinations were performed 8 wk later. ``RESULTS: The Lanza scores (mean ± SD) of the gastro-mucosal lesions were 1.0 ± 1.9 and 1.9 ± 2.3 in 8 and 16 patients receiving prevention therapy with a PPI and an H2RA, respectively. Both scores were significantly smaller than the scores in 34 patients who were not receiving prevention therapy (4.7 ± 1.0) and in 10 patients receiving cytoprotective anti-ulcer drugs (4.3 ± 1.6). In the prospective study, 18 and 13 patients received a PPI and an H2RA, respectively. Endoscopic examinations revealed that the tissue in the region of the gastro-mucosal lesions had reverted to normal in all patients in the PPI-treated group and in 12 patients (92%) in the H2RA-treated group; no significant differences were observed between the groups. CONCLUSION: H2RA therapy was effective for both the prevention and treatment of low-dose aspirininduced peptic ulcer, similar to the effects of PPIs, while cytoprotective anti-ulcer drugs were ineffective in preventing ulceration.

  17. An overview of history, pathogenesis and treatment of perforated peptic ulcer disease with evaluation of prognostic scoring in adults.

    Science.gov (United States)

    Prabhu, V; Shivani, A

    2014-01-01

    Peptic ulcer disease including both gastric and duodenal ulcer form a substantial part of patients seeking surgical opinion world-wide. The concept of acid in peptic ulcer disease, which was the basis of treatment of peptic ulcer was revolutionized by the discovery of H2-receptor antagonists, that led to the principle of acid suppression therapy for duodenal ulcer which followed decades of preference for surgical interventions in the form of gastric resections, vagotomy etc., After the discovery of Helicobacter pylori organism as the causative factor a triple drug regime was identified to treat peptic disease which was further modified to sequential therapy to avoid antibiotic resistance. This recognition has not concluded the chapter on peptic ulcers. The management of ulcer disease and its complications remain a surgical challenge. All the materials for this review have been accessed from various internet search engines. The references have been narrowed down to 34 by excluding cross references, duplicated citations, pediatric studies, case reports, iatrogenic and malignant perforations and including microbiological, immunohistochemistry references and studies with more than a sample size of ten. Case control, cohort studies, prospective/retrospective, metaanalytical studies were preferred in that order. This article attempts to take an overview of all aspects of the management of peptic ulcer.

  18. Omeprazole maintenance therapy prevents recurrent ulcer bleeding after surgery for duodenal ulcer

    Institute of Scientific and Technical Information of China (English)

    Konstantinos Demertzis; Dimitrios Polymeros; Theodoros Emmanuel; Konstantinos Triantafyllou; Pericles Tassios; Spiros D Ladas

    2006-01-01

    AIM: To evaluate the omeprazole maintenance therapy in patients with recurrent ulcer bleeding after surgery for duodenal ulcer.METHODS: We studied 15 consecutive patients with recurrent ulcer bleeding after surgery for duodenal ulcer.Omeprazole (20 mg/d) maintenance therapy was given after ulcer healing. In addition to clinical follow-up, ambulatory 24-h gastric pH assay was performed before and during omeprazole therapy in those patients and controls with previous duodenal ulcer surgery but no ulcer recurrence.RESULTS: All the 15 ulcers were healed after being treated with omeprazole (40 mg/d) for 2 mo. Eleven patients with two (1-9) episodes of recurrent ulcer bleeding completed the follow-up (43, 12-72 mo). None of them had a bleeding episode while on omeprazole. One patient discontinued the therapy and had recurrent bleeding. The median 24-h fraction time of gastric pH <4 in patients was 80, 46-95% , and was reduced to 32, 13-70% by omeprazole (P = 0.002).CONCLUSION: Long-term maintenance therapy with omeprazole (20 mg/day) is effective in preventing recurrent ulcer bleeding.

  19. [Peptic ulcer in children (7 cases). Importance of fiberendoscopy (author's transl)].

    Science.gov (United States)

    Bueno, M; Fleta, J; Tejedo, V; Sarriá, A

    1979-05-01

    The authors studied 7 cases of peptic ulcers (2 gastric and 5 duodenals) in patients whose ages ranged between 3 and 13 4/12 years. They represented 0.5% of hospital inpatients. A history of acetyl salicilic acid ingestion was present in 3 of the cases. In 2 of the cases emotional factors were associated. Initial symptoms were distributed as follows: abdominal (4), hematemesis (2) and melena (1). The clinical course was favorable for 5 of the patients; in one of them signs of bulboduodenitis became evident in the fourth month; in another one the clinical signs persisted and a new ulcer appeared 4 months after the initial diagnosis. High levels of gastrin were found in this case. The importance of gastroduodenal fiberendoscopy in infancy for the diagnosis, histological confirmation and follow-up of peptic ulcer is emphasized.

  20. Peptic Ulcer Perforation as the First Manifestation of Previously Unknown Primary Hyperparathyroidism

    Directory of Open Access Journals (Sweden)

    Eleni I. Efremidou

    2007-06-01

    Full Text Available A patient admitted for acute abdomen was incidentally found with elevated serum calcium level. In surgery, under conservative treatment of the hypercalcemia, a perforated duodenal ulcer was found and simple closure was performed. Postoperatively, calcium level continued to rise, parathyroid hormone was elevated and ultrasonographic examination showed a lesion in the right anterior neck, while serum gastrin level was normal, thus documenting the diagnosis of primary hyperparathyroidism. Conservative treatment had no effect on calcium level and the patient was subjected to emergency neck exploration, where a large parathyroid adenoma was removed. After surgery, calcium and PTH levels were normalized and the patient was discharged on the 5th postoperative day. Peptic ulcer and its complications are usual manifestations of primary hyperparathyroidism, with or without increased gastrin level. On the other hand, cases of a perforation of peptic ulcer as the first clinical manifestation of primary hyperparathyroidism are extremely rare.

  1. High prevalence of ulcer bleeding risk factors in dual antiplatelet-treated patients after percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Jensen, Berit Elin S; Hansen, Jane M; Junker, Anders B;

    2015-01-01

    . The following characteristics were considered risk factors: increasing age (age 60-69 years and ≥ 70 years); dyspepsia; previous peptic ulcer; use of non-steroidal anti-inflammatory drugs (NSAIDs) (weekly or daily), corticosteroids, selective serotonin reuptake inhibitors (SSRIs) and anticoagulants. RESULTS......: A total of 1,358 patients with a mean age of 64.1 years (range: 33-92 years) were included. The distribution of risk factors was as follows: dyspepsia: 681 patients (50.1%); previous ulcer: 110 (8.1%; 2.3% with bleeding); use of NSAIDs: 214 (15.8%); corticosteroids (2.9%), SSRIs (5.8%) and anticoagulants...

  2. Comparative analysis of assessment methods for operational and anesthetic risks in ulcerative gastroduodenal bleeding

    Directory of Open Access Journals (Sweden)

    Potakhin S.N.

    2015-09-01

    Full Text Available Aim of the investigation: to conduct a comparative analysis of methods of evaluation of surgical and anesthetic risks in ulcerative gastroduodenal bleeding. Materials and methods. A retrospective analysis ofthe extent of the surgical and anesthetic risks and results of treatment of 71 patients with peptic ulcer bleeding has been conducted in the study. To evaluate the surgical and anesthetic risks classification trees are used, scale ТА. Rockall and prognosis System of rebleeding (SPRK, proposed by N. V. Lebedev et al. in 2009, enabling to evaluate the probability of a fatal outcome. To compare the efficacy ofthe methods the following indicators are used: sensitivity, specificity and prediction of positive result. Results. The study compared the results ofthe risk assessment emergency operation by using these methods with the outcome ofthe operation. The comparison ofthe prognosis results in sensitivity leads to the conclusion that the scales ТА. Rockall and SPRK are worse than the developed method of classification trees in recognizing patients with poor outcome of surgery. Conclusion. The method of classification trees can be considered as the most accurate method of evaluation of surgical and anesthetic risks in ulcerative gastroduodenal bleeding.

  3. Associations between DSM-IV mental disorders and onset of self-reported peptic ulcer in the World Mental Health Surveys

    NARCIS (Netherlands)

    Scott, Kate M.; Alonso, Jordi; de Jonge, Peter; Carmen Viana, Maria; Liu, Zhaorui; O'Neill, Siobhan; Aguilar-Gaxiola, Sergio; Bruffaerts, Ronny; Caldas-de-Almeida, Jose Miguel; Stein, Dan J.; Angermeyer, Matthias; Benjet, Corina; de Girolamo, Giovanni; Firuleasa, Ingrid-Laura; Hu, Chiyi; Kiejna, Andrzej; Kovess-Masfety, Viviane; Levinson, Daphna; Nakane, Yoshibumi; Piazza, Marina; Posada-Villa, Jose A.; Khalaf, Mohammad Salih; Lim, Carmen C. W.; Kessler, Ronald C.

    2013-01-01

    Objective: Recent research demonstrating concurrent associations between mental disorders and peptic ulcers has renewed interest in links between psychological factors and ulcers. However, little is known about associations between temporally prior mental disorders and subsequent ulcer onset. Nor ha

  4. Opinions in Denmark on the causes of peptic ulcer disease. A survey among Danish physicians and patients

    DEFF Research Database (Denmark)

    Christensen, A H; Gjørup, T; Andersen, I B;

    1994-01-01

    stated more causes than did their male colleagues (p grief, anxiety, and stress, were contributory causes of peptic ulcer disease, whereas only around 40% believed that coffee/tea, alcohol, smoking, side effects...

  5. Risk of peptic ulcer, oesophagitis, pancreatitis or gallstone in patients with unexplained chest/epigastric pain and normal upper endoscopy

    DEFF Research Database (Denmark)

    Munk, E.M.; Drewes, A.M.; Gorst-Rasmussen, Anders

    2007-01-01

    Background: No studies have examined the risk of upper gastrointestinal diseases among patients with unexplained chest/epigastric pain (UCEP) and a normal upper endoscopy. Aim: To examine the relative risk of peptic ulcer, oesophagitis, pancreatitis or gallstone in UCEP patients. Methods: This Da......Background: No studies have examined the risk of upper gastrointestinal diseases among patients with unexplained chest/epigastric pain (UCEP) and a normal upper endoscopy. Aim: To examine the relative risk of peptic ulcer, oesophagitis, pancreatitis or gallstone in UCEP patients. Methods...... for peptic ulcer, oesophagitis, pancreatitis or gallstone. Results: Compared with controls, the adjusted relative risks among UCEP patients Conclusions: UCEP is positively associated with all study outcomes especially in the first year after upper endoscopy, indicating that peptic ulcer, oesophagitis......, pancreatitis or gallstone could be underlying early UCEP symptoms. However, the long-term association remained strong for pancreatitis and gallstone, suggesting a genuine excess risk....

  6. Genome Sequencing of 10 Helicobacter pylori Pediatric Strains from Patients with Nonulcer Dyspepsia and Peptic Ulcer Disease.

    Science.gov (United States)

    Nunes, Alexandra; Rocha, Raquel; Vale, Filipa F; Vieira, Luís; Sampaio, Daniel A; Dias, Ricardo; Gomes, João P; Oleastro, Mónica

    2015-02-05

    We present draft genome sequences of 10 Helicobacter pylori clinical strains isolated from children. This will be important for future studies of comparative genomics in order to better understand the virulence determinants underlying peptic ulcer disease.

  7. Downregulated regulatory T cell function is associated with increased peptic ulcer in Helicobacter pylori-infection.

    Science.gov (United States)

    Bagheri, Nader; Shirzad, Hedayatollah; Elahi, Shokrollah; Azadegan-Dehkordi, Fatemeh; Rahimian, Ghorbanali; Shafigh, Mohammedhadi; Rashidii, Reza; Sarafnejad, Abdulfatah; Rafieian-Kopaei, Mahmoud; Faridani, Rana; Tahmasbi, Kamran; Kheiri, Soleiman; Razavi, Alireza

    2017-09-01

    Helicobacter pylori (H. pylori) chronically colonizes gastric/duodenal mucosa and induces gastroduodenal disease such as gastritis and peptic ulcer and induces vigorous innate and specific immune responses; however, the infection is not removed, a state of chronic active gastritis persists for life if untreated. The objective of this study was to determine the number of regulatory T cells (Tregs) in gastric mucosa of patients with gastritis and peptic ulcer and determined the relationship between main virulence factor of H. pylori and Tregs. A total of 89 patients with gastritis, 63 patients with peptic ulcer and 40 healthy, H. pylori-negative subjects were enrolled in this study. Expression of CD4 and Foxp3 was determined by immunohistochemistry. Antrum biopsy was obtained for detection of H. pylori, bacterial virulence factors and histopathological assessments. TGF-β1, IL-10 and FOXP3 expressions were determined by real-time polymerase chain reaction (qPCR). The numbers of CD4(+) and Foxp3(+) T cells as well as the expression of IL-10, TGF-β1, FOXP3, INF-γ and IL-17A in infected patients were significantly higher than the ones in uninfected patients. Also, the number of CD4(+) T cells was independent on the vacuolating cytotoxin A (vacA) and outer inflammatory protein A (oipA), but it was positively correlated with cytotoxin-associated gene A (cagA). Instead, the number of Foxp3(+) T cells was dependent on the vacA and oipA, but it was independent on cagA. The number of Foxp3(+) T cells and the expression of IL-10, TGF-β1 and FOXP3 in infected patients with gastritis were significantly higher than the ones in infected patients with peptic ulcer. Moreover, the number of CD4(+) T cells and the expression of IL-17A and INF-γ was the lowest in the gastritis patients, however, increased progressively in the peptic ulcer patients. Additionally, the numbers of CD4(+) and Foxp3(+) T cells as well as the expression of IL-10, TGF-β1, FOXP3 and INF-γ were

  8. Mast cells are critical for protection against peptic ulcers induced by the NSAID piroxicam.

    Directory of Open Access Journals (Sweden)

    Daniel D Hampton

    Full Text Available Many commonly used non-steroidal anti-inflammatory drugs (NSAIDs also cause gastrointestinal toxicity, including the development of life-threatening peptic ulcers. We report that mast cell-deficient mice have an extremely high incidence of severe peptic ulceration when exposed to the NSAID piroxicam. This enhanced ulcer susceptibility can be reversed by reconstitution with mast cells. Furthermore, wild type mice treated with diphenhydramine hydrochloride, a commonly used antihistamine that blocks histamine H1 receptors, develop a similarly high incidence of peptic ulcers following piroxicam exposure. The protective effect of mast cells is independent of TNF, blockade of H2 receptors, or acid secretion. These data indicate a critical role for mast cells and the histamine that they produce in prevention and/or repair of piroxicam-induced gastric mucosal injury. Additional studies will be required to determine whether this represents a NSAID class effect that can be exploited to develop novel therapeutic strategies to limit the incidence of NSAID-induced side effects in humans.

  9. Does Helicobacter pylori infection eradication modify peptic ulcer prevalence? A 10 years' endoscopical survey

    Institute of Scientific and Technical Information of China (English)

    Giorgio Nervi; Giancarlo Colla; Angelo Franzè; Francesco Di Mario; Stefania Liatopoulou; Lucas Giovanni Cavallaro; Alessandro Gnocchi; Nadia Dal Bò; Massimo Rugge; Veronica Iori; Giulia Martina Cavestro; Marta Maino

    2006-01-01

    AIM: To compare peptic ulcer prevalence in patients referred for upper gastrointestinal endoscopy in two Italian hospitals in pre-Helicobacter era and ten years after the progressive diffusion of eradication therapy.METHODS: We checked all the endoscopic examinations consecutively performed in the Gastroenterology Unit of Padova during 1986-87 and 1995-96, and in the Gastroenterology Unit of Parma during 1992 and 2002.Chi Square test was used for statistic analysis.RESULTS: Data from both the endoscopic centers showed a statistically significant decrease in the prevalence of ulcers: from 12.7% to 6.3% (P<0.001) in Padova and from 15.6% to 12% (P<0.001) in Parma.The decrease was significant both for duodenal (from 8.8% to 4.8%, P<0.001) and gastric ulcer (3.9% to 1.5%, P<0.001) in Padova, and only for duodenal ulcer in Parma (9.2% to 6.1%, P<0.001; gastric ulcer: 6.3%to 5.8%, NS).CONCLUSION:Ten years of extensive Helicobacter pylori(H pylori) eradication in symptomatic patients led to a significant reduction in peptic ulcer prevalence.This reduction was particularly evident in Padova, where a project for the sensibilization of H pylori eradication among general practioners was carried out between 1990 and 1992. Should our hypothesis be true, H pylori eradication might in the future lead to peptic ulcer as a rare endoscopic finding.

  10. Mortality from nonulcer bleeding is similar to that of ulcer bleeding in high-risk patients with nonvariceal hemorrhage: a prospective database study in Italy.

    Science.gov (United States)

    Marmo, Riccardo; Del Piano, Mario; Rotondano, Gianluca; Koch, Maurizio; Bianco, Maria Antonia; Zambelli, Alessandro; Di Matteo, Giovanni; Grossi, Enzo; Cipolletta, Livio; Prometeo Investigators

    2012-02-01

    Nonulcer causes of bleeding are often regarded as minor, ie, associated with a lower risk of mortality. To assess the risk of death from nonulcer causes of upper GI bleeding (UGIB). Secondary analysis of prospectively collected data from 3 national databases. Community and teaching hospitals. Consecutive patients admitted for acute nonvariceal UGIB. Early endoscopy, medical and endoscopic treatment as appropriate. Thirty-day mortality, recurrent bleeding, and need for surgery. A total of 3207 patients (65.8% male), mean (standard deviation) age 68.3 (16.4) years, were analyzed. Overall mortality was 4.45% (143 patients). According to the source of bleeding, mortality was 9.8% for neoplasia, 4.8% for Mallory-Weiss tears, 4.8% for vascular lesions, 4.4% for gastroduodenal erosions, 4.4% for duodenal ulcer, and 3.1% for gastric ulcer. Frequency of death was not different among benign endoscopic diagnoses (overall P = .567). Risk of death was significantly higher in patients with neoplasia compared with benign conditions (odds ratio 2.50; 95% CI, 1.32-4.46; P bleeding peptic ulcers in the clinical context of a high-risk patient. Copyright © 2012 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

  11. Risk factors associated with uncomplicated peptic ulcer and changes in medication use after diagnosis.

    Directory of Open Access Journals (Sweden)

    Antonio González-Pérez

    Full Text Available BACKGROUND: Few epidemiologic studies have investigated predictors of uncomplicated peptic ulcer disease (PUD separately from predictors of complicated PUD. OBJECTIVE: To analyze risk factors associated with uncomplicated PUD and medication use after diagnosis. METHODS: Patients diagnosed with uncomplicated PUD (n = 3,914 were identified from The Health Improvement Network database among individuals aged 40-84 years during 1997-2005, with no previous history of PUD. Prescription records for the year after the date of diagnosis were reviewed and a nested case-control analysis was performed to calculate the odds ratios for the association of potential risk factors with PUD. RESULTS: Medications associated with developing uncomplicated PUD included current use of acetylsalicylic acid (ASA, nonsteroidal anti-inflammatory drugs (NSAIDs, paracetamol, selective serotonin reuptake inhibitors, antidepressants, antihypertensives or acid suppressants. Uncomplicated PUD was significantly associated with being a current or former smoker and having had a score of at least 3 on the Townsend deprivation index. Approximately 50% of patients who were users of ASA (19% of patients or chronic users of NSAIDs (7% of patients at diagnosis did not receive another prescription of the medication in the 60 days after diagnosis, and 30% were not represcribed therapy within a year. Among patients who were current users of ASA or chronic NSAIDs at the time of the PUD diagnosis and received a subsequent prescription for their ASA or NSAID during the following year, the vast majority (80-90% also received a proton pump inhibitor coprescription. CONCLUSIONS: Our results indicate that several risk factors for upper gastrointestinal bleeding are also predictors of uncomplicated PUD, and that some patients do not restart therapy with ASA or NSAIDs after a diagnosis of uncomplicated PUD. Further investigation is needed regarding the consequences for these patients in terms of

  12. Epidemiology of peptic ulcer disease: endoscopic results of a systematic investigation in iran.

    Science.gov (United States)

    Barazandeh, Farhad; Yazdanbod, Abbas; Pourfarzi, Farhad; Sepanlou, Sadaf Ghajarieh; Derakhshan, Mohammad H; Malekzadeh, Reza

    2012-04-01

    BACKGROUND Peptic ulcer disease is a multifactorial health problem affecting almost all populations worldwide. Large scale population-based studies are crucial to understanding its scope and specifications in various nations. We aimed to explore environmental risk factors of peptic ulcer disease in the first population based study in Ardabil, Northwest Iran. METHODS This study was a part of a larger survey on upper gastrointestinal tract health conducted in Ardabil and Meshkinshahr with a total catchment area population of 600,000 persons during 2000-01. Using a random sampling proportional to place of residence, 1122 persons aged 40 or elder were selected. 1011 (90.1%) accepted participation and underwent a comprehensive medical examination and a systematic upper gastrointestinal endoscopy. Point prevalence of peptic ulcers was correlated to various life style risk factors. RESULTS Gastric and duodenal ulcers were identified in 33 (3.26%) and 50 (4.94%) participants, making an overall prevalence of 8.20%. Based on multivariable logistic regression analyses, H.pylori infection (OR 3.1, 95% CI: 2.1-4.7), Smoking (OR 1.8, 95% CI: 1.1-6.8), and chronic intake of NSAIDs (OR 2.8, 95% CI: 1.3-4.4) were main risk factors of gastric ulcer. For duodenal ulcer, in addition to H.pylori infection (OR 5.6, 95% CI: 1.9-8.8) and Smoking (OR 2.3, 95% CI: 1.4-6.5), male gender (OR 3.6, 95% CI: 1.2-5.8) and living in an urban area (OR 1.9, 95% CI: 1.1-5.2) were among significant risk factors. CONCLUSION This is the first population-based endoscopic study in North West of Iran reporting accurate point prevalence of peptic ulcer disease. The rate of 3.3% for gastric ulcer and 4.9% for duodenal ulcers are substantially lower than the estimates reported in Asian population-based endoscopic studies but higher than European reports.

  13. 258例高原老年消化性溃疡临床分析%CLINICAL ANALYSIS OF 258 PATIENTS WITH PEPTIC ULCER IN PLATEAU

    Institute of Scientific and Technical Information of China (English)

    窦炜

    2011-01-01

    [目的]探讨青海高原地区老年消化性溃疡的特点.[方法]对258例老年消化性溃疡患者进行相关因素分析,并与同期的中青年消化性溃疡260例进行对比. [结果] 258例老年消化性溃疡中,以呕血、黑便为首发症状179例(69.4%),高于中青年组的27例(10.4%) (P<0.01),高位溃疡和巨大溃疡发生率高,并发症184例(71.3%),伴随其他疾病者169例(65.5%),高于中青年组的48例(18.5%) (P<0.01). [结论]高原老年消化性溃疡具有发病率高、并发出血多、病情危重等特点,应在患者全身情况许可下尽早胃镜检查,给予治疗.同时应兼顾治疗并发症及伴随疾病,是提高生存质量、减少并发症、降低病死率的关键.%[Objective] To study the elderly peptic ulcer in Qinghai plateau. [Methods] The risk factors of 258 patients with peptic ulcer were analyzed, and in the same period, compared with 260 young and middle-aged cases of peptic ulcer disease. [Results] 258 patients with peptic ulcer, The rates of hematemesis and raelena as first symptoms (69.4%) were found in 179 cases, which higher than the younger group (10.4%) (P< 0.01) , the incidences of high ulcer and of giant ulcer were high, 184 cases complications (71.3%), along with other diseases, 169 cases (65.5%), which higher than the younger group (18.5%) (P< 0.01). [Conclusion] The with peptic ulcer disease among elderly patients in plateau is with characteristics including high incidence, bleeding, critical condition.lt should give gastroscopy in patients as soon as possible, and treat complications and associated diseases to improve the quality of life and reduce complications and mortality.

  14. Is there any role of acid reducing gastric surgery in peptic ulcer perforation?

    Science.gov (United States)

    Nivatvongs, Supanit

    2005-09-01

    Helicobacter pylori (H. pylori) is known to be the prime factor of peptic ulcer disease as well as NSAID usage. Although medical treatment of the bacteria can eliminate the problem for more than 90% of the infected people but the cost of treatment is high then acid reducing gastric surgery still has a definite role. The prevalence of H. pylori in peptic ulcer perferation is still unknown also whether vagotomy and gastrectomy could eradicate H. pylori. Now laparoscopic surgery especially the simple repair of the perforation has became routinely used in many part of the world. So acid reducing gastric surgery is a good choice in chronic user of NSAID and also an option for people who have H. pylori infection.

  15. Clinical Outcomes of Endoscopic Hemostasis in Marginal Ulcer Bleeding.

    Science.gov (United States)

    Yamasaki, Yasushi; Takenaka, Ryuta; Hori, Keisuke; Takemoto, Koji; Kawano, Seiji; Kawahara, Yoshiro; Fujiki, Shigeatsu; Okada, Hiroyuki

    2016-12-01

    The usefulness of endoscopy in marginal ulcer bleeding has rarely been studied, and the optimal method for preventing rebleeding is unclear. Here we assessed the efficacy of endoscopy in marginal ulcer bleeding and examined the efficacy of proton pump inhibitors (PPIs) in the prevention of rebleeding. A total of 28 patients with marginal ulcer bleeding (21 men, 7 women; median age 58.5 years) were treated by endoscopy. We analyzed the clinical characteristics, results of endoscopic therapy, characteristics of rebleeding patients, and relation between the use of PPIs and the duration of rebleeding. Sixteen patients had active bleeding. Initial hemostasis was achieved in all patients. There were no procedure-related adverse events. Rebleeding occurred in one patient within the first month and in 7 patients thereafter. There was a significant difference in the rebleeding rate between the patients who received a PPI and those who did not. In a multivariate analysis, the non-use of PPIs was a risk factor for rebleeding (hazard ratio, 6.22). Therapeutic endoscopy is effective in achieving hemostasis from marginal ulcer bleeding. PPIs may prevent rebleeding from marginal ulcers.

  16. The "Internal Leak" as a possible cause in the pathogenesis of peptic ulcer.

    Science.gov (United States)

    Demling, L; Riemann, J F; Schmidt, H; Richter, K

    1981-06-01

    In cat gastric mucosa stimulated with histamine and damaged by direct application of acetylsalicylic acid, the fluorescent dye acridine orange may be found outside the parietal cell. Normally it is distributed throughout, or bound to the limiting membrane of, the vesicles in the parietal cell. The special properties of this cationic dye in an acid environment, support the hypothesis that a so-called "internal leak" may possibly play an important role in the pathogenesis of peptic ulcer.

  17. A NEW AND SAFER SURGICAL TECHNIQUE FIGURE OF EIGHT STITCH FOR MANAGEMENT OF PERFORATED PEPTIC ULCER

    Directory of Open Access Journals (Sweden)

    Lalit

    2014-05-01

    Full Text Available There are many methods for closing the perforated peptic ulcer. The technique of closure of perforation by figure of 8 stitch method has been found to be very effective in managing patients with this common problem. MATERIAL AND METHOD: The present study was conducted in Unit III of Department of General Surgery, Government Medical College and Dr. Susheela Tiwari Government Hospital Haldwani, from January 2012 to December 2013 on the cases of peptic ulcer perforation peritonitis. All patients with clinical and radiological features and intraoperative findings suggestive of perforated peptic ulcer were included in the study. RESULTS: A total of 153 patients were included in the study. Out of these, 128 patients (84% were males and 25 patients (16% were females. In 120 patients (78% there was duodenal perforation and in 33 patients (22 % gastric perforation was present. Out of these 33 patients, 6 patients had posterior gastric perforation. 140 patients were managed with midline laparotomy and 13 with laparoscopic method, with one converted to open due to presence of posterior gastric perforation. The average time of patient reporting to the emergency was3-4 days, with earliest reporting time of 2-3 hours and late reporting up to 7-8 days. Age ranged from 15 years to 90 years (average 35 - 45 years. In the postoperative period, 3 patients had leakage from repair site, 7 patients died, rest showed good outcome. CONCLUSION: Figure of 8 stitch method showed very good and acceptable result. Therefore, in our opinion this method should be promoted for surgery of perforated peptic ulcer

  18. Laparoscopic Repair of Perforated Peptic Ulcer: Outcome and Associated Morbidity and Mortality

    Science.gov (United States)

    Alemrajabi, Mahdi; Safari, Saeed; Tizmaghz, Adnan; Alemrajabi, Fatemeh; Shabestanipour, Ghazaal

    2016-01-01

    Introduction The mainstay of treatment for perforated peptic ulcer is Omental patch closure. With the advent of laparoscopic surgery, this approach is being used for the treatment of perforated peptic ulcer. The aim of this study was to evaluate the outcome of laparoscopy in Firoozgar general hospital over a period of 18 months. The outcome of the laparoscopic approach and the associated morbidity and mortality, operation time, conversion rate and hospital stay were assessed. Methods A prospective analysis of 29 consecutive patients (mean age 37.5 years; 23 men) with perforated peptic ulcers and who had undergone laparoscopic surgery was carried over a period of 18 months from March 2014 until September 2015. Pre-operative, intra-operative, and post-operative clinical data were collectively analyzed by SPSS 19 for Windows. Results Seventeen patients had a history of cigarette smoking, 11 patients had a history of opium consumption, 19 were chronic NSAID users, 26 had Helicobacter pylori infections, and six had a co-morbid condition. Previous surgical history included laparotomy for pancreatic cancer in two patients, for sigmoid colon cancer in one patient, and for acute appendicitis in four patients. The average operating time for all cases was 47.5 + 20 min. The mean lag time between onset of symptoms and surgery was 20.4 hours. All patients underwent laparoscopic closure of the perforation with Omental patch closure. No morbidity was observed, and none of the patients needed conversion to open surgery. One patient died after 11 months of follow-up due to the progression of underlying pancreatic cancer. The mean postoperative hospital stay was 4.2 days. Conclusions The results of the laparoscopic approach for perforated peptic ulcer were promising, with no conversion to open surgery, no morbidity, and mortality. PMID:27504170

  19. A prospective cohort study of postoperative complications in the management of perforated peptic ulcer

    Directory of Open Access Journals (Sweden)

    Sharma Mamta S

    2006-06-01

    Full Text Available Abstract Background With dwindling rates of postoperative mortality in perforated peptic ulcer that is attributable to H2-receptor blocker usage, there is a need to shift the focus towards the prevention of postoperative morbidity. Further, the simultaneous contribution of several putative clinical predictors to this postoperative morbidity is not fully appreciated. Our objective was to assess the predictors of the risk, rate and number of postoperative complications in surgically treated patients of perforated peptic ulcer. Methods In a prospective cohort study of 96 subjects presenting as perforated peptic ulcer and treated using Graham's omentoplatsy patch or gastrojejunostomy (with total truncal vagotomy, we assessed the association of clinical predictors with three domains of postoperative complications: the risk of developing a complication, the rate of developing the first complication and the risk of developing higher number of complications. We used multiple regression methods – logistic regression, Cox proportional hazards regression and Poisson regression, respectively – to examine the association of the predictors with these three domains. Results We observed that the risk of developing a postoperative complication was significantly influenced by the presence of a concomitant medical illness [odds ratio (OR = 8.9, p = 0.001], abdominal distension (3.8, 0.048 and a need of blood transfusion (OR = 8.2, p = 0.027. Using Poisson regression, it was observed that the risk for a higher number of complications was influenced by the same three factors [relative risk (RR = 2.6, p = 0.015; RR = 4.6, p - blood group (RH = 4.7, p = 0.04. Conclusion Abdominal distension, presence of a concomitant medical illness and a history suggestive of shock at the time of admission warrant a closer and alacritous postoperative management in patients of perforated peptic ulcer.

  20. A New Strategy to Address Loss of Submarine Qualifications in Submariners Who are Helicobacter Pylori Positive and Diagnosed with Peptic Ulcer Disease: Background to the Change in Policy.

    Science.gov (United States)

    2007-11-02

    peptic ulcer disease has been changed. FINDINGS: The medical literature shows that infection with Helicobacter pylori is causally related to the... peptic ulcer disease results in a dramatic reduction of ulcer recurrence from as high as 74 to 95% to between 1.1% and 8%. This recurrence rate includes

  1. Opinions in Denmark on the causes of peptic ulcer disease. A survey among Danish physicians and patients

    DEFF Research Database (Denmark)

    Christensen, A H; Gjørup, T; Andersen, I B

    1994-01-01

    , infection, and working conditions could play a causal role in ulcer disease. It is concluded that the opinion on causal agents in peptic ulcer disease differ considerably among both patients and physicians. Opinions on causes of diseases may influence the way we treat and advise our patients, and attempts......The aim of the study was to investigate opinions among Danish patients and physicians on causes of peptic ulcer disease. Fifty-nine patients with an ulcer history and 77 physicians with a special interest in gastroenterology participated. They were given a questionnaire listing 16 possible causes...... of medicine, and working conditions played a causal role. Around 95% of the physicians indicated that medical drugs and smoking were contributory causes of peptic ulcer disease, and around 80% that alcohol and psychologic factors were so. Only 30-40% of the physicians believed that coffee/tea, food habits...

  2. Generalized peritonitis requiring re-operation after leakage of omental patch repair of perforated peptic ulcer

    Directory of Open Access Journals (Sweden)

    Hemmat Maghsoudi

    2011-01-01

    Full Text Available Background/Aim: Peptic ulcer perforations are a common emergency, but available literature is silent on the exact definition, incidence, management, and complications of peritonitis due to omental patch leakage. Patients and Methods: Retrospective data were collected on 422 patients who underwent omental patch repair of perforated peptic ulcer between March 20, 1999 and March 20, 2006. The definitive diagnosis of perforated peptic ulcer and omental patch leakage was obtained at surgery. Results: Seventeen (4% patients experienced generalized peritonitis due to omental patch leakage. Mean age was 60.6 years. Mortality rate was 29.4%, and the mean hospital stay was 23.6 days. Delay in surgical approach, shock on admission, and age were all significantly associated with increased mortality. Conclusions: Peritonitis due to omental patch leakage can result in significant morbidity and mortality. The most common causes of omental patch leakage and operative procedures were unknown and reinsertion of omentum, respectively. Factors such as shock on admission or delayed surgery, have significantly contributed to fatal outcomes and need careful attention.

  3. [Peptic ulcer disease and helicobacter pylori: How we know what we know].

    Science.gov (United States)

    Scholl, Raphael

    2015-07-01

    The bacterium Helicobacter pylori is one of the main causes of peptic ulcers. But how was this causal relationship demonstrated? A historical and philosophical analysis of a series of studies conducted during the 1980s can elucidate the question. In the beginning, a mere correlation between the newly discovered bacterium and peptic ulcers was found in gastric biopsies. It remained an open question whether the bacterium caused the disease, or whether it constituted merely an opportunistic infection. Yet determining the direction of causality was difficult in the absence of an animal model: Even though gastritis was observed in a courageous self-experiment involving a swallowed bacterial culture, tf!e significance of the individual case was small. The failings of the self-experiment could only be rectified by a randomised, placebo-controlled trial which met the requirements of Koch's third postulate. Moreover, it was necessary to gain an initial understanding of the mechanism by which the causal relationship between H. pylori and peptic ulcers is mediated: How, forexample, does the bacterium survive in the acid environment of the stomach? The study of the case from the perspective of the history and philosophy of science illustrates how medical knowledge is established incrementally.

  4. Impact of nonresective operations for complicated peptic ulcer disease in a high-risk population.

    Science.gov (United States)

    Smith, Brian R; Wilson, Samuel Eric

    2010-10-01

    Over the past two decades, surgery for complicated peptic ulcer disease has evolved to a "less-is-more" approach due predominately to improved medical therapy. This study sought to determine whether a nonresective operative strategy has been an effective and prudent approach. A 20-year retrospective evaluation was conducted to compare outcomes of patients from the first decade (1990-1999) with those from the more recent decade (2000-2009). In all, 50 patients underwent surgery for complications of peptic ulcer disease, 36 in the early period and 14 in the later period, with 94 per cent being urgent or emergent. Acid-reducing procedures (vagotomy) decreased significantly from 29 to 7 over the two periods (P = 0.04), as did gastric resections from 23 to 3 (P = 0.01). The prevalence of H. pylori and use of NSAIDs both increased from 28 per cent to 36 per cent and 31 per cent to 43 per cent, respectively. Postoperative mortality remained unchanged, 22 per cent vs. 7 per cent (P = 0.41) over the two periods. Resections and definitive acid-reducing procedures continue to decline with no increase in adverse outcomes. This more moderate operative approach to complicated peptic ulcer surgery is appropriate given the trend towards lower mortality and improved medical treatment. In our high-risk veteran population, overall perioperative mortality, length of stay, and reoperations have been reduced.

  5. Acid-NSAID/aspirin interaction in peptic ulcer disease.

    Science.gov (United States)

    Hunt, Richard H; Yuan, Yuhong

    2011-01-01

    The presence of gastric acid plays a critical role in the mechanisms of NSAIDs/aspirin-associated gastric and duodenal mucosal injury and ulceration. The role of gastric acid and its relationship to NSAIDs/aspirin in mucosal damage, ulcer and ulcer complications continues to be an important concern because of the increasing worldwide use of NSAIDs and aspirin. Acid suppression continues to be an important prevention strategy for NSAID-associated gastric and duodenal ulcer and ulcer complications. While a coxib or an NSAID and PPI in combination are considered to have comparable safety profiles, the evidence from direct comparisons in high-risk patients is limited, and the cardiovascular safety of coxibs and NSAIDs remains a concern especially in patients with a high risk of cardiovascular disease. An evaluation of individual gastrointestinal and cardiovascular risks and benefits, selection of the most appropriate NSAID and dose for each particular patient should always be emphasized. Twice daily PPI is more appropriate to protect a patient who is taking NSAIDs twice daily. PPI co-therapy is still recommended in patients receiving dual antiplatelet treatment, although conflicting results have been reported about adverse drug interactions between PPIs and clopidogrel.

  6. Amylase clearance in differentiating acute pancreatitis from peptic ulcer with hyperamylasemia.

    Science.gov (United States)

    Warshaw, A L; Lesser, P B

    1975-03-01

    Thirty-four patients with abdominal pain, tenderness, and hyperamylasemia suggesting acute pancreatitis were studied prospectively to elucidate the relationship between peptic ulcer disease and pancreatitis. Confirming evidence of pancreatitis and/or ulcer was obtained either at laparotomy of by upper gastrointestinal roentgenograms. The presence or absence of pancreatitis was substantiated by measurement of the amylase/creatinine clearance ratio, which is significantly higher (p less than 0.001) in patients with acute pancreatitis (9.3 plus or minus 0.9), than in patients without pancreatitis (3.1 plus or minus 0.2). Nine of the 34 patients were found to have gastric or duodenal ulcers. However, seven of the nine, despite an elevated serum amylase, had no sign of pancreatitis at surgery, on radiological examination, or by elevation of the amylase/creatinine clearance ratio (3.1 plus or minus 0.4). It is suggested that hyperamylasemia associated with peptic ulcer disease is most often not indicative of acute pancreatitis and that treatment is most appropriately directed at the ulcer.

  7. Evaluation of Helicobacter pylori infection and other risk factors in patients with benign peptic ulcer disease

    Directory of Open Access Journals (Sweden)

    Depender Kumar Timshina

    2011-03-01

    Full Text Available Objective: To assess and compare the risk factors in patients with benign gastric and duodenal ulcers and to correlate the prevalence of Helicobacter pylori (H. pylori infection in benign peptic ulcer disease. Methods: A total of 30 consecutive patients with peptic ulcer disease were included in this study after upper gastrointestinal endoscopy. Their clinical profile and endoscopic findings were noted. Antral biopsies were subjected to histopathological examination and urease test for detection of H. pylori. Results were correlated. The study was cleared by the Institute Research Council and the Ethics committee. Results: The male: female ratio was 11:4. Overall, H. pylori infection was prevalent in 93.3% of the patients. Patients who took spicy food had a significantly higher rate of H. pylori positivity (P=0.04. Smoking, alcohol intake and NSAIDs did not affect H. pylori status in patients. There was no significant association between the site of the ulcer and H. pylori infection. Conclusions: Based on our observations we conclude that prevalence of H. pylori infection is similar in duodenal and gastric ulcers and intake of spicy food is a significant risk factor.

  8. A new factor in the blood of patients with peptic ulcer. Distribution in blood fractions.

    Science.gov (United States)

    Necheles, H; Geisel, A; Berg, M; Jefferson, N C

    1975-08-01

    Previous work on a factor in the blood of patients with peptic ulcer which contracts smooth muscle was confirmed and the work extended to investigation of the activity of blood fractions. Whole heparinized blood and its fractions were tested on a strip of guinea pig ileum and height of contraction and latent period were used as criteria of activity. Whole heparinized blood of ulcer patients had significantly higher activity than that of normal controls. Differences between the fractions of ulcer patients and controls were less significant. With the lysed buffy coat, however, while the differences between the height of contraction between the groups did not differ statistically, the speed of the reaction (shorter latent period) was significantly greater in the ulcer patients. The cellular alterations causing this response are unknown.

  9. Histopathological evaluation of gastric mucosal environments in peptic ulcer using the endoscopic 5-point gastric biopsy method.

    Directory of Open Access Journals (Sweden)

    Kobayashi,Hisataka

    1995-08-01

    Full Text Available Although a strong association has been established between chronic Helicobacter pylori infection and peptic ulcers, the role of H. pylori is not necessarily causative because there are many patients infected with H. pylori who do not develop peptic ulcer. Therefore, we studied the relationship between the gastric mucosal environment and the development of peptic ulcers. We examined 165 endoscopic biopsy specimens from the gastric mucosa of 33 patients with peptic ulcers using the 5-point gastric biopsy method. The follow-up biopsies done within 3 weeks were well correlated with the first biopsy samples. We also reviewed the clinicohistopathological findings of 2250 endoscopic biopsy specimens from 450 patients with active gastric and/or duodenal ulcers. Over 90% of the patients with duodenal ulcer, with or without gastric ulcer, had no fundic gland atrophy, and a high incidence of intestinal metaplasia and pyloric mucosal atrophy was found in the patients with gastric ulcer. These findings suggest that patients with concomitant active gastric and duodenal ulcers exhibit severe atrophic changes in the antral mucosa but not in the fundic mucosa.

  10. [The use of nifedipine in gastric and duodenal peptic ulcer].

    Science.gov (United States)

    Oparin, A G; Korenovskiĭ, I P; Chonka, V Iu; Fedchenko, Iu G; Demerchan, T I; Iakovenko, E L

    1996-01-01

    It has been ascertained that use of nifedipine in antiulcer therapy is justified from the clinical standpoint as well as pathogenetically substantiated since its incorporation into the complex of therapeutic measures designed to treat patients with ulcer disease makes for a speedier cicatrization of ulcers as well as augmentation of the gastric mucose levels of periodic acid-Schiff reaction-positive substances and acid mucopolysaccharides, dispelling of hyperthermia foci, increase in bioelectric potentials and activation of motion of nuclei of epithelial cells of the pyloric portion of the stomach.

  11. Management of acute nonvariceal upper gastrointestinal bleeding: Current policies and future perspectives

    NARCIS (Netherlands)

    I.L. Holster (Ingrid); E.J. Kuipers (Ernst)

    2012-01-01

    textabstractAcute upper gastrointestinal bleeding (UGIB) is a gastroenterological emergency with a mortality of 6%-13%. The vast majority of these bleeds are due to peptic ulcers. Nonsteroidal anti-inflammatory drugs and Helicobacter pylori are the main risk factors for peptic ulcer disease. Endosco

  12. Quality of peptic ulcer healing induced by lansoprazole and roxatidine.

    Science.gov (United States)

    Fujino, M A; Morozumi, A; Kobayashi, K; Ueda, F; Suzuki, Y; Uchida, N; Tachikawa, H; Sano, S; Ohtsuka, H; Yamamoto, Y

    1995-01-01

    This study reports preliminary results of a controlled, multicenter trial on the quality of ulcer healing induced by lansoprazole (LPZ) or roxatidine (R) in gastric ulcer (GU) or duodenal ulcer (DU) patients. Group A received LPZ 30 mg q.d. and group B received R 75 mg b.i.d. All drugs were given for 8 weeks in GU and for 6 weeks in DU. Endoscopy and gastric biopsy were performed to detect Helicobacter pylori before and on completion of treatment. The healing rates of groups A and B were 100 and 69.2%, respectively, in GU and 100 and 70.0%, respectively, in DU. This difference (p < 0.01) was significant between the two groups in GU. There was no significant difference between the two groups in the S2 stage shift rate in GU and DU. The H. pylori clearance rates of groups A and B were 33.3 and 20.0%, respectively, in GU and 62.5 and 33.3%, respectively, in DU. The differences in treatment response (healing rates and S2 shift rates) between the LPZ group and the R group may be related to the differences in suppression of acid secretion and in bactericidal effects on H. pylori.

  13. Opinions in Denmark on the causes of peptic ulcer disease. A survey among Danish physicians and patients

    DEFF Research Database (Denmark)

    Christensen, A H; Gjørup, T; Andersen, I B;

    1994-01-01

    The aim of the study was to investigate opinions among Danish patients and physicians on causes of peptic ulcer disease. Fifty-nine patients with an ulcer history and 77 physicians with a special interest in gastroenterology participated. They were given a questionnaire listing 16 possible causes...... stated more causes than did their male colleagues (p peptic ulcer disease, whereas only around 40% believed that coffee/tea, alcohol, smoking, side effects...... of medicine, and working conditions played a causal role. Around 95% of the physicians indicated that medical drugs and smoking were contributory causes of peptic ulcer disease, and around 80% that alcohol and psychologic factors were so. Only 30-40% of the physicians believed that coffee/tea, food habits...

  14. A randomized comparison of triple therapy Helicobacter pylori eradication regimens in children with peptic ulcers.

    Science.gov (United States)

    Shcherbakov, P L; Filin, V A; Volkov, I A; Tatarinov, P A; Belousov, Y B

    2001-01-01

    An open, randomized trial was performed to compare the efficacy of three Helicobacter pylori eradication regimens in children with peptic ulcer disease. A total of 106 children (5 - 15 years) were treated for 1 week with metronidazole, 30 - 40 mg/kg per day depending on age, amoxycillin, 750 mg/day, and one of three anti-secretory agents: proprietary omeprazole, 20 - 40 mg/day depending on age; generic omeprazole, 20 - 40 mg/day; or ranitidine, 150 mg twice daily. The H. pylori eradication rate was significantly higher in patients receiving proprietary omeprazole (88.9%) than in those receiving generic omeprazole (80.0%) or ranitidine (74.3%), and this was associated with a trend towards faster ulcer healing. It is concluded that triple therapy consisting of an anti-secretory agent and two antimicrobials produces effective eradication of H. pylori and ulcer healing in children with peptic ulcer disease, and that proprietary omeprazole is more effective than both ranitidine and the generic formulation used in this study.

  15. Moluo Yangping Granule (摩罗疡平冲剂) in Treating 64 Peptic Ulcer Patients

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@ Peptic ulcer is a common and frequently encountered disease. H2 receptor blocker and several other drugs have been used in treating peptic ulcer (PU) since many years ago, but there still remain a rather large number of intractable ulcer and recurrent ulcer. Recently the discovery of Helicobacter pylori (HP), as well as the relationship between HP and PU relapse was confirmed, but there still lacks of perfect therapeutic program for anti-HP infection(1). From June 1993 to August 1996, we used a pure TCM preparation Moluo Yangping granule (摩罗疡平冲剂, MYG) in treating 64 PU patients, and satisfactory results have been obtained. The report is as follows. METHODS Patient Selection   According to the diagnostic standard of PU worked out by Ministry of Health in “Guiding Principles for Clinical Study of New Chinese Drugs”, 126 PU patients with typical symptoms and signs were enrolled, who were confirmed to have PU before treatment with biopsy sample performed urease quick diagnostic method under gastroscopy, and pathological special stain were microscopically examined to verify the HP infection. Basal acid output (BAO), maximal acid output (MAO), peak acid output (PAO) and the amount of parietal cells were measured in all the patients.

  16. Helicobacter pylori and its involvement in gastritis and peptic ulcer formation.

    Science.gov (United States)

    Konturek, S J; Konturek, P C; Konturek, J W; Plonka, M; Czesnikiewicz-Guzik, M; Brzozowski, T; Bielanski, W

    2006-09-01

    Modern gastroenterology started in early 19(th) century with the identification by W. Prout of the inorganic (hydrochloric) acid in the stomach and continued through 20(th) century with the discoveries by I.P. Pavlov of neuro-reflex stimulation of gastric secretion for which he was awarded first Nobel Prize in 1904. When concept of nervism or complete neural control of all digestive functions reached apogeum in Eastern Europe, on the other side of Europe (in United Kingdom), E. Edkins discovered in 1906 that a hormone, gastrin, may serve as chemical messenger in stimulation of gastric acid secretion, while L. Popielski revealed in 1916 that histamine is the most potent gastric secretagogue. K. Schwartz, without considering neural or hormonal nature of gastric secretory stimulation, enunciated in 1910 famous dictum; "no acid no ulcer"; and suggested gastrectomy as the best medication for excessive gastric acid secretion and peptic ulcer. In early 70s, J.W. Black, basing on earlier L. Popielski's histamine concept, identified histamine-H(2) receptors (H(2)-R) and obtained their antagonists, which were found very useful in the control of gastric acid secretion and ulcer therapy for which he was awarded in 1972 second Nobel Prize in gastrology. With discovery by G. Sachs in 1973 of proton pumps and their inhibitors (PPI), even more effective in gastric acid inhibition and ulcer therapy than H(2)-R antagonists, gastric surgery, namely gastrectomy, practiced since first gastric resection in 1881 by L. Rydygier, has been considered obsolete for ulcer treatment. Despite of the progress in gastric pharmacology, the ulcer disease remained essentially "undefeated" and showed periodic exacerbation and relapses. The discovery of spiral bacteria in the stomach in 1983 by B.J. Marshall and R.J. Warren, Australian, clinical researches, awarded in 2005 the Nobel Prize for the third time in gastrology, has been widely considered as a major breakthrough in pathophysiology of

  17. Perforated peptic ulcer in an adolescent boy with acute appendicitis: a case report

    Directory of Open Access Journals (Sweden)

    Aazam Khorassani

    2013-06-01

    Full Text Available Background: Peptic ulcer disease is one of the most common GI disorders. Perforation has the highest mortality rate of any complication of ulcer disease, while early diagno-sis and emergency treatment save patient life.Case presentation: This paper reports an adolescent boy admitted to the Ziaeian University Hospital. He suffered from severe abdominal pain with dyspnea had been started since past three hours. Periumbilical pain started from past 2-3 days, gradually localized to the right lower quadrant. He had anorexia without nausea and vomiting. He was tachycardic and tachypneic, but he did not have fever. On physical examination, bowel sound was hypoactive, there was generalize tenderness, guarding and rebound tender-ness focused in the right lower quadrant and suprapubic region. Laboratory finding indicated leukocytosis. Chest X-ray showed free air under diaphragm. Once the diagno-sis has been made, the patient was given analgesia and antibiotics, resuscitated with isotonic fluid, and taken to the operating room. Laparotomy was implemented through a midline incision. There was bile secretion in the peritoneal cavity. Appendix was inflamated. Cecum and ileum were normal. A small perforation, 4mm in size was detected in first portion of duodenum. Appendectomy and omental patch repair were done. Ten days later, the patient was discharged in a good state. Serologic test for helicobacter pylori was negative.Conclusion: Stomach and duodenal perforation should be considered in patients with-out peptic ulcer disease, especially in children and adolescents with sudden and severe abdominal pain who are admitted to the hospital for other diseases. Because some patients present with peptic ulcer complications that are seemingly exacerbated by stressful life events.

  18. Epinephrine injection therapy versus a combination of epinephrine injection and endoscopic hemoclip in the treatment of bleeding ulcers

    Institute of Scientific and Technical Information of China (English)

    Tju-Siang Chua; Kwong-Ming Fock; Tay-Meng Ng; Eng-Kiong Teo; Jessica Yi-Lyn Tan; Tiing-Leong Ang

    2005-01-01

    AIM: To assess the efficacy of hemoclip application in combination with epinephrine injection in the treatment of bleeding peptic ulcers and to compare the clinical outcomes between patients treated with such a combination therapy and those treated with epinephrine injection alone.METHODS: A total of 293 patients (211 males, 82females) underwent endoscopic therapy for bleeding peptic ulcers. Of these, 202 patients (152 males, 50females) received epinephrine injection therapy while 91patients (59 males, 32 females) received combination therapy. The choice of endoscopic therapy was made by the endoscopist. Hemostatic rates, rebleeding rates, need for emergency surgery and 30-d mortality were the outcome measures studied.RESULTS: Patients who received combination therapy were significantly older (mean age 66±16 years, range24-90 years) and more suffered from chronic renal failure compared to those who received epinephrine injection therapy alone (mean age 61±17 years, range 21-89 years).Failure to achieve permanent hemostasis was 4% in the group who received epinephrine injection alone and 11%in the group who received combination therapy. When the differences in age and renal function between the two treatment groups were taken into account by multivariate analysis, the rates of initial hemostasis,rebleeding rates, need for surgery and 30-d mortality for both treatment options were not significantly different.CONCLUSION: Combination therapy of epinephrine injection with endoscopic hemoclip application is an effective method of achieving hemostasis in bleeding peptic ulcer diseases. However, superiority of combination therapy over epinephrine injection alone, could not be demonstrated.

  19. Association between early Helicobacter pylori eradication and a lower risk of recurrent complicated peptic ulcers in end-stage renal disease patients.

    Science.gov (United States)

    Chang, Shen-Shong; Hu, Hsiao-Yun

    2015-01-01

    End-stage renal disease (ESRD) patients exhibit an increased incidence of peptic ulcer disease. Helicobacter pylori plays a central role in the development of peptic ulcers. The effect of early H pylori eradication on the recurrence of complicated peptic ulcer disease in ESRD patients remains unclear. The aim of the present study was to explore whether early H pylori eradication therapy in ESRD patients can reduce the risk of recurrent complicated peptic ulcers.We conducted a population-based cohort study and recruited patients with ESRD who had developed peptic ulcers. We categorized patients into early (time lag ≦120 days after peptic ulcer diagnosis) and late H pylori eradication therapy groups. The Cox proportional hazards model was used. The endpoint was based on hospitalization for complicated recurrent peptic ulcers.The early and late H pylori eradication therapy groups consisted of 2406 and 1356 ESRD patients, respectively, in a time lag of 120 days. After adjusting for possible confounders, the early eradication group exhibited a lower rate of complicated recurrent peptic ulcer disease (hazard ratio [HR] = 0.76, 95% confidence interval [CI] = 0.64-0.91, P = 0.003) in a time lag of ≦120 days, but a similar rate of complicated recurrent peptic ulcer disease in time lags of ≦1 year (HR = 0.97, 95% CI 0.79-1.19, P = 0.758) and 2 years (HR = 1.11, 95% CI 0.86-1.44, P = 0.433) compared with the late eradication group.We recommend administering H pylori eradication within 120 days after peptic ulcer diagnosis to H pylori infected ESRD patients who have developed peptic ulcers.

  20. Molecular hydrogen in human breath: a new strategy for selectively diagnosing peptic ulcer disease, non-ulcerous dyspepsia and Helicobacter pylori infection.

    Science.gov (United States)

    Maity, Abhijit; Pal, Mithun; Maithani, Sanchi; Ghosh, Barnali; Chaudhuri, Sujit; Pradhan, Manik

    2016-07-22

    The gastric pathogen Helicobacter pylori utilizes molecular hydrogen (H2) as a respiratory substrate during colonization in the gastric mucosa. However, the link between molecular H2 and the pathogenesis of peptic-ulcer disease (PUD) and non-ulcerous dyspepsia (NUD) by the enzymatic activity of H. pylori still remains mostly unknown. Here we provide evidence that breath H2 excretion profiles are distinctly altered by the enzymatic activity of H. pylori for individuals with NUD and PUD. We subsequently unravelled the potential molecular mechanisms responsible for the alteration of H2 in exhaled breath in association with peptic ulcers, encompassing both gastric and duodenal ulcers, along with NUD. We also established that carbon-isotopic fractionations in the acid-mediated bacterial environment regulated by bacterial urease activity cannot discriminate the actual disease state i.e. whether it is peptic ulcer or NUD. However, our findings illuminate the unusual molecular H2 in breath that can track the precise evolution of PUD and NUD, even after the eradication of H. pylori infection. This deepens our understanding of the pathophysiology of PUD and NUD, reveals non-invasively the actual disease state in real-time and thus offers a novel and robust new-generation strategy for treating peptic-ulcer disease together with non-ulcer related complications even when the existing (13)C-urea breath test ((13)C-UBT) fails to diagnose.

  1. Active Peptic Ulcer Disease in Patients with Hepatitis C Virus-Related Cirrhosis: The Role of Helicobacter pylori Infection and Portal Hypertensive Gastropathy

    Directory of Open Access Journals (Sweden)

    Maria Dore

    2004-01-01

    Full Text Available BACKGROUND & AIM: The relationship between Helicobacter pylori infection and peptic ulcer disease in cirrhosis remains controversial. The purpose of the present study was to investigate the role of H pylori infection and portal hypertension gastropathy in the prevalence of active peptic ulcer among dyspeptic patients with compensated hepatitis C virus (HCV-related cirrhosis.

  2. Clinical care analysis of peptic ulcer disease in children%小儿消化性溃疡病临床护理分析

    Institute of Scientific and Technical Information of China (English)

    由利芬

    2013-01-01

    目的:分析与探讨小儿消化性疾病的临床护理措施。方法选取本院2008年2月~2010年2月期间收治的小儿消化性溃疡患儿共58例,对其临床病理资料进行回顾性分析,所有患儿均经精心护理。结果58例患者中有29例为十二指肠溃疡,22例为胃溃疡,7例为复合型溃疡。通过对患儿精心的护理与治疗,所有患儿均在7d内康复出院。结论对小儿消化性溃疡疾病进行准确的诊断、有效的护理,对于预防溃疡出血以及其他并发症的发生有着重要的意义。%Objective To analyze and discuss the clinical care measures of pediatric digestive disease. Methods 58 children with peptic ulcer disease from February 2008 to February 2010 in our hospital were seleted,their clinical datum were retrospectively analyzed,all the children were given meticulously care. Results Of 58 patients,there were 29 cases of duodenal ulcer,22 cases of gastric ulcer,7 cases of complex ulcers.Through meticulous care and treatment,all patients were discharged within seven days. Conclusion Acurate diagnosis and effective care for children with peptic ulcer disease,it has great significance in preventing ulcer bleeding and other complications.

  3. Perforated peptic duodenal ulcer in a paraesophageal hernia – a case report of a rare surgical emergency

    Directory of Open Access Journals (Sweden)

    Willner Julian

    2006-01-01

    Full Text Available Abstract Background Paraesophageal hernias are quite common and sometimes feared due to the risk of incarceration and strangulation of any herniated organ. The hereby reported combination of an incarcerated paraesophageal hernia containing a perforated peptic ulcer is extremely rare. Case presentation An elderly man with multiple medical conditions was admitted due to severe upper abdominal pain. The patient was found to have a paraesophageal hernia and underwent a laparotomy. In the hernia, a perforated benign peptic duodenal ulcer was found. The duodenal defect was over-sewn, the hernial defect was closed and the former hernial cavity was drained by a right-sided chest tube. The patient was discharged one month after surgery and was found to do well at follow-up one month after discharge. Conclusion This is the first report of a patient surviving the extremely rare and life-threatening combination of a perforated peptic duodenal ulcer in a paraesophageal hernia.

  4. Non-operative treatment for perforated gastro-duodenal peptic ulcer in Duchenne Muscular Dystrophy: a case report

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    Wever Jan

    2004-01-01

    Full Text Available Abstract Background Clinical characteristics and complications of Duchenne muscular dystrophy caused by skeletal and cardiac muscle degeneration are well known. Gastro-intestinal involvement has also been recognised in these patients. However an acute perforated gastro-duodenal peptic ulcer has not been documented up to now. Case presentation A 26-year-old male with Duchenne muscular dystrophy with a clinical and radiographic diagnosis of acute perforated gastro-duodenal peptic ulcer is treated non-operatively with naso-gastric suction and intravenous medication. Gastrointestinal involvement in Duchenne muscular dystrophy and therapeutic considerations in a high risk patient are discussed. Conclusion Non-surgical treatment for perforated gastro-duodenal peptic ulcer should be considered in high risk patients, as is the case in patients with Duchenne muscular dystrophy. Patients must be carefully observed and operated on if non-operative treatment is unsuccessful.

  5. Epidemiological Clinical Features and Evolution of Gastroduodenal Ulcer Bleeding in a Tertiary Care Hospital in Spain, during the Last Seven Years

    Directory of Open Access Journals (Sweden)

    Eugenia Lauret

    2013-01-01

    Full Text Available Background. Gastroduodenal ulcer bleeding is a common medical emergency. The aim of this study was to analyze the characteristics of bleeding episodes and to identify changes in the clinical trends over seven years. Methods. Retrospective observational clinical study on a cohort of 272 consecutive adult patients with peptic ulcer bleeding, during the 2006–2012 period. Results. Mean annual admission rate was 12.8 per 100.000 inhabitants. Men were predominant (71%, with a mean age of 66.6 years. Comorbidities were present in 131 cases (48.2% and 156 patients (57.4% had received ulcerogenic drugs. Duodenal ulcer was the commonest location (61%. Endoscopic therapy was necessary in 183 cases (67.3% and rebleeding occurred in 30 patients (11%. Overall mortality rate was 5.5%, with a significant association with the presence of comorbidities (P<0.01. There were no differences in trends of annual hospitalization, clinical features at presentation, and outcomes during this 7-years period. Conclusions. Annual hospitalization rates and prognosis of peptic ulcer bleeding have remained unchanged in the study period. This may be due to the fact that the effect of improved approach on this condition is probably counteracted by risk factors such as older age, severe comorbidities, and ulcerogenic drugs consumption, which have also remained stable over recent years.

  6. [Role of Allelic Genes of Matrix Metalloproteinases and Their Tissue Inhibitors in the Peptic Ulcer Disease Development].

    Science.gov (United States)

    Shaymardanova, E Kh; Nurgalieva, A Kh; Khidiyatova, I M; Gabbasova, L V; Kuramshina, O A; Kryukova, A Ya; Sagitov, R B; Munasipov, F R; Khusnutdinova, E Kh

    2016-03-01

    Peptic ulcer disease is a chronic disease of the gastrointestinal tract, mainly manifesting itself in the formation of the fairly persistent ulcer defect of the mucous membrane of the stomach and/or duodenum. Association analysis of common polymorphisms of matrix metalloproteinases genes MMP-1 (rs1799750, rs494379), MMP-2 (rs2285052), MMP-3 (rs3025058), MMP-9 (rs3918242, rs17576), and MMP-12 (rs2276109) and their tissue inhibitors TIMP-2 (rs8179090) and TIMP-3 (rs9619311) was carried out in 353 patients with a gastric ulcer or duodenal ulcer and in 325 unrelated healthy individuals from the Republic of Bashkortostan. Associations of polymorphic variants rs1799750 and rs494379 of gene MMP-1, rs3025058 of gene MMP-3, rs3918242 and rs17576 of gene MMP-9, and rs9619311 of gene TIMP-3 with the risk of peptic ulcer disease in Russians and Tatars were revealed.

  7. A pilot study of Helicobacter pylori genotypes and cytokine gene polymorphisms in reflux oesophagitis and peptic ulcer disease.

    Science.gov (United States)

    Akdogan, R A; Ozgur, O; Gucuyeter, S; Kaklikkaya, N; Cobanoglu, U; Aydin, F

    2014-01-01

    Helicobacter pylori causes various diseases such as chronic gastritis, peptic ulcer and gastric cancer. While majority of the people infected with H. pylori is asymptomatic, 15-20 % of them develop such diseases. The main factors, which determine the development of H. pylori related diseases might be bacterial virulence, host genetic and environmental factors.The aim of this study was to reveal the factors that play a role in the disease development in patients with reflux esophagitis and peptic ulcer, infected with Helicobacter pylori. Environmental factors such as medical agents, smoking and body mass index were evaluated. The factors specific to bacteria such as vacA, CagA, babA and iceA virulence genotypes and the host factors such as IL-1, IL-2, IL-4, IL-6, IL-10, IL-12, interferon-γ, TNF-α, ve TGF-β1 gene polymorphisms were compared between the two groups.H. pylori infected twenty five patients with reflux esophagitis and peptic ulcer were enrolled in the study. There was no statistical difference between the two groups regarding environmental factors. IL-2 -330T +166T (p=0.037) and IL10 -1082A; -819C (p=0.049) gene polymorphisms were significantly more common in the group of patients with peptic ulcer compared to the group with reflux esophagitis. In both groups of patients, either with reflux esophagitis or peptic ulcer, multiple H. pylori virulence genotypes (cagA, vacA, babA) (mean values 74 %, 78 %, 54 % respectively) were observed.In this study, we revealed that cytokine gene polymorphisms may play a role in the development peptic ulcer while H. pylori virulence genotypes seem to be crucial for the development of associated diseases (Tab. 4, Ref. 51).

  8. N-butyl cyanoacrylate embolotherapy for acute gastroduodenal ulcer bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Young Ho; Kim, Ji Hoon; Koh, Young Hwan; Han, Dae Hee; Cha, Joo Hee; Seong, Chang Kyu; Song, Chi Sung [Seoul National University Boramae Hospital, Seoul (Korea, Republic of)

    2007-01-15

    Various embolic agents have been used for embolization of acute gastrointestinal (GI) arterial bleeding. N-butyl cyanoacrylate (NBCA) is not easy to handle, but it is a useful embolic agent. In this retrospective study, we describe our experience with NBCA embolization of acute gastroduodenal ulcer bleeding. NBCA embolization was performed in seven patients with acute upper GI arterial bleeding; they had five gastric ulcers and two duodenal ulcers. NBCA embolization was done in the left gastric artery (n = 3), right gastric artery (n = 2), gastroduodenal artery (n = 1) and pancreaticoduodenal artery (n = 1). Coil was used along with NBCA in a gastric bleeding patient because of difficulty in selecting a feeding artery. NBCA was mixed with Lipiodol at the ratio of 1:1 to 1:2. The blood pressure and heart rate around the time of embolization, the serial hemoglobin and hematocrit levels and the transfusion requirements were reviewed to evaluate hemostasis and rebleeding. Technical success was achieved in all the cases. Two procedure-related complications happened; embolism of the NBCA mixture to the common hepatic artery occurred in a case with embolization of the left gastric artery, and reflux of the NBCA mixture occurred into the adjacent gastric tissue, but these did not cause any clinical problems. Four of seven patients did not present with rebleeding, but two had rebleeding 10 and 16 days, respectively, after embolization and they died of cardiac arrest at 2 months and 37 days, respectively. One other patient died of sepsis and respiratory failure within 24 hours without rebleeding. NBCA embolization with or without other embolic agents could be safe and effective for treating acute gastroduodenal ulcer bleeding.

  9. Application mexidol in treatment patients of inflammatory periodontal diseases in the combination to peptic ulcer of stomach and duodenal intestine

    Directory of Open Access Journals (Sweden)

    Charish N.A.

    2011-03-01

    Full Text Available For the purpose to determine the clinical pathogenetic efficacy of Mexidol in the combined therapy of parodontitis in patients with peptic ulcer of stomach and duodenal intestine medical examination and treatment of 296 patients was carried out. It was established that use of Mexidol in the combined treatment of patients with parodontitis against peptic ulcer of stomach and duodenal intestine allowed to decrease infection load (Helicobacter pylori in parodontal recess and evidence of local inflammation with reduction of activity of interleukin-6, -10, -18, that provided acceleration of recovery processes, lowering in frequency of periodontitis recurrences

  10. Behavioral Studies Peptic Ulcer Patients Self-Medication by Visiting Pharmacy in Pontianak

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    Eka K. Untari

    2013-09-01

    Full Text Available Self-medication practices is now considered as a component of self-care. Gastric ulcer is one of minor symptom that can be treated by self-medication. The aim of this study was to determine the prevalence, behavior, and appropriateness of self-medication practice for gastric ulcer or its related symptom amongst population. The population of this study attended community pharmacies in Pontianak of West Borneo province. This study was a cross sectional survey involving 98 adults who did self-medication on peptic ulcer or its related symptom. This study was conducted in 2010. The result of showed that 67.3% of gastric ulcer self-medication practice was appropriate; 66.3% subject used antacida class to treat the symptom; 6.1% participant however, still used antibiotic; and only 27% subject satisfied with the information given during self-medication process. Although self-medication practice for gastric ulcer was often done, some practice might be harmful. Thus, there is a need to educate the community to ensure its safe practices.

  11. Microcirculatory remodeling in marginal zone of duodenal ulcer after bleeding

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    Sulayeva О.N.

    2009-01-01

    Full Text Available To estimate objectively vessels network remodeling in duodenal mucosa after ulcer bleeding the morphometric analysis of marginal ulcer zone biopsies was performed in 32 patients. It was shown that reparation is accompanied with chronic inflammation and acute alteration of microcirculation. Injection hemostasis led to enhancement of microcirculation, development of edema and ischemic alteration of mucosal tissues. Acute neutrophilic infiltration during 1 day was changed on 3 day with granular tissue development and angiogenesis stimulation. Intensification and prolongation of angiogenesis paral-leled with lymphocytes infiltration after 7 days resulted to villi dysmorphogenesis and changes in cellular content of intestinal epithelium.

  12. A STUDY ON PATIENTS WITH PEPTIC ULCER PERFORATION WITH RESPECT TO AETIOLOGY AND FACTORS AFFECTING OUTCOME OF MANAGEMENT

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    Yeganathan Rajappan

    2016-07-01

    Full Text Available BACKGROUND Perforation peritonitis is one of the commonest surgical emergency encountered by surgeons. The aim of the study is to provide an overview of aetiological factors causing peptic ulcer perforation and the factors affecting the outcome of management. MATERIALS AND METHODS This study was conducted at Mahathma Gandhi Memorial Hospital, Trichirapalli, between December 2014 and August 2015. This study included 81 cases of Peptic ulcer perforation who are managed with laparotomy or peritoneal drainage, were studied retrospectively for the factors causing peptic ulcer perforation, site of perforation, surgical management, complications and outcome and factors influencing outcome of management. Data analysed done by using SPSS 17 software with appropriate statistical test. RESULTS The incidence of Peptic ulcer perforation at MGM Hospital has been worked out to be <1% (0.74%. Peptic ulcer perforation is commonly seen in 5th decade of life; 65% of the cases in the age group of 25 to 55 years. The youngest patient was 15 years old and the oldest 70 years old. Male:Female ratio is 9:1. More commonly seen in people who are having blood group “O” constituting 49% of the total. Past history of peptic ulcer was present in 73% of cases of perforation; 65.4% of the cases are addicted to chronic smoking and 66.7% of the cases are addicted to alcohol; 94% were taking mixed diet. Family history of peptic ulcer was present in 32% of the cases of duodenal ulcer perforation; 94% patients consume diet with plenty of chillies and spices. Out of 73% of cases with past history of duodenal ulcer, 80-85% of patients had taken medical treatment with antacids and H2 receptor blockers, proton pump inhibitors drugs irregularly. Diagnosis was made on clinical history and physical examination of abdomen and aided by plain X-ray abdomen in erect posture, which showed pneumo-peritoneum in 96.3% of cases of duodenal ulcer perforations. Obliteration of liver dullness was

  13. Helicobacter pylori virulence genes and host genetic polymorphisms as risk factors for peptic ulcer disease.

    Science.gov (United States)

    Miftahussurur, Muhammad; Yamaoka, Yoshio

    2015-01-01

    Helicobacter pylori infection plays an important role in the pathogenesis of peptic ulcer disease (PUD). Several factors have been proposed as possible H. pylori virulence determinants; for example, bacterial adhesins and gastric inflammation factors are associated with an increased risk of PUD. However, differences in bacterial virulence factors alone cannot explain the opposite ends of the PUD disease spectrum, that is duodenal and gastric ulcers; presumably, both bacterial and host factors contribute to the differential response. Carriers of the high-producer alleles of the pro-inflammatory cytokines IL-1B, IL-6, IL-8, IL-10, and TNF-α who also carry low-producer allele of anti-inflammatory cytokines have severe gastric mucosal inflammation, whereas carriers of the alternative alleles have mild inflammation. Recent reports have suggested that the PSCA and CYP2C19 ultra-rapid metabolizer genotypes are also associated with PUD.

  14. Influence of body mass index on mortality after surgery for perforated peptic ulcer

    DEFF Research Database (Denmark)

    Buck, David Levarett; Møller, M H

    2014-01-01

    BACKGROUND: Body mass index (BMI) is a strong predictor of mortality in the general population. In spite of the medical hazards of obesity, a protective effect on mortality has been suggested in surgical patients: the obesity paradox. The aim of the present nationwide cohort study was to examine...... the association between BMI and mortality in patients treated surgically for perforated peptic ulcer (PPU). METHODS: This was a national prospective cohort study of all Danish patients treated surgically for PPU between 1 February 2003 and 31 August 2009, for whom BMI was registered. Non-surgically treated...... patients and those with malignant ulcers were excluded. The primary outcome measure was 90-day mortality. The association between BMI and mortality was calculated as crude and adjusted relative risks (RRs) with 95 per cent confidence intervals (c.i.). RESULTS: Of 2668 patients who underwent surgical...

  15. Quadruple therapy with furazolidone for retreatment in patients with peptic ulcer disease

    Institute of Scientific and Technical Information of China (English)

    Guilherme Eduardo Goncalves Felga; Fernando Marcuz Silva; Ricardo Correa Barbuti; Tomás Navarro-Rodriguez; Schlioma Zaterka; Jaime Natan Eisig

    2008-01-01

    AIM: To establish the efficacy and safety of a 7-d therapeutic regimen using omeprazole, bismuth subcitrate, furazolidone and amoxicillin in patients with peptic ulcer disease who had been previously treated with other therapeutic regimens without success.METHODS: Open cohort study which included patients with peptic ulcer who had previously been treated unsuccessfully with one or more eradication regimens. The therapeutic regimen consisted of 20 mg omeprazole, 240 mg colloidal bismuth subcitrate, 1000 mg amoxicillin, and 200 mg furazolidone, taken twice a day for 7 d. Patients were considered as eradicated when samples taken from the gastric antrum and corpus 12 wk after the end of treatment were negative for Helicobacter pylori (H pylori) (rapidurease test and histology). Safety was determined by the presence of adverse effects. RESULTS: Fifty-one patients were enrolled. The eradication rate was 68.8% (31145). Adverse effects were reported by 31.4% of the patients, and these were usually considered to be slight or moderate in the majority of the cases. Three patients had to withdraw from the treatment due to the presence of severe adverse effects. CONCLUSION: The association of bismuth, furazolidone, amoxicillin and a proton-pump inhibitor is a valuable alternative for patients who failed to respond to other eradication regimens. It is an effective, cheap and safe option for salvage therapy of positive patients.

  16. Is there a role of abdominal drainage in primarily repaired perforated peptic ulcers?

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    Musharraf Husain

    2012-02-01

    Full Text Available Objective: To compare the survival and post-op complications following primary closure of perforated peptic ulcer by omental patch technique in 4 groups of patients as follows: two-drain group, one-drain subhepatic group, one-drain pelvic group and no-drain group. Methods: This is a prospective case-controlled clinical study performed in the Jawaharlal Nehru Medical College Hospital, Aligarh Muslim University, Aligarh, India. A total of 114 patients with perforated peptic ulcer who underwent emergency laparotomy with primary closure by omental patch technique were studied in 4 groups as mentioned above. Tube drains were used throughout the study. Results: Mean age of patients was 45±12.7 years (range 15- 75 with M:F ratio of 5:1. Clinical profile of patients matched in the 4 groups. Post-operative fever, vomiting, laparotomy wound infection, wound dehiscence and intraperitoneal collection were significantly lower in the no-drain group as compared to drain groups. There was found no significant difference between the no-drain and drain groups with respect to the post-operative abdominal distension, pain, intraabdominal sepsis, gastro-intestinal leak, adult respiratory distress syndrome and mortality. Drain-related complications were recorded in 36.8% of patients with tube drain(s. Conclusion: Peptic perforation closure with omental patch technique is safe without prophylactic drainage and a high rate of drain-related morbidity negates the concept of the routine drainage after this procedure. One drain placement is as good as the two drain placement and sub-hepatic drain is more useful than the pelvic drain. [J Exp Integr Med 2012; 2(1.000: 47-54

  17. Clinical profile and outcome of surgical treatment of perforated peptic ulcers in Northwestern Tanzania: A tertiary hospital experience

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    Kabangila Rodrick

    2011-08-01

    Full Text Available Abstract Background Perforated peptic ulcer is a serious complication of peptic ulcers with potential risk of grave complications. There is paucity of published reports on perforated peptic ulcer disease in our local environment. This study was conducted to evaluate the clinical presentation, management and outcome of patients with peptic ulcer perforation in our setting and to identify predictors of outcome of these patients. Methods This was a combined retrospective and prospective study of patients who were operated for perforated peptic ulcers at Bugando Medical Centre between April 2006 and March 2011. Data were collected using a pre-tested and coded questionnaire and analyzed using SPSS computer software version 15.0. Ethical approval to conduct the study was obtained from relevant authority before the commencement of the study. Results A total of 84 patients were studied. Males outnumbered females by a ratio of 1.3: 1. Their median age was 28 years and the modal age group was 21-30 years. The median duration of illness was 5.8 days. The majority of patients (69.0% had no previous history of treatment for peptic ulcer disease. The use of non-steroidal anti-inflammatory drugs, alcohol and smoking was reported in 10.7%, 85.7% and 64.3% respectively. Eight (9.5% patients were HIV positive with a median CD4 count of 220 cells/μl. Most perforations were located on the duodenum {90.4% with the duodenal to gastric ulcers ratio of 12.7: 1. Graham's omental patch (Graham's omentopexy of the perforations was performed in 83.3% of cases. Complication and mortality rates were 29.8% and 10.7% respectively. The factors significantly related to complications were premorbid illness, HIV status, CD 4 count 24 hrs, shock at admission (systolic BP Conclusion Perforation of peptic ulcer remains a frequent clinical problem in our environment predominantly affecting young males not known to suffer from PUD. Simple closure with omental patch followed by

  18. Does Helicobacter pylori eradication therapy for peptic ulcer prevent gastric cancer?

    Institute of Scientific and Technical Information of China (English)

    Katsuhiro Mabe; Mikako Takahashi; Haruhumi Oizumi; Hideaki Tsukuma; Akiko Shibata; Kazutoshi Fukase; Toru Matsuda; Hiroaki Takeda; Sumio Kawata

    2009-01-01

    AIM: To investigate the effects of Helicobacter pylori (H pylori ) eradication therapy for treatment of peptic ulcer on the incidence of gastric cancer. METHODS: A multicenter prospective cohort study was conducted between November 2000 and December 2007 in Yamagata Prefecture, Japan. The study included patients with H pylori -positive peptic ulcer who decided themselves whether to receive H pylori eradication (eradication group) or conventional antacid therapy (non-eradication group). Incidence of gastric cancer in the two groups was determined based on the results of annual endoscopy and questionnaire surveys, as well as Yamagata Prefectural Cancer Registry data, and was compared between the two groups and by results of H pylori therapy. RESULTS: A total of 4133 patients aged between 13 and 91 years (mean 52.9 years) were registered, and 56 cases of gastric cancer were identified over a mean follow-up of 5.6 years. The sex- and age-adjusted incidence ratio of gastric cancer in the eradication group, as compared with the non-eradication group, was 0.58 (95% CI: 0.28-1.19) and ratios by follow-up period (< 1 year, 1-3 years, > 3 years) were 1.16 (0.27-5.00), 0.50 (0.17-1.49), and 0.34 (0.09-1.28), respectively. Longer follow-up tended to be associated with better prevention of gastric cancer, although not to a significant extent. No significant difference in incidence of gastric cancer was observed between patients with successful eradication therapy (32/2451 patients, 1.31%) and those with treatment failure (11/639 patients, 1.72%). Among patients with duodenal ulcer, which is known to be more prevalent in younger individuals, the incidence of gastric cancer was significantly less in those with successful eradication therapy (2/845 patients, 0.24%) than in those with treatment failure (3/216 patients, 1.39%). CONCLUSION: H pylori eradication therapy for peptic ulcer patients with a mean age of 52.9 years at registration did not significantly decrease the

  19. Six-year follow-up after successful triple therapy for Helicobacter pylori infection in patients with peptic ulcer disease

    NARCIS (Netherlands)

    van der Wouden, EJ; Thijs, JC; van Zwet, AA; Kleibeuker, JH

    2001-01-01

    Objective & Design We question whether Helicobacter pylori eradication in peptic ulcer disease patients leads to a decrease in symptoms and reduced use of anti-dyspeptic drugs. Therefore, the recurrence rate of H. pylori, upper abdominal symptoms and the use of acid-suppressive drugs were determined

  20. Peptic ulcer

    Science.gov (United States)

    ... occurs in the first part of the small intestine. Causes Normally, the lining of the stomach and small intestines can protect itself against strong stomach acids. But if the lining breaks down, the result may be: Swollen and ...

  1. Peptic Ulcers

    Science.gov (United States)

    ... Looking for Health Lessons? Visit KidsHealth in the Classroom What Other Parents Are Reading Your Child's Development ( ... improve with an acid suppressor and stopping or changing the NSAID. No antibiotics are needed to treat ...

  2. The IL-1B Genetic Polymorphism Is Associated with Aspirin-Induced PepticUlcers in a Korean Ethnic Group.

    Science.gov (United States)

    Cho, Jae Hee; Choi, Ja Sung; Chun, Song Wook; Lee, Sangheun; Han, Ki Jun; Kim, Hee Man

    2016-05-23

    Single nucleotide polymorphisms (SNPs) are associated with aspirin-induced peptic ulcers. However, SNPs of specific genes vary among races, and data regarding SNPs in the Korean population are scarce. In this study, we aimed to investigate the relationships between SNPs of the COX-1, IL-1β, IL-1RN, and TNF genes and aspirin-induced peptic ulcers, as pilot research in a Korean population. Patients who had been taking low-dose aspirin (100 mg) for at least 4 weeks were prospectively enrolled. DNA was extracted from whole blood, and DNA sequencing was subsequently performed. A total of 48 patients were enrolled (23 peptic ulcer patients vs 25 nonulcer controls). Three exon SNPs (IL-1β -581C/T [rs1143627], IL-1β -1061C/ T [rs16944], and IL-1RN -1129 [rs4251961]) and one intron SNP (IL-1β IVS2+242C/T) were significantly different between the two groups. On the multivariate analysis after adjustments for age and sex, the CC/CT genotypes of IL-1β -581C/ T, and the CT/TT genotypes of IL-1β -1061C/T were positively associated with aspirin-induced peptic ulcers (odds ratio [OR], 4.6, 95% confidence interval [CI], 1.054 to 20.303, p=0.04; OR, 4.6, 95% CI, 1.054 to 20.303, p=0.04). The IL-1β -581C/T and IL-1β -1061C/T genotypes may be associated with low-dose aspirin-induced peptic ulcers in a Korean ethnic group.

  3. Roxatidine acetate as maintenance treatment for patients with peptic ulcer disease. The European Cooperative Roxatidine Study Group.

    Science.gov (United States)

    1991-01-01

    The efficacy and safety of 75 mg of roxatidine acetate at night as maintenance treatment for chronic peptic ulcer disease was investigated in two double-blind randomized placebo-controlled multicenter studies. A total of 725 patients with endoscopic demonstration of a healed ulcer were recruited; 420 patients were enrolled by 28 centers in the duodenal ulcer study and 305 patients were enrolled by 24 centers in the gastric ulcer study. The duration of treatment in each study was 12 months. The primary efficacy endpoint was ulcer relapse, confirmed on scheduled endoscopy at two, four, six, nine, and 12 months or as necessitated clinically. The total ulcer recurrence rate was significantly lower in patients on active treatment: 35% and 32% of patients with a previously healed duodenal or gastric ulcer relapsed within 12 months while on roxatidine acetate, compared with 66% and 71% of patients in each study on placebo (life-table analysis, P = 0.0001). Both active and placebo treatments were well tolerated. There was no evidence of any clinically significant drug-related laboratory abnormalities, electrocardiographic changes, or changes in vital signs with either treatment. It is concluded that 75 mg of roxatidine acetate at night is a safe and effective maintenance treatment to sustain remission in patients with peptic ulcers.

  4. Excessive bleeding from genital ulcers of Behçet's disease.

    Science.gov (United States)

    Bostankolu, A; Aksungur, V L; Aksungur, E H; Ozpoyraz, M; Yücel, A; Memisoglu, H R

    1997-09-01

    Although genital ulcers are a common manifestation of Behçet's disease, bleeding from these lesions is unusual. In this report, a patient with excessive bleeding from genital ulcers is presented. A 22-year-old man with recurrent oral and genital ulcers, erythema nodosum, folliculitis, positive pathergic reaction, uveitis, superior vena cava syndrome, and generalized lymphadenopathy fulfilled the diagnostic criteria of Behçet's disease. Three years after presenting he was admitted to our clinic with excessive bleeding from large ulcers on the scrotum and upper thighs and with a leg ulcer. Bleeding was controlled with compresses. Examination of a biopsy specimen obtained from the leg ulcer showed findings consistent with Kaposi-like acroangiodermatitis. Results of various radiologic investigations showed thrombosis of the inferior vena cava, peritesticular varicosities, and venous insufficiency of the lower extremities. We suggest that the bleeding was secondary to the extension of genital ulcers to the varicose veins.

  5. Clinical significance of pyloric aperture in the aetiology of peptic ulcer disease: a prospective study.

    Science.gov (United States)

    Saha, Sisir Kumar

    2009-04-01

    Despite so much contributions reported in the literature, the aetiology of the duodenal ulcer remains an enigmatic subject to the medical profession. Findings of Helicobacter pylori seem to have overshadowed the real issue, in that, how a small area of the duodenal mucosa could be inflicted with the acid-pepsin injury has not been questioned? One hundred and sixty-eight consecutive patients, presented with epigastric pain were included in the endoscopic study. The aim of the study was to find out the prevalence and its clinical importance on the sizes of the pyloric aperture in the aetiology of peptic ulcer disease. Demographic data on the sizes of the pyloric aperture were divided into two groups, in that, those up to 3 mm in diameter were included in one and those over the size of 3 mm in another. Among the 168 cases, the gastric ulcer was found in 12 and duodenal ulcer in 27 patients. The sex ratio of men to women was 1.4:1 found in the former and 8:1 in the latter. Among other findings, a knuckle of duodenal mucoa was noticed prolapsing through the large pyloric aperture. It could be postulated that a knuckle of the mucosa that keeps peeping through the pylorus acts as a mucosal plug in empty stomach, like a cork in the acid bottle. The main physiological function is to protect the mucosa from being damaged by the acid-pepsin injury or by the reflux of bile, but the tip of the plug seems to be subjected to such injury. Furthermore, the surface epithelial cells could also be subjected to ischaemic change while prolapsing through the pylorus. This may lead to reduced production of the mucosal gel and bicarbonate secretion, thus exposing the damaged mucosa to acid bath. This supports the concept, how a small area of the stomach or duodenum could be inflicted with ulceration.

  6. Endoscopic Management of Nonvariceal, Nonulcer Upper Gastrointestinal Bleeding

    NARCIS (Netherlands)

    Tjwa, E.T.; Holster, I.L.; Kuipers, E.J.

    2014-01-01

    Upper gastrointestinal bleeding (UGIB) is the most common emergency condition in gastroenterology. Although peptic ulcer and esophagogastric varices are the predominant causes, other conditions account for up to 50% of UGIBs. These conditions, among others, include angiodysplasia, Dieulafoy and Mall

  7. Distinctive aspects of peptic ulcer disease, Dieulafoy's lesion, and Mallory-Weiss syndrome in patients with advanced alcoholic liver disease or cirrhosis.

    Science.gov (United States)

    Nojkov, Borko; Cappell, Mitchell S

    2016-01-07

    To systematically review the data on distinctive aspects of peptic ulcer disease (PUD), Dieulafoy's lesion (DL), and Mallory-Weiss syndrome (MWS) in patients with advanced alcoholic liver disease (aALD), including alcoholic hepatitis or alcoholic cirrhosis. Computerized literature search performed via PubMed using the following medical subject heading terms and keywords: "alcoholic liver disease", "alcoholic hepatitis"," alcoholic cirrhosis", "cirrhosis", "liver disease", "upper gastrointestinal bleeding", "non-variceal upper gastrointestinal bleeding", "PUD", ''DL'', ''Mallory-Weiss tear", and "MWS''. While the majority of acute gastrointestinal (GI) bleeding with aALD is related to portal hypertension, about 30%-40% of acute GI bleeding in patients with aALD is unrelated to portal hypertension. Such bleeding constitutes an important complication of aALD because of its frequency, severity, and associated mortality. Patients with cirrhosis have a markedly increased risk of PUD, which further increases with the progression of cirrhosis. Patients with cirrhosis or aALD and peptic ulcer bleeding (PUB) have worse clinical outcomes than other patients with PUB, including uncontrolled bleeding, rebleeding, and mortality. Alcohol consumption, nonsteroidal anti-inflammatory drug use, and portal hypertension may have a pathogenic role in the development of PUD in patients with aALD. Limited data suggest that Helicobacter pylori does not play a significant role in the pathogenesis of PUD in most cirrhotic patients. The frequency of bleeding from DL appears to be increased in patients with aALD. DL may be associated with an especially high mortality in these patients. MWS is strongly associated with heavy alcohol consumption from binge drinking or chronic alcoholism, and is associated with aALD. Patients with aALD have more severe MWS bleeding and are more likely to rebleed when compared to non-cirrhotics. Pre-endoscopic management of acute GI bleeding in patients with a

  8. IS PEPTIC ULCER WITH HELICOBACTER INFEC¬TION THE CAUSE OF CHRONIC URTICARIA?

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    A. Farhoudi

    2000-01-01

    Full Text Available Helicobacter pylori, the most important cause of gastritis and peptic ulcer, has recently been associated with several extradigestive diseases. The aim of this study was to assess the prevalence of Helicobacter pylori infection and effects of bacterium eradication in 50 patients affected by idiopathic chronic urticaria. Helicobacter pylori was assessed by serology or biopsy and urease test or 13C urea breath test. Amoxicillin, bismuth subcitrate (Denol, metronidazole and cimetidine were given to infected patients for 2 weeks. The results of therapy were assessed by urea breath test six weeks after therapy. In response to treatment urticaria clinically regressed in 16 out of 24 patients (66.6%. Thus bacterium eradication was associated with a remission of urticaria symptoms, suggesting a possible role in the pathogenesis of this disorder.

  9. Technetium-99m colloidal bismuth subcitrate: A novel method for the evaluation of peptic ulcer disease

    Energy Technology Data Exchange (ETDEWEB)

    Vasquez, T.E.; Lyons, K.P.; Raiszadeh, M.; Fardi, M.; Snider, P.

    1984-01-01

    The therapeutic agent colloidal bismuth subcitrate (CBS) selectively binds to peptic ulcers. The authors have developed a method for labeling this agent with Tc-99m. Chromatographic quality control studies of the agent on silica gel coated strips (ITLC-SG) showed that more than 97% of Tc-99m was bound to CBS. During in-vitro stability testing, the radio-label was stable for a minimum of 6 hours. The chromatographic findings are in agreement with the in-vivo distribution of the agent which showed no significant radioactivity in thyroid, kidneys, liver, or bladder. The resulting Tc-99m-CBS solution is administered orally in drinking water. Preliminary animal studies have been conducted on 5 adult 3 kg New Zealand rabbits sedated with 50 mg Ketamine I.M. The rabbits were intubated with I.V. tubing advanced to the stomach. They were given a gastric erosive suspension of 600-1000 mg/kg of pulverized ASA in 10 cc tap water. Four hours later they were given 3-4 mCi of the radiotracer in a 5 cc volume of water. Serial in-vivo images were obtained for 2 hours which included thyroid, abdomen, and urinary bladder. Next the stomachs were excised, opened along the greater curvature, imaged, vigorously washed and reimaged. All 5 rabbits showed avid localized binding of radiotracer which remained fixed even with vigorous washing. Areas of normal appearing mucosa were relatively devoid of radiotracer. This new compound may have significant clinical usefulness in the detection of peptic ulcer disease. In addition, such a non-invasive technique, carrying none of the risks or discomfort of endoscopy could also find application in the evaluation of the response to therapy.

  10. Importance of Helicobacter pylori eradcation for maintenance of remission of drug associated peptic ulcer disease

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    Dajani A

    2006-01-01

    Full Text Available Background: The role of Helicobacter pylori (H. pylori eradication in non-steroidal anti inflammatory drug (NSAID users with peptic ulcer disease is controversial especially in countries with a high prevalence of the infection. Furthermore the value of low dose omeprazole for maintenance of remission is not yet known. Patients and methods: 138 symptomatic out-patients receiving continuous COX 1 NSAID therapy, were treated with omeprazole 40mg/day upon endoscopic confirmation of gastro-duodenal ulceration or erosions while those infected with H. pylori received in addition clarithromycin 500 mg and amoxycillin 1000 mg twice daily during the first week of treatment. After endoscopic confirmation of healing at the end of week 5, the patients were randomized to receive omeprazole 10 mg (n=50 or 20 mg once daily (n=66 and endoscopy repeated after 20 weeks. Results: The overall healing rate (per protocol at five weeks (116/128 was 90.6% while in 85.5% (65/76 eradication was successful. The healing rate for the H. pylori eradicated patients (58/65 was 89.2%. For those who failed eradication (8/11 it was 72.7% (NS, while for patients not infected with H. pylori at entry to the study (50/52 it was 96.2% (NS. An intention to treat analysis showed that after 20 weeks of omeprazole prophylaxis with the 10mg dose 86% (43/50 had maintained healing while for the 20mg dose a similar figure was observed (87.9; 58/66. Only three patients in the two groups (pp had persistent H. pylori infection, all of whom relapsed. No patients discontinued treatment because of adverse effects of the drugs. Conclusion: H. pylori eradication was not associated with impaired ulcer healing in a Middle Eastern population with symptomatic NSAID induced gastro/duodenal lesions, when a high healing dose of omeprazole (40 mg was used. After eradication, omeprazole 10 or 20 mg per day were highly and equally effective for maintenance of gastroduodenal mucosal integrity during continued

  11. Characteristics of gastric cancer in peptic ulcer patients with Helicobacter pylori infection.

    Science.gov (United States)

    Hwang, Jae Jin; Lee, Dong Ho; Lee, Ae-Ra; Yoon, Hyuk; Shin, Cheol Min; Park, Young Soo; Kim, Nayoung

    2015-04-28

    To evaluate the incidence and clinical characteristics of gastric cancer (GC) in peptic ulcer patients with Helicobacter pylori (H. pylori) infection. Between January 2003 and December 2013, the medical records of patients diagnosed with GC were retrospectively reviewed. Those with previous gastric ulcer (GU) and H. pylori infection were assigned to the HpGU-GC group (n = 86) and those with previous duodenal ulcer (DU) disease and H. pylori infection were assigned to the HpDU-GC group (n = 35). The incidence rates of GC in the HpGU-GC and HpDU-GC groups were analyzed. Data on demographics (age, gender, peptic ulcer complications and cancer treatment), GC clinical characteristics [location, pathological diagnosis, differentiation, T stage, Lauren's classification, atrophy of surrounding mucosa and intestinal metaplasia (IM)], outcome of eradication therapy for H. pylori infection, esophagogastroduodenoscopy number and the duration until GC onset were reviewed. Univariate and multivariate analyses were performed to identify factors influencing GC development. The relative risk of GC was evaluated using a Cox proportional hazards model. The incidence rates of GC were 3.60% (86/2387) in the HpGU-GC group and 1.66% (35/2098) in the HpDU-GC group. The annual incidence was 0.41% in the HpGU-GC group and 0.11% in the HpDU-GC group. The rates of moderate-to-severe atrophy of the surrounding mucosa and IM were higher in the HpGU-GC group than in the HpDU-GC group (86% vs 34.3%, respectively, and 61.6% vs 14.3%, respectively, P < 0.05). In the univariate analysis, atrophy of surrounding mucosa, IM and eradication therapy for H. pylori infection were significantly associated with the development of GC (P < 0.05). There was no significant difference in the prognosis of GC patients between the HpGU-GC and HpDU-GC groups (P = 0.347). The relative risk of GC development in the HpGU-GC group compared to that of the HpDU-GC group, after correction for age and gender, was 1.71 (95%CI

  12. Cytotoxic isolates of Helicobacter pylori from Peptic Ulcer Diseases decrease K+-dependent ATPase Activity in HeLa cells

    Directory of Open Access Journals (Sweden)

    Archana Ayyagari

    2003-11-01

    Full Text Available Abstract Background Helicobacter pylori is a Gram negative bacterium that plays a central role in the etiology of chronic gastritis and peptic ulcer diseases. However, not all H. pylori positive cases develop advanced disease. This discriminatory behavior has been attributed to the difference in virulence of the bacteria. Among all virulence factors, cytotoxin released by H. pylori is the most important factor. In this work, we studied variation in H. pylori isolates from Indian dyspeptic patients on the basis of cytotoxin production and associated changes in K+-dependent ATPase (one of its targets enzyme activity in HeLa cells. Methods The patients were retrospectively grouped on the basis of endoscopic and histopathological observation as having gastritis or peptic ulcer. The HeLa cells were incubated with the broth culture filtrates (BCFs of H. pylori isolates from patients of both groups and observed for the cytopathic effects: morphological changes and viability. In addition, the K+-dependent ATPase activity was measured in HeLa cells extracts. Results The cytotoxin production was observed in 3/7 (gastritis and 4/4 (peptic ulcer H. pylori isolates. The BCFs of cytotoxin producing H. pylori strains reduced the ATPase activity of HeLa cells to 40% of that measured with non-cytotoxin producing H. pylori strains (1.33 μmole Pi/mg protein and 3.36 μmole Pi/mg protein, respectively, p Conclusions Our results suggest that the isolation of cytotoxic H. pylori is more common in severe form of acid peptic diseases (peptic ulcer than in gastritis patients from India. Also the cytotoxin released by H. pylori impairs the ion-transporting ATPase and is a measure of cytotoxicity.

  13. Effect of a specific cyclooxygenase-gene polymorphism (A-842G/C50T) on the occurrence of peptic ulcer hemorrhage.

    NARCIS (Netherlands)

    Oijen, M.G.H. van; Laheij, R.J.F.; Koetsier, M.I.A.; Kleine, E. de; Morsche, R.H.M. te; Kerkhoven, L.A.S. van; Jansen, J.B.M.J.; Drenth, J.P.H.

    2006-01-01

    Cyclooxygenases (COX) catalyze the conversion of arachidonic acid to prostaglandins (PGs). COX-inhibiting drugs, such as nonsteroidal anti-inflammatory drugs (NSAIDs), increase the risk for peptic ulcer disease. As a corollary, COX gene polymorphisms could be important in the pathogenesis of peptic

  14. Effect of a specific cyclooxygenase-gene polymorphism (A-842G/C50T) on the occurrence of peptic ulcer hemorrhage.

    NARCIS (Netherlands)

    Oijen, M.G.H. van; Laheij, R.J.F.; Koetsier, M.I.A.; Kleine, E. de; Morsche, R.H.M. te; Kerkhoven, L.A.S. van; Jansen, J.B.M.J.; Drenth, J.P.H.

    2006-01-01

    Cyclooxygenases (COX) catalyze the conversion of arachidonic acid to prostaglandins (PGs). COX-inhibiting drugs, such as nonsteroidal anti-inflammatory drugs (NSAIDs), increase the risk for peptic ulcer disease. As a corollary, COX gene polymorphisms could be important in the pathogenesis of peptic

  15. Prevalence and risk factors of asymptomatic peptic ulcer disease in Taiwan

    Institute of Scientific and Technical Information of China (English)

    Fu-Wei Wang; Ming-Shium Tu; Guang-Yuan Mar; Hung-Yi Chuang; Hsien-Chung Yu; Lung-Chih Cheng; Ping-I Hsu

    2011-01-01

    AIM: To investigate the prevalence and risk factors of asymptomatic peptic ulcer disease (PUD) in a general Taiwanese population. METHODS: From January to August 2008, consecu-tive asymptomatic subjects undergoing a routine health check-up were evaluated by upper gastrointestinal en-doscopy. Gastroduodenal mucosal breaks were carefully assessed, and a complete medical history and demo-graphic data were obtained from each patient. Logistic regression analysis was conducted to identify indepen-dent risk factors for asymptomatic PUD. RESULTS: Of the 572 asymptomatic subjects, 54 (9.4%) were diagnosed as having PUD. The prevalence of gas-tric ulcer, duodenal ulcer and both gastric and duode-nal ulcers were 4.7%, 3.9%, and 0.9%, respectively. Multivariate analysis revealed that prior history of PUD [odds ratio (OR), 2.0, 95% CI: 1.3-2.9], high body mass index [body mass index (BMI) 25-30: OR, 1.5, 95% CI: 1.0-2.2; BMI > 30 kg/m2: OR, 3.6, 95% CI: 1.5-8.7] and current smoker (OR, 2.6, 95% CI: 1.6-4.4) were in-dependent predictors of asymptomatic PUD. In contrast, high education level was a negative predictor of PUD (years of education 10-12: OR, 0.5, 95% CI: 0.3-0.8; years of education > 12: OR, 0.6, 95% CI: 0.3-0.9).CONCLUSION: The prevalence of PUD in asymptom-atic subjects is 9.4% in Taiwan. Prior history of PUD, low education level, a high BMI and current smoker are independent risk factors for developing asymptomatic PUD.

  16. [THE ROLE OF HELICOBACTER PYLORI IN NORMOMICROBIOCENOSIS AND DYSBACTERIOSIS OF MUCOSAL MICROFLORA OF OESOPHAGOGASTRODUODENAL ZONE IN THE CASES OF PEPTIC ULCER, CHRONIC GASTRITIS AND OESOPHAGITIS].

    Science.gov (United States)

    Chernin, V V; Chervinets, V M; Bazlov, S N

    2016-01-01

    Determine the qualitative and quantitative composition of the mucosal microflora of oesophagogastroduodenal zone to determine the location of Helicobocter pylori and its place in normomicrobiocenosis and dysbacteriosis in cases of peptic ulcer, chronic gastritis and oesophagitis. Clinical and microbiological studies were conducted in 30 healthy individuals-volunteers, 130 patients with peptic ulcer, 36--chronic gastritis and 24--chronic esophagitis. Helicobacter pylori in 33% of cases included in normomicrobiocenosis of mucosal microflora oesophagogastroduodenal zone, which consists of 12 genera of microorganisms and carries out all protection functions. The recurrence of peptic ulcer disease, exacerbation of chronic active gastritis and oesophagitis are accompanied by a dysbacteriosis of mucosal microflora with overgrowth of typical and atypical microorganisms for normal biotope with reduced occurrenceof Helicobocter pylori. Helicobacter pylori in the biocenosis of mucosal microflora of oesophagogastroduodenal zone is not an infection, has no independent significance in the development of peptic ulcer, chronic gastritis and esophagitis, does not require eradication.

  17. Effect of the oral intake of probiotic Pediococcus acidilactici BA28 on Helicobacter pylori causing peptic ulcer in C57BL/6 mice models.

    Science.gov (United States)

    Kaur, Baljinder; Garg, Neena; Sachdev, Atul; Kumar, Balvir

    2014-01-01

    Probiotic lactic acid bacteria are being proposed to cure peptic ulcers by reducing colonization of Helicobacter pylori within the stomach mucosa and by eradicating already established infection. In lieu of that, in vitro inhibitory activity of pediocin-producing probiotic Pediococcus acidilactici BA28 was evaluated against H. pylori by growth inhibition assays. Further, chronic gastritis was first induced in two groups of C57BL/6 mice by orogastric inoculation with H. pylori with polyethylene catheter, and probiotic P. acidilactici BA28 was orally administered to study the eradication and cure of peptic ulcer disease. H. pylori and P. acidilactici BA28 were detected in gastric biopsy and fecal samples of mice, respectively. A probiotic treatment with P. acidilactici BA28, which is able to eliminate H. pylori infection and could reverse peptic ulcer disease, is being suggested as a co-adjustment with conventional antibiotic treatment. The study provided an evidence of controlling peptic ulcer disease, by diet mod

  18. Distinctive aspects of peptic ulcer disease, Dieulafoy's lesion, and Mallory-Weiss syndrome in patients with advanced alcoholic liver disease or cirrhosis

    Science.gov (United States)

    Nojkov, Borko; Cappell, Mitchell S

    2016-01-01

    AIM: To systematically review the data on distinctive aspects of peptic ulcer disease (PUD), Dieulafoy’s lesion (DL), and Mallory-Weiss syndrome (MWS) in patients with advanced alcoholic liver disease (aALD), including alcoholic hepatitis or alcoholic cirrhosis. METHODS: Computerized literature search performed via PubMed using the following medical subject heading terms and keywords: “alcoholic liver disease”, “alcoholic hepatitis”,“ alcoholic cirrhosis”, “cirrhosis”, “liver disease”, “upper gastrointestinal bleeding”, “non-variceal upper gastrointestinal bleeding”, “PUD”, ‘‘DL’’, ‘‘Mallory-Weiss tear”, and “MWS’’. RESULTS: While the majority of acute gastrointestinal (GI) bleeding with aALD is related to portal hypertension, about 30%-40% of acute GI bleeding in patients with aALD is unrelated to portal hypertension. Such bleeding constitutes an important complication of aALD because of its frequency, severity, and associated mortality. Patients with cirrhosis have a markedly increased risk of PUD, which further increases with the progression of cirrhosis. Patients with cirrhosis or aALD and peptic ulcer bleeding (PUB) have worse clinical outcomes than other patients with PUB, including uncontrolled bleeding, rebleeding, and mortality. Alcohol consumption, nonsteroidal anti-inflammatory drug use, and portal hypertension may have a pathogenic role in the development of PUD in patients with aALD. Limited data suggest that Helicobacter pylori does not play a significant role in the pathogenesis of PUD in most cirrhotic patients. The frequency of bleeding from DL appears to be increased in patients with aALD. DL may be associated with an especially high mortality in these patients. MWS is strongly associated with heavy alcohol consumption from binge drinking or chronic alcoholism, and is associated with aALD. Patients with aALD have more severe MWS bleeding and are more likely to rebleed when compared to non

  19. Pantoprazole before Endoscopy in Patients with Gastroduodenal Ulcer Bleeding: Does the duration of Infusion and Ulcer Location Influence the Effects?

    Directory of Open Access Journals (Sweden)

    Istvan Rácz

    2012-01-01

    Full Text Available The aim of this study was to investigate the effect of preemptive pantoprazole infusion on early endoscopic findings in patients with acute ulcer bleeding. Records of 333 patients admitted with acute ulcer bleeding were analyzed. Ulcer bleeders were given either 80 mg bolus of pantoprazole followed by continuous infusion of 8 mg per hour or saline infusion until endoscopy. In 93 patients saline infusion whereas in 240 patients bolus plus infusion of pantoprazole was administrated with mean (±SD durations of 5.45±12.9 hours and 6.9±13.2 hours, respectively (P=0.29. Actively bleeding ulcers were detected in 46/240 (19.2% of cases in the pantoprazole group as compared with 23/93 (24.7% in the saline infusion group (P=0.26. Different durations of pantoprazole infusion (0–4 hours, >4 hours, and >6 hours had no significant effect on endoscopic and clinical outcome parameters in duodenal ulcer bleeders. Gastric ulcer bleeders on pantoprazole infusion longer than 4 and 6 hours before endoscopy had actively bleeding ulcers in 4.3% and 5% compared to the 19.5% active bleeding rate in the saline group (P=0.02 and P=0.04. Preemptive infusion of high-dose pantoprazole longer than 4 hours before endoscopy decreased the ratio of active bleeding only in gastric but not in duodenal ulcer patients.

  20. PA01.62. Mukta-sukti bhasma; nectar for acid peptic disorders, w.s.r to its anti-ulcer activity - an experimental study

    OpenAIRE

    Sreejith, R; ,

    2012-01-01

    Purpose: Mukta Shukti (Pearl oyster shell); a sudha varga dravya, attains better therapeutic properties with proper sodhana and marana processes. It is indicated in Amlapitta, Parinamashoola and Annadravashoola. Acharya Susruta mentioned; Amla is the property of Vidagdha Pitta. The term Amlapitta may be correlated with Acid reflux syndrome which comprises of various types of Gastro esophageal reflux diseases like Gastritis, Peptic ulcer etc. A peptic ulcer is a sore on the lining of the stoma...

  1. Trends in peptic ulcer disease and the identification of Helicobacter Pylori as a causative organism: Population-based estimates from the US nationwide inpatient sample

    Directory of Open Access Journals (Sweden)

    Bronislava Bashinskaya

    2011-01-01

    Full Text Available Background: Peptic ulcer disease can lead to serious complications including massive hemorrhage or bowel perforation. The modern treatment of peptic ulcer disease has transitioned from the control of gastric acid secretion to include antibiotic therapy in light of the identification of Helicobacter pylori as a causative infectious organism. We sought to determine trends related to this discovery by using a national database. Materials and Methods: Patient discharges with peptic ulcer disease and associated sequelae were queried from the Nationwide Inpatient Sample, 1993 to 2007, under the auspices of a data user agreement. To account for the Nationwide Inpatient Sample weighting schema, design-adjusted analyses were used. Standard error was calculated using SUDAAN software (Research Triangle International, NC, USA. Results: Decreases in the incidences of gastrointestinal perforation, gastrointestinal hemorrhage, and surgical procedures most specific to peptic ulcer disease were statistically significant over the study period [range of P value (two tailed = 0.000 - 0.00353; significant at P < 0.001 to < 0.01]. The incidence of H. pylori rose dramatically, peaking at an estimated 97,823 cases in 1998 [SE = 3155; 95% CI = 6,184]. Since that time it has decreased and then stabilized. Conclusions: The identification of H. pylori as the causative agent in the majority of peptic ulcer disease has revolutionized the understanding and management of the disease. Medical conditions and surgical procedures associated with end-stage peptic ulcer disease have significantly decreased according to analysis of selected index categories. Resident physician education objectives may need to be modified in light of these trends. Review Criteria: We reviewed patients with peptic ulcer disease. The database used was the Nationwide Inpatient Sample, 1993 to 2007. Message for the Clinic: Medical therapy has resulted in decreased morbidity from H. pylori infection as it

  2. The Mental Health Status and Nurse Measures in the Inpatients with Peptic Ulcer%消化性溃痬病人的心理健康状况及心理护理措施

    Institute of Scientific and Technical Information of China (English)

    顾华英; 戈兰; 李柳芳; 梁艶娉

    2002-01-01

    Objective To explore mental health status and nurse measures and nurse measures in the inpatient withpeptic ulcer. Methods Symptom Checklist 90 was applied to the inpatients with peptic ulcer(30 cases) and health subjects(30 cases).Results Symptom Checklist 90 show that all scores were significant highter in the patients with peptic ulcer thanones in the control. Conclusion There were serious psychologic obstacle in the patients with peptic ulcer, especial anxiety,depression and sleeping, food appetite disorder. The psychogical nurse measures were provided acording to the mental healthstatus in the inpatient with peptic ulcer.

  3. [Medical, social, and economic effectiveness of treatment of day-case patients with peptic ulcer].

    Science.gov (United States)

    Butorov, I V; Osoianu, Iu P; Maksimov, V V; Butorov, S I

    2006-01-01

    The purpose of the study was to evaluate medical, social, and economic effectiveness of treatment of day-case patients with peptic ulcer (PU). The subjects of the study were 60 day-case patients with duodenal ulcer aged 18 to 60, who underwent clinical and instrumental examination including esophagogastroduodenoscopy with biopsy and Helicobacter pylori (HP) detection. The patients received 7-day eradication therapy, which included omeprazol in a dose of 20 mg twice a day, clarithromycin--500 mg twice a day, and metronidazole--500 mg twice a day. There was a control group, which included 60 inpatients treated in Gastroenterology Division of the hospital. The use of the three-component medication in the day-case patients and the inpatients led to disappearance of pain syndrome 7.4 +/- 0.3 and 8.6 +/- 0.2 days after the beginning of the treatment, respectively; dyspepsia disappeared in the day-case patients and the inpatients 7.6 +/- 0.2 and 8.8 +/- 0.3 days after the beginning of the treatment, respectively. HP eradication was effective in 86.7% of the day-case patients, and in 88.3% of the inpatients. The course of the disease was recurrence-free during two years in 80% of the day-case patients, and in 76.4% of the inpatients; the cost of the treatment was 2.1 times higher in the group of inpatients. The results show that high effectiveness of the three-component medication, judging by the results of HP eradication, terms of disappearance of pain syndrome and ulcer healing, allows recommending this regimen for wide clinical application in day-case patients with PU.

  4. Clinical and laboratory substantiation of Mexidol use in complex treatment of periodontitis in patients with peptic ulcers

    Directory of Open Access Journals (Sweden)

    Ostrovskaya L.U.

    2011-06-01

    Full Text Available To determine the clinical pathogenetic efficacy of Mexidol in the combined therapy of parodontitis in patients with peptic ulcers medical examination and treatment of 296 patients were carried out. Endoscopic, histological and im-munohistochemical studies were performed in all examined patients. Investigation of interleukin -6, -10, -18 in oral cavity by immunofermental analysis was conducted. It was established that Mexidol use in the combined treatment of patients with periodontitis and peptic ulcer allowed to decrease evidence of local inflammation, to normalize processes of neurohumoral and cytokine regulation, that provided acceleration of recovery processes, decrease in periodontitis recurrences. The statistical programs Exsel и Statistica 6.0 were used in the study. The subsequent analysis of the received data was carried out

  5. Epidemiological Clinical Features and Evolution of Gastroduodenal Ulcer Bleeding in a Tertiary Care Hospital in Spain, during the Last Seven Years.

    Science.gov (United States)

    Lauret, Eugenia; Herrero, Jesús; Blanco, Lorena; Castaño, Olegario; Rodriguez, Maria; Pérez, Isabel; Alvarez, Verónica; Suárez, Adolfo; Rodrigo, Luis

    2013-01-01

    Background. Gastroduodenal ulcer bleeding is a common medical emergency. The aim of this study was to analyze the characteristics of bleeding episodes and to identify changes in the clinical trends over seven years. Methods. Retrospective observational clinical study on a cohort of 272 consecutive adult patients with peptic ulcer bleeding, during the 2006-2012 period. Results. Mean annual admission rate was 12.8 per 100.000 inhabitants. Men were predominant (71%), with a mean age of 66.6 years. Comorbidities were present in 131 cases (48.2%) and 156 patients (57.4%) had received ulcerogenic drugs. Duodenal ulcer was the commonest location (61%). Endoscopic therapy was necessary in 183 cases (67.3%) and rebleeding occurred in 30 patients (11%). Overall mortality rate was 5.5%, with a significant association with the presence of comorbidities (P ulcer bleeding have remained unchanged in the study period. This may be due to the fact that the effect of improved approach on this condition is probably counteracted by risk factors such as older age, severe comorbidities, and ulcerogenic drugs consumption, which have also remained stable over recent years.

  6. Does Helicobacter pylori Eradication Reduce the Risk of Open Angle Glaucoma in Patients With Peptic Ulcer Disease?

    Science.gov (United States)

    Chen, Hsin-Yi; Lin, Cheng-Li; Chen, Wen-Chi; Kao, Chia-Hung

    2015-09-01

    To investigate whether Helicobacter pylori (H pylori) eradication would influence the risk of primary open angle glaucoma (POAG) in patients with peptic ulcer disease. From the Longitudinal Health Insurance Database 2000, 6061 patients with peptic ulcer and receiving H pylori eradication therapy were recruited. The study cohort was subdivided into early (within 1 year) and late (after 1 year) eradication cohorts. The 24,244 control cohort subjects were those who without peptic ulcer and without receiving H pylori eradication therapy and were frequency-matched with the H pylori eradication cohort by age, sex, and the year of receiving H pylori eradication therapy. The higher incidence of POAG was observed in late H pylori eradication cohort and in early H pylori eradication cohort than in control cohort (1.57, 1.32, and 0.95, per 1000 person-year, respectively). However, overall risk of glaucoma was not significantly higher in the late eradication than in the early eradication (adjusted hazard ratio = 0.85, 95% confidence interval = 0.48-1.53). The POAG incidence was greater in the late H pylori eradication cohort when follow-up duration ≤ 5 years (1.59, per 1000 person-years). However, when follow-up duration >5 years, the incidence of POAG was greater in the early H pylori eradication cohort (1.68, per 1000 person-years). These relationships were not associated with a significantly increased or decreased risk of POAG in multivariable analyses. Either early or late H pylori eradication does not significantly reduce the risk of glaucoma in patients with peptic ulcer disease compared with normal control.

  7. Association of Helicobacter pylori cagA Gene with Gastric Cancer and Peptic Ulcer in Saudi Patients.

    Science.gov (United States)

    Saber, Taisir; Ghonaim, Mabrouk M; Yousef, Amany R; Khalifa, Amany; Al Qurashi, Hesham; Shaqhan, Mohammad; Samaha, Mohammad

    2015-07-01

    This study was conducted to assess the relationship between occurrence of gastric cancer and peptic ulcer, and the presence of H. pylori cagA gene and anti-CagA IgG, and to estimate the value of these antibodies in detecting infection by cagA gene-positive H. pylori strains in Saudi patients. The study included 180 patients who were subjected to upper gastrointestinal endoscopy in Taif province and Western region of Saudi Arabia (60 gastric cancer, 60 peptic ulcer, and 60 with non-ulcer dyspepsia). Gastric biopsy specimens were obtained and tested for H. pylori infection by rapid urease test and culture. PCR was performed on the isolated strains and biopsy specimens for detection of the cagA gene. Blood samples were collected and tested for CagA IgG by ELISA. H. pylori infection was detected among 72.8% of patients. The cagA gene and anti-CagA IgG were found in 63.4% and 61.8% of H. pylori-infected patients, respectively. They were significantly (p ulcer compared with those with non-ulcer dyspepsia. Detection of the CagA IgG was 91.6% sensitive, 89.6% specific, and 90.8% accurate compared with detection of the cagA gene. Its positive and negative predictive values were 93.8% and 86%, respectively. The study showed a significant association between the presence of the cagA gene and gastric cancer and peptic ulcer disease, and between anti-CagA IgG and the cagA gene in Saudi patients. However, a further larger study is required to confirm this finding.

  8. Transarterial embolization of massive gastric ulcer bleeding in gastrostomy patients caused by a balloon replacement tube: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Youn, Byong Jong; Hur, Jin; Lee, Kwang Hun; Won, Jong Yun [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2007-02-15

    We present the case of a 77-year-old woman with massive gastric ulcer bleeding caused by a balloon replacement tube that required emergent transcatheter left gastric arterial embolization in stop the ulcer bleeding.

  9. Significance of serum markers pepsinogen I and II for chronic atrophic gastritis, peptic ulcer, and gastric cancer.

    Science.gov (United States)

    Matsukura, N; Onda, M; Tokunaga, A; Fujita, I; Okuda, T; Mizutani, T; Kyono, S; Yamashita, K

    1993-01-01

    Chronic atrophic gastritis (CAG) is closely correlated with gastric cancer and is predominant in Japan. Epidemiologically, food habits are the primary factor in both CAG and gastric cancer. Two potential serum markers for CAG have recently been investigated, i.e., the concentration of serum pepsinogen (PG) and the presence of serum antibodies against Helicobacter pylori. Serum PG I and II and the PG I:PG II ratio have been reported to be useful as indicators of recurrent peptic ulcer and for screening of patients at risk from gastric cancer. In this study, we examined PG I and II in serum from 483 patients by RIA (DAINABOT), and endoscopic examination performed in the same patients before serological assay revealed CAG in 68, peptic ulcer in 91, and gastric cancer in 48. Analysis of the mean values according to patients age showed that CAG patients in their forties to eighties had low ( or = 70 ng/ml) levels, except for those in their seventies, and gastric cancer patients in their twenties to sixties had low (< 3.0) PG I:PG II ratios, except for those in their sixties. Thus serum PG assay has potential utility for detection of CAG, peptic ulcer, and gastric cancer.

  10. Decreasing incidence of peptic ulcer complications after the introduction of the proton pump inhibitors, a study of the Swedish population from 1974–2002

    Directory of Open Access Journals (Sweden)

    Ranstam Jonas

    2009-04-01

    Full Text Available Abstract Background Despite a decreasing incidence of peptic ulcer disease, most previous studies report a stabile incidence of ulcer complications. We wanted to investigate the incidence of peptic ulcer complications in Sweden before and after the introduction of the proton pump inhibitors (PPI in 1988 and compare these data to the sales of non-steroid anti-inflammatory drugs (NSAID and acetylsalicylic acid (ASA. Methods All cases of gastric and duodenal ulcer complications diagnosed in Sweden from 1974 to 2002 were identified using the National hospital discharge register. Information on sales of ASA/NSAID was obtained from the National prescription survey. Results When comparing the time-periods before and after 1988 we found a significantly lower incidence of peptic ulcer complications during the later period for both sexes (p Conclusion When comparing the periods before and after the introduction of the proton pump inhibitors we found a significant decrease in the incidence of peptic ulcer complications in the Swedish population after 1988 when PPI were introduced on the market. The cause of this decrease is most likely multifactorial, including smoking habits, NSAID consumption, prevalence of Helicobacter pylori and the introduction of PPI. Sales of prescribed NSAID/ASA increased, especially in middle-aged and elderly women. This fact seems to have had little effect on the incidence of peptic ulcer complications.

  11. The Development of Diabetes after Subtotal Gastrectomy with Billroth II Anastomosis for Peptic Ulcer Disease

    Science.gov (United States)

    Chen, Chien-Hua; Hsu, Che-Ming; Lin, Cheng-Li

    2016-01-01

    Purpose A duodenal bypass after a Roux-en-Y gastric bypass operation for obesity can ameliorate the development of diabetes mellitus (DM). We attempted to determine the subsequent risk of developing DM after subtotal gastrectomy with Billroth II anastomosis (SGBIIA) for peptic ulcer disease (PUD). Methods We identified 662 patients undergoing SGBIIA for PUD between 2000 and 2011 from the Longitudinal Health Insurance Database as the study cohort, and we randomly selected 2647 controls from the peptic ulcer population not undergoing SGBIIA and were frequency-matched by age, sex, and index year for the control cohort. All patient cases in both cohorts were followed until the end of 2011 to measure the incidence of DM. We analyzed DM risk by using a Cox proportional hazards regression model. Results The patients who underwent SGBIIA demonstrated a lower cumulative incidence of DM compared with the control cohort (log-rank test, P < .001 and 6.73 vs 12.6 per 1000 person-y). The difference in the DM risk between patients with and without SGBIIA increased gradually with the follow-up duration. Age and sex did not affect the subsequent risk of developing DM, according to the multivariable Cox regression model. Nevertheless, the SGBIIA cohort exhibited a lower DM risk after we adjusted for the comorbidities of hypertension, hyperlipidemia, and coronary artery disease (adjusted hazard ratio (aHR): 0.56, 95% confidence interval (CI): 0.40–0.78). The incidence rate ratio (IRR) of DM in the SGBIIA cohort was lower than that in the control cohort for all age groups (age ≤ 49 y, IRR: 0.40, 95% CI: 0.16–0.99; age 50–64 y, IRR: 0.54, 95% CI: 0.31–0.96; age ≧ 65 y, IRR: 0.57, 95% CI: 0.36–0.91). Moreover, the IRR of DM was significantly lower in the SGBIIA cohort with comorbidities (IRR: 0.50, 95% CI: 0.31–0.78) compared with those without a comorbidity (IRR: 0.65, 95% CI: 0.40–1.04). Conclusion The findings of this population-based cohort study revealed that

  12. CXC chemokine CXCL12 tissue expression and circulating levels in peptic ulcer patients with Helicobacter pylori infection.

    Science.gov (United States)

    Bagheri, Vahid; Hassanshahi, Gholamhossein; Mirzaee, Vahid; Khorramdelazad, Hossein

    2016-09-01

    Helicobacter pylori (H. pylori) infection is among the most prevalent human infections. CXCL12 is a well-known CXC chemokine involved in inflammation and play major roles in angiogenesis. There is currently very limited data on the role of CXCL12 in peptic ulcer disease. Hence, we aimed to explore whether CXCL12 is involved in the pathogenesis of peptic ulcer induced by H. pylori. In this study, we enrolled 102 H. pylori-infected patients, including 51 with active ulcer (GA) and 51 with healing ulcer (GH). We also recruited 50 healthy subjects as control, which did not show any sign or symptoms of chronic inflammatory diseases, infection, or immune-related disorders. Endoscopy was performed to determine the stage of the disease. ELISA was used for detection of H. pylori infection and CXCL12 measurement. We also employed western blotting to detect CXCL12 in ulcerative lesions of H. pylori. Demographic data were also collected by questionnaire. Our results demonstrated that CXCL12 serum levels in GA group (151.8±18.31pg/mL) were significantly higher than those in GH (36.89±6.78pg/mL) and control groups (33.77±9.12pg/mL) (Pulcer. CXCL12 serum levels may also be used to distinguish between GA and GH phases of the disease.

  13. Incidence of Duodenal Ulcers and Gastric Ulcers in a Western Population: Back to Where It Started

    Directory of Open Access Journals (Sweden)

    Marcel JM Groenen

    2009-01-01

    Full Text Available BACKGROUND/OBJECTIVES: As recently as 40 years ago, a decline in the incidence of peptic ulcers was observed. The discovery of Helicobacter pylori had a further major impact on the incidence of ulcer disease. Our aim was to evaluate the trends in the incidence and bleeding complications of ulcer disease in the Netherlands.

  14. Helicobacter pylori and risk of ulcer bleeding among users of nonsteroidal anti-inflammatory drugs: a case-control study

    DEFF Research Database (Denmark)

    Aalykke, C; Lauritsen, Jens; Hallas, J

    1999-01-01

    Peptic ulcer complications related to use of nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most common serious adverse drug reactions. Whether Helicobacter pylori infection potentiates this gastrointestinal toxicity of NSAIDs is still unresolved. In this study, we investigated...

  15. Helicobacter pylori and risk of ulcer bleeding among users of nonsteroidal anti-inflammatory drugs: a case-control study

    DEFF Research Database (Denmark)

    Aalykke, C; Lauritsen, Jens; Hallas, J

    1999-01-01

    Peptic ulcer complications related to use of nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most common serious adverse drug reactions. Whether Helicobacter pylori infection potentiates this gastrointestinal toxicity of NSAIDs is still unresolved. In this study, we investigated...

  16. Adult hypertrophic pyloric stenosis due to peptic ulcer disease: a rare presentation

    Directory of Open Access Journals (Sweden)

    Shameer Deen

    2016-05-01

    Full Text Available Primary adult hypertrophic stenosis is uncommon with an uncertain etiopathogenesis and associated gastric outlet obstruction mimics gastric carcinoma. We present a case of AHPS as sequel of peptic ulcer disease in a 72 year old male. With the advent of proton pump inhibitors as a mainstay of medical therapy, complication into gastric outlet obstruction is a rare disease today. Upper GI endoscopy revealed a distended stomach, residual food and a hyperemic bulky pylorus not accommodating the endoscope. Barium meal follow-through revealed a dilated stomach and minimal barium passing through the pylorus. Histological analysis revealed mild dysplasia at the focus with dense inflammatory infiltrates composed of lymphocytes and eosinophils in the lamina propria. No evidence of malignancy was noted, favouring chronic gastritis. The condition mimics other forms of proliferative disorders like carcinoma, gastrointestinal stromal tumors. We present the clinical findings, imaging analysis and discuss etiopathogenesis and management. [Int J Res Med Sci 2016; 4(5.000: 1730-1732

  17. Depression and the Risk of Peptic Ulcer Disease: A Nationwide Population-Based Study.

    Science.gov (United States)

    Hsu, Chih-Chao; Hsu, Yi-Chao; Chang, Kuang-Hsi; Lee, Chang-Yin; Chong, Lee-Won; Lin, Cheng-Li; Shang, Chuin-Shee; Sung, Fung-Chang; Kao, Chia-Hung

    2015-12-01

    The risk of peptic ulcer disease (PUD) among patients with depression has raised concern. This study determined the association between depression and the subsequent development of PUD using claims data.Patients newly diagnosed with depression in 2000 to 2010 were identified as depression cohort from the Taiwan National Health Insurance Research Database. The comparison cohort was randomly selected from subjects without depression, frequency matched by age and gender and diagnosis date, with a size 2-fold of the size of the depression cohort. The incidence of PUD was evaluated for both cohorts by the end of 2011. We calculated the hazard ratios (HRs) and 95% confidence intervals (CIs) of PUD using the Cox proportional hazards regression model.The depression cohort consisted of 23,536 subjects (129,751 person-years), and the comparison cohort consisted of 47,069 subjects (285,592 person-years). The incidence of PUD was 2-fold higher in the depression cohort than in the comparison cohort (33.2 vs 16.8 per 1000 person-years) with an age adjusted HR of 1.97 (95% CI = 1.89-2.06) or a multivariable adjusted HR of 1.35 (95% CI = 1.29-1.42).Depression might increase the risk of developing PUD. Prospective clinical studies of the relationship between depression and PUD are warranted.

  18. Heuristic reevaluation of the bacterial hypothesis of peptic ulcer disease in the 1950s.

    Science.gov (United States)

    Šešelja, Dunja; Straßer, Christian

    2014-12-01

    Throughout the first half of the twentieth century the research on peptic ulcer disease (PUD) focused on two rivaling hypothesis: the "acidity" and the "bacterial" one. According to the received view, the latter was dismissed during the 1950s only to be revived with Warren's and Marshall's discovery of Helicobacter pylori in the 1980s. In this paper we investigate why the bacterial hypothesis was largely abandoned in the 1950s, and whether there were good epistemic reasons for its dismissal. Of special interest for our research question is Palmer's 1954 large-scale study, which challenged the bacterial hypothesis with serious counter-evidence, and which by many scholars is considered as the shifting point in the research on PUD. However, we show that: (1) The perceived refutatory impact of Palmer's study was disproportionate to its methodological rigor. This undermines its perceived status as a crucial experiment against the bacterial hypothesis. (2) In view of this and other considerations we argue that the bacterial hypothesis was worthy of pursuit in the 1950s.

  19. Fermented foods: are they tasty medicines for Helicobacter pylori associated peptic ulcer and gastric cancer?

    Directory of Open Access Journals (Sweden)

    Mydhily Nair R B

    2016-07-01

    Full Text Available More than a million people die every year due to gastric cancer and peptic ulcer. Helicobacter pylori infection in stomach is the most important reason for these diseases. Interestingly, only 10-20% of the H. pylori infected individuals suffer from these gastric diseases and rest of the infected individuals remain asymptomatic. The genotypes of H. pylori, host genetic background, lifestyle including smoking and diet may determine clinical outcomes. People from different geographical regions have different food habits, which also include several unique fermented products of plant and animal origins. When consumed raw, the fermented foods bring in fresh inocula of microbes to gastrointestinal tract and several strains of these microbes, like Lactobacillus and Saccharomyces are known probiotics. In vitro and in vivo experiments as well as clinical trials suggest that several probiotics have anti-H. pylori effects. Here we discuss the possibility of using natural probiotics present in traditional fermented food and beverages to obtain protection against H. pylori induced gastric diseases.

  20. Association of peptic ulcer disease with obesity, nutritional components, and blood parameters in the Korean population.

    Science.gov (United States)

    Kim, Jihye; Kim, Keun Ho; Lee, Bum Ju

    2017-01-01

    Peptic ulcer disease (PUD) is a common disorder, but whether an association exists between PUD and anthropometric indicators remains controversial. Furthermore, no studies on the association of PUD with anthropometric indices, blood parameters, and nutritional components have been reported. The aim of this study was to assess associations of anthropometrics, blood parameters, nutritional components, and lifestyle factors with PUD in the Korean population. Data were collected from a nationally representative sample of the South Korean population using the Korea National Health and Nutrition Examination Survey. Logistic regression was used to examine associations of anthropometrics, blood parameters and nutritional components among patients with PUD. Age was the factor most strongly associated with PUD in women (p = blood parameters were associated with PUD in women, and only triglyceride level was associated with PUD in men (adjusted p = 0.0169, adjusted OR = 1.227 [1.037-1.451]). We found that obesity was associated with PUD in the Korean population; additionally, the association between nutritional components and PUD was greater in women than in men.

  1. [THE EFFECTIVENESS OF ERADICATION IN PATIENTS WITH PEPTIC ULCER DISEASE ASSOCIATED WITH HELICOBACTER PYLORI, DEPENDING ON THE GENOTYPE OF THE DRUGMETABOLISM OF PROTON PUMP INHIBITORS].

    Science.gov (United States)

    Elokhina, E V; Kostenko, M B; Livzan, M A; Scalskiy, S V

    2015-01-01

    One of the most likely causes of the lack of effectiveness of eradication therapy of peptic ulcer associated with Helicobacter pylori, is a feature of omeprazole metabolism by cytochrome CYP2C19. The paper work presents evidence that the rate of reduction of the clinical picture and the likelihood of scarring ulcers and eradication rates higher in patients slow metabolizers of omeprazole.

  2. Efficacy of omeprazole and amoxicillin with either clarithromycin or metronidazole on eradication of Helicobacter pylori in Chinese peptic ulcer patients

    Institute of Scientific and Technical Information of China (English)

    Wei-Hao Sun; Han Su; Xi-Long Ou; Da-Zhong Cao; Qian Yu; Ting Yu; Jin-Ming Hu; Feng Zhu; Yun-Liang Sun; Xi-Ling Fu

    2005-01-01

    AIM: One-week triple therapy with proton pump inhibitors, clarithromycin and amoxicillin has recently been proposed as the first-line treatment for Helicobacter pylori(H pylori) infection; however, data regarding the effects of this regimen in China are scarce. The aim of this prospective and randomized study was to compare the efficacy of clarithromycin and metronidazole when they were combined with omeprazole and amoxicillin on eradication of H pylori and ulcer healing in Chinese peptic ulcer patients.METHODS: A total of 103 subjects with H pylori-positive peptic ulcer were randomly divided into two groups, and accepted triple therapy with omeprazole 20 mg, amoxicillin 1 000 mg and either clarithromycin 500 mg (OAC group,n = 58) or metronidazole 400 mg (OAM group, n = 45).All drugs were given twice daily for 7 d. Patients with active peptic ulcer were treated with omeprazole 20 mg daily for 2-4 wk after anti-H pylori therapy. Six to eight weeks after omeprazole therapy, all patients underwent endoscopies and four biopsies (two from the antrum and two others from the corpus of stomach) were taken for rapid urease test and histological analysis (with modified Giemsa staining) to examine H pylori. Successful eradication was defined as negative results from both examination methods.RESULTS: One hundred patients completed the entire course of therapy and returned for follow-up. The eradication rate of H pylori for the per-protocol analysis was 89.3% (50/56) in OAC group and 84.1% (37/44) in OAM group. Based on the intention-to-treat analysis, the eradication rate of H pylori was 86.2% (50/58) in OAC group and 82.2% (37/45) in OAM group. There were no significant differences in eradication rates between the two groups on either analysis. The active ulcer-healing rate was 96.7% (29/30) in OAC group and 100% (21/21)in OAM group (per-protocol analysis, P>0.05). Six patients in OAC group (10.3%) and five in OAM group (11.1%)reported adverse events (P>0.05).CONCLUSION

  3. Platelet aggregation measurement for assessment of hemostasis failure mechanisms in patients with gastroduodenal ulcer bleeding

    Science.gov (United States)

    Barinov, Edward; Sulaieva, Oksana; Lyakch, Yuriy; Guryanov, Vitaliy; Kondratenko, Petr; Radenko, Yevgeniy

    2013-01-01

    Background The purpose of this study was to identify factors associated with the risk of unsustainable hemostasis in patients with gastric and duodenal ulcer bleeding by in vitro assessment of platelet reactivity using artificial neural networks. Methods Patients with gastroduodenal ulcers complicated by bleeding were studied. Platelet aggregation was measured using aggregometry with adenosine diphosphate 5 μM, epinephrine 2.5 μM, 5-hydroxytryptophan 10 μM, collagen 1 μM, and thrombin 0.06 NIH Unit/mL as agonists. Multiple logistic regression was used to evaluate the independent relationship between demographic, clinical, endoscopic, and laboratory data and in vitro assessment of platelet reactivity and local parameters of hemostasis in patients with ulcer bleeding. Results Analysis of platelet aggregation in patients with gastroduodenal ulcer bleeding allowed the variability of platelet response to different agonists used in effective concentration which induces 50% platelet aggregation (EC50) to be established. The relationship between platelet aggregation and the spatial-temporal characteristics of ulcers complicated by bleeding was demonstrated. Adrenoreactivity of platelets was associated with time elapsed since the start of ulcer bleeding and degree of hemorrhage. The lowest platelet response to collagen and thrombin was detected in patients with active bleeding (P < 0.001) and unsustainable recent bleeding (P < 0.01). Decreased adenosine diphosphate-induced platelet aggregation in patients with ulcer bleeding was correlated with the platelet response to thrombin (r = 0.714, P < 0.001) and collagen (r = 0.584, P < 0.01). Conclusion Estimation of platelet reactivity in vitro indicates the key mechanisms of failure of hemostasis in patients with ulcer bleeding. In addition to gender, an important determinant of unsustainable hemostasis was a decreased platelet response to thrombin and adenosine diphosphate. PMID:23950655

  4. 30-days mortality in patients with perforated peptic ulcer: A national audit

    Directory of Open Access Journals (Sweden)

    Anne Nakano

    2008-11-01

    20%, and the new indicators for postoperative monitoring were developed. The DNIP continues to evaluate if these initiatives will improve the results on mortality.Keywords: mortality, perforated peptic ulcer, ulcer, audit

  5. Different risk factors influence peptic ulcer disease development in a Brazilian population

    Institute of Scientific and Technical Information of China (English)

    Rodrigo Buzinaro Suzuki; Rodrigo Faria Cola; Larissa Tranquilino Bardela Cola; Camila Garcia Ferrari; Fred Ellinger; Altino Luiz Therezo; Luis Carlos da Silva

    2012-01-01

    AIM:To investigate age,sex,histopathology and Helicobacter pylori (H.pylori) status,as risk factors for gastroduodenal disease outcome in Brazilian dyspeptic patients.METHODS:From all 1466 consecutive dyspeptic patients submitted to upper gastroscopy at Hospital das Clinicas of Marilia,antral biopsy specimens were obtained and subjected to histopathology and H.pylori diagnosis.All patients presenting chronic gastritis (CG)and peptic ulcer (PU) disease localized in the stomach,gastric ulcer (GU) and/or duodenal ulcer (DU) were included in the study.Gastric biopsies (n =668) positive for H.pylori by rapid urease test were investigated for vacuolating cytotoxin A (vacA) medium (m) region mosaicism by polymerase chain reaction.Logistic regression analysis was performed to verify the association of age,sex,histopathologic alterations,H.pylori diagnosis and vacA m region mosaicism with the incidence of DU,GU and CG in patients.RESULTS:Of 1466 patients submitted to endoscopy,1060 (72.3%) presented CG [male/female =506/554;mean age (year) ± SD =51.2 ± 17.81],88 (6.0%)presented DU [male/female =54/34; mean age (year)± SD =51.4 ± 17.14],and 75 (5.1%) presented GU[male/female =54/21; mean age (year) ± SD =51.3± 17.12] and were included in the comparative analysis.Sex and age showed no detectable effect on CG incidence (overall x2 =2.1,P =0.3423).Sex [Odds ratios (OR) =1.8631,P =0.0058] but not age (OR =0.9929,P =0.2699) was associated with DU and both parameters had a highly significant effect on GU (overall x2 =30.5,P < 0.0001).The histopathological results showed a significant contribution of ageing for both atrophy (OR =1.0297,P < 0.0001) and intestinal metaplasia (OR =1.0520,P < 0.0001).Presence of H.pylori was significantly associated with decreasing age (OR =0.9827,P < 0.0001) and with the incidence of DU (OR =3.6077,P < 0.0001).The prevalence of ml in DU was statistically significant (OR =2.3563,P =0.0018) but not in CG (OR =2.678,P =0.0863) and

  6. Analysis the relationship between helicobacter pylori negative peptic ulcer and hemorrhages%幽门螺杆菌阴性消化性溃疡与出血关系的分析

    Institute of Scientific and Technical Information of China (English)

    李辉; 王毓麟; 崔立红; 刘超群

    2012-01-01

    OBJECTIVE To explore the relationship between helicobacter pylori negative peptic ulcer and hemorrhages. METHODS The patients with peptic ulcer were randomly divided into pure ulcer group and bleeding ulcer group. We examined whether patients were detected with helicobacter pylori by RUT and histological examination. RESULTS Among 90 patients with peptic ulcer, 30 patients had negative helicobacter pylori infection with negative rate of 33.3%. However, among 90 pure ulcer group, 18 patients showed negative helicobacter pylori infection with the negative rate of 20%. There was significant difference in the two groups. CONCLUSION The incidence of peptic ulcer showed lower in negative helicobacter pylori infection patients than positive patients. However, the incidence of hemorrhage is high, and we should pay attention to them and taken property measure to improve the cure rate.%目的 探讨幽门螺旋杆菌阴性消化性溃疡与消化道出血之同的关系.方法 将发生消化性溃疡的病人分为单纯溃疡组以及溃疡合并出血组,通过快速尿素酶实验以及组织学检查两组消化性患者是否感染幽门螺旋杆菌.结果 溃疡合并出血组90例病人中,幽门螺旋杆菌阴性者有30人,阴性率为33.3%;而单纯溃疡组90例病人中,幽门螺旋杆菌阴性者仅为18人,阴性率为20.0%,两组差异有统计学意义.结论 幽门螺旋杆菌阴性消化性溃疡在消化性溃疡所占比例要低于幽门螺旋杆菌阳性消化性溃疡,但是并发出血的可能性更高,对这类病人要引起足够的重视,采取合适的治疗措施,提高治愈率.

  7. Accuracy of three diagnostic tests used alone and in combination for detecting Helicobacter pylori infection in patients with bleeding gastric ulcers

    Institute of Scientific and Technical Information of China (English)

    廖健仲; 李嘉龙; 赖永智; 黄世鸿; 李瑞成; 吴启华; 涂天健; 陈振宽; 白其卉

    2003-01-01

    Objective Accuracy of diagnostic methods for detecting Helicobacter pylori (H. pylori) infection among patients with bleeding peptic ulcers has not been thoroughly investigated. The aim of this study was to compare the diagnostic tests and their combined usage in detection of H. pylori infection in patients with bleeding gastric ulcers and without the use of nonsteroidal anti-inflammatory drugs.Methods A total of 57 patients who presented with bleeding gastric ulcers by endoscopy were enrolled. The status of H. pylori was identified by performing the rapid urease test (RUT), histology and 13C-labeled urea breath test (UBT). The criteria for having H. pylori infection was a minimum of two positive tests.Results The prevalence of H. pylori infection in our patient group was 80.7%. Among the three tests used: RUT, histology, and UBT, sensitivities were 56.5%, 97.8% and 100%, while specificities were 100%, 45.5% and 81.8%, respectively. The overall accuracies of the tests were 78.3%, 71.6% and 90.9%, respectively. Although UBT obtained significantly higher accuracy than histology (P=0.02) as opposed to RUT (P=0.11), UBT had significantly higher sensitivity than RUT (P<0.001). In terms of combining any two of the three tests, more accuracy (98.9%) was achieved when both UBT and histology were used to confirm the diagnosis of the other. Conversely, failure to use combined tests generated the potential of missing a proper H. pylori diagnosis.Conclusions UBT is superior to the other two tests in bleeding gastric ulcers. RUT lacks sensitivity for detection of H. pylori infection. However, the concomitant use of UBT and histology seems to be more accurate when gastric ulcers present with bleeding.

  8. Relationship of plasmid profile with the antibiotic sensitivity pattern of helicobacter pylori isolates from peptic ulcer disease patients in Chennai

    Directory of Open Access Journals (Sweden)

    Dharmalingam S

    2003-01-01

    Full Text Available PURPOSE: One hundred and ten Helicobacter pylori isolates from peptic ulcer disease patients and matched controls were analysed for any possible relationship between the presence of cryptic plasmids and their antibiotic sensitivity pattern. METHODS: Antral biopsies of patients with gastric and duodenal ulcer, gastric cancer, non ulcer dyspepsia and matched controls were cultured for H.pylori. Antibiotic susceptibility and MIC analysis of the clinical isolates was done by E-test. Plasmid profiles of the isolates were analysed using mini ultra prep plasmid kit. RESULTS: Out of the 110 isolates tested, 89.1% isolates were resistant to metronidazole, 10.9 % were resistant to clarithromycin and 0.9% were resistant to multiple drugs. Isolates harbouring plasmids were seen in all the groups and constituted 5.4% of total isolates. CONCLUSIONS: The presence of plasmids in the clinical isolates of H.pylori did not have any correlation with their antibiotic resistance pattern.

  9. Psychological Stress Increases Risk for Peptic Ulcer, Regardless of Helicobacter pylori Infection or Use of Nonsteroidal Anti-inflammatory Drugs

    DEFF Research Database (Denmark)

    Levenstein, Susan; Rosenstock, Steffen; Jacobsen, Rikke Kart

    2015-01-01

    antibodies against Helicobacter pylori in stored sera, alcohol consumption, or sleep duration but lower after adjusting for socioeconomic status (1.17; 95% CI, 1.07-1.29; P drugs, and lack of exercise (1.......11; 95% CI, 1.01-1.23; P = .04). The risk for ulcer related to stress was similar among subjects who were H pylori seropositive, those who were H pylori seronegative, and those exposed to neither H pylori nor nonsteroidal anti-inflammatory drugs. On multivariable analysis, stress, socioeconomic status......, smoking, H pylori infection, and use of nonsteroidal anti-inflammatory drugs were independent predictors of ulcer. CONCLUSIONS: In a prospective study of a population-based Danish cohort, psychological stress increased the incidence of peptic ulcer, in part by influencing health risk behaviors. Stress had...

  10. Prevalence of Helicobacter Pylori-Negative, Non-Steroidal Anti-Inflammatory Drug Related Peptic Ulcer Disease in Patients Referred to Afzalipour Hospital.

    Science.gov (United States)

    Seyed Mirzaei, Seyed Mahdi; Zahedi, Mohammad Javad; Shafiei Pour, Sara

    2015-10-01

    BACKGROUND Although Helicobacter pylori and non-steroidal anti-inflammatory drugs (NSAIDs) are the main causes of peptic ulcers disease (PUD), recently the prevalence of idiopathic peptic ulcer (IPU) is increasing in most parts of the world. The aim of this study was to assess the prevalence of IPU in Kerman, the center of largest province in south-east Iran. METHODS We included 215 patients with peptic ulcer in our study. Combined methods rapid urease test (RUT), histology, and real time polymerase chain reaction (PCR) was performed on endoscopic samples of peptic ulcers. NSAID use was determined by medical history. SPSS software version 16 was used for data analysis. p valueulcer, four (1.8%) had H.pylorinegative and NSAID-negative PUD. There were not significant differences between patients with IPU and patients with peptic ulcer associated with H.pylori or NSAIDs regarding the sex, age, cigarette smoking, and opioid abuse. CONCLUSION Our study showed that in contrast to other reports from western and some Asian countries, the prevalence of IPU is low in Kerman and H.pylori infection is still the major cause of PUD. We recommend a large and multi-central study to determine the prevalence of IPU in Iran.

  11. Gastric ulcer penetrating to liver diagnosed by endoscopic biopsy

    Institute of Scientific and Technical Information of China (English)

    Ertugrul Kayacetin; Serra Kayacetin

    2004-01-01

    Liver penetration is a rare but serious complication of peptic ulcer disease. Usually the diagnosis is made by operation or autopsy. Clinical and laboratory data were no specific. A 64-year-old man was admitted with upper gastrointestinal bleeding. Hepatic penetration was diagnosed as the cause of bleeding. Endoscopy showed a large gastric ulcer with a pseudotumoral mass protruding from the ulcer bed. Definitive diagnosis was established by endoscopic biopsies of the ulcer base.

  12. The results of Helicobacter pylori eradication on repeated bleeding in patients with stomach ulcer.

    Science.gov (United States)

    Horvat, Darko; Vcev, Aleksandar; Soldo, Ivan; Timarac, Jasna; Dmitrović, Branko; Misević, Tonci; Ivezić, Zdravko; Kraljik, Nikola

    2005-06-01

    The triple therapy of Helicobacter pylori eradication prevents repeated bleeding from stomach ulcer. The aim of this one-way blind prospective study was to evaluate the efficiency of the two-week triple therapy for Helicobacter pylori eradication in preventing renewed bleeding in patients with stomach ulcer within one year. This research included 60 hospitalized patients with bleeding stomach ulcer and positive Helicobacter pylori infection, 34 men and 26 women (average age 59.7 years). The patients were given therapeutic scheme of omeprazol--amoxicilin--metrodinazol (OAM) eradication for 14 days. Eradication of H. pylori infection was defined as lack of proof of the infection one month or several months after therapy suspension. By applying triple OAM therapy within two weeks the eradication was successful in 72%. In the group of 17 H. pylori positive patients there were 8 patients (47.6%) with repeated stomach ulcer and 3 patients (18%) with bleeding. Within the group of 43 H. pylori negative patients there were only 2 patients (4.65%) with repeated stomach ulcer and 1 patient (2%) with bleeding, during the observed period of 12 months. This research confirms the hypothesis about the necessity of eradication of Helicobacter pylori infection in patients with bleeding stomach ulcer as prevention of repeated bleeding.

  13. Effects of pirenzepine on omeprazole-induced hypergastrinemia and acid suppression in peptic ulcer patients.

    Science.gov (United States)

    Tari, A; Hamada, M; Kamiyasu, T; Fukino, Y; Sumii, M; Haruma, K; Sumii, K; Inoue, M; Kajiyama, G

    1996-04-01

    Omeprazole effectively suppresses acid secretion, resulting in the long-term elevation of intragastric pH and serum gastrin level. Pirenzepine has been reported to inhibit gastrin secretion. This study was carried out to examine the effects of additional pirenzepine treatment on the hypergastrinemia and gastric acid suppression induced by omeprazole. Concentrations of serum gastrin and plasma somatostatin were measured in 28 peptic ulcer patients before treatment, after omeprazole treatment (20 mg/day) for 2 weeks, and after omeprazole and pirenzepine (100 mg/day) treatment for 2 weeks. The acid inhibitory effect of pirenzepine treatment in addition to omeprazole was evaluated by 24-h intragastric pH measurement in six healthy volunteers. Serum gastrin level was increased significantly, to 2.4-fold the pretreatment level, by omeprazole treatment. Additional treatment with pirenzepine suppressed serum gastrin level to 0.6-fold the omeprazole-treatment level. The serum somatostatin level was not altered significantly either by omeprazole treatment or by omeprazole and pirenzepine treatment. In healthy volunteers whose pH 3 holding time on 24-h intragastric pH monitoring was 70% by omeprazole treatment, omeprazole and pirenzepine treatment markedly increased the pH 3 holding time, to 89%. These findings suggest that pirenzepine is useful in reducing the undesirable effects of omeprazole-induced hypergastrinemia, i.e., the excessive trophic effect of omeprazole on the acid-secreting part of the stomach and the overstimulation of acid secretion. The additional pirenzepine treatment is also effective in suppressing acid secretion.

  14. Peptic Ulcer Disease in Healthcare Workers: A Nationwide Population-Based Cohort Study.

    Science.gov (United States)

    Lin, Hong-Yue; Weng, Shih-Feng; Lin, Hung-Jung; Hsu, Chien-Chin; Wang, Jhi-Joung; Su, Shih-Bin; Guo, How-Ran; Huang, Chien-Cheng

    2015-01-01

    Health care workers (HCWs) in Taiwan have heavy, stressful workloads, are on-call, and have rotating nightshifts, all of which might contribute to peptic ulcer disease (PUD). We wanted to evaluate the PUD risk in HCWs, which is not clear. Using Taiwan's National Health Insurance Research Database, we identified 50,226 physicians, 122,357 nurses, 20,677 pharmacists, and 25,059 other HCWs (dieticians, technicians, rehabilitation therapists, and social workers) as the study cohort, and randomly selected an identical number of non-HCW patients (i.e., general population) as the comparison cohort. Conditional logistical regression analysis was used to compare the PUD risk between them. Subgroup analysis for physician specialties was also done. Nurses and other HCWs had a significantly higher PUD risk than did the general population (odds ratio [OR]: 1.477; 95% confidence interval [CI]: 1.433-1.521 and OR: 1.328; 95% CI: 1.245-1.418, respectively); pharmacists had a lower risk (OR: 0.884; 95% CI: 0.828-0.945); physicians had a nonsignificantly different risk (OR: 1.029; 95% CI: 0.987-1.072). In the physician specialty subgroup analysis, internal medicine, surgery, Ob/Gyn, and family medicine specialists had a higher PUD risk than other physicians (OR: 1.579; 95% CI: 1.441-1.731, OR: 1.734; 95% CI: 1.565-1.922, OR: 1.336; 95% CI: 1.151-1.550, and OR: 1.615; 95% CI: 1.425-1.831, respectively). In contrast, emergency physicians had a lower risk (OR: 0.544; 95% CI: 0.359-0.822). Heavy workloads, long working hours, workplace stress, rotating nightshifts, and coping skills may explain our epidemiological findings of higher risks for PUD in some HCWs, which might help us improve our health policies for HCWs.

  15. Increased Risk of Osteoporosis in Patients With Peptic Ulcer Disease: A Nationwide Population-Based Study.

    Science.gov (United States)

    Wu, Chieh-Hsin; Tung, Yi-Ching; Chai, Chee-Yin; Lu, Ying-Yi; Su, Yu-Feng; Tsai, Tai-Hsin; Kuo, Keng-Liang; Lin, Chih-Lung

    2016-04-01

    To investigate osteoporosis risk in patients with peptic ulcer disease (PUD) using a nationwide population-based dataset. This Taiwan National Health Insurance Research Database (NHIRD) analysis included 27,132 patients aged 18 years and older who had been diagnosed with PUD (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] codes 531-534) during 1996 to 2010. The control group consisted of 27,132 randomly selected (age- and gender)-matched patients without PUD. The association between PUD and the risk of developing osteoporosis was estimated using a Cox proportional hazard regression model. During the follow-up period, osteoporosis was diagnosed in 2538 (9.35 %) patients in the PUD group and in 2259 (8.33 %) participants in the non-PUD group. After adjusting for covariates, osteoporosis risk was 1.85 times greater in the PUD group compared to the non-PUD group (13.99 vs 5.80 per 1000 person-years, respectively). Osteoporosis developed 1 year after PUD diagnosis. The 1-year follow-up period exhibited the highest significance between the 2 groups (hazard ratio [HR] = 63.44, 95% confidence interval [CI] = 28.19-142.74, P < 0.001). Osteoporosis risk was significantly higher in PUD patients with proton-pump-inhibitors (PPIs) use (HR = 1.17, 95% CI = 1.03-1.34) compared to PUD patients without PPIs use. This study revealed a significant association between PUD and subsequent risk of osteoporosis. Therefore, PUD patients, especially those treated with PPIs, should be evaluated for subsequent risk of osteoporosis to minimize the occurrence of adverse events.

  16. The Association Between Peptic Ulcer Disease and Ischemic Stroke: A Population-Based Longitudinal Study.

    Science.gov (United States)

    Cheng, Tain-Junn; Guo, How-Ran; Chang, Chia-Yu; Weng, Shih-Feng; Li, Pi-I; Wang, Jhi-Joung; Wu, Wen-Shiann

    2016-05-01

    Stroke is a common cause of death worldwide, but about 30% of ischemic stroke (IS) patients have no identifiable contributing risk factors. Because peptic ulcer disease (PUD) and vascular events share some common risk factors, we conducted a population-based study to evaluate the association between PUD and IS.We followed up a representative sample of 1 million residents of Taiwan using the National Health Insurance Research Database from 1997 to 2011. We defined patients who received medications for PUD and had related diagnosis codes as the PUD group, and a reference group matched by age and sex was sampled from those who did not have PUD. We also collected data on medical history and monthly income. The events of IS occurred after enrollment were compared between the 2 groups. The data were analyzed using Cox proportional hazard models at the 2-tailed significant level of 0.05.The PUD group had higher income and prevalence of hypertension, diabetes mellitus (DM), heart disease, and hyperlipidemia. They also had a higher risk of developing IS with an adjusted hazard ratio of 1.31 (95% confidence interval: 1.20-1.41). Other independent risk factors included male sex, older age, lower income, and co-morbidity of hypertension, diabetes mellitus (DM), and heart disease.PUD is a risk factor for IS, independent of conventional risk factors such as male sex, older age, lower income, and co-morbidity of hypertension, DM, and heart disease. Prevention strategies taking into account PUD should be developed and evaluated.

  17. Helicobacter pylori heterogeneity in patients with gastritis and peptic ulcer disease.

    Science.gov (United States)

    Armitano, Rita Inés; Matteo, Mario José; Goldman, Cinthia; Wonaga, Andrés; Viola, Luis Alberto; De Palma, Gerardo Zerbetto; Catalano, Mariana

    2013-06-01

    Genetic diversification allows Helicobacter pylori to persist during chronic colonization/infection. We investigated the intra-host variation of several markers that suggested microevolution in patients with chonic gastritis (CG) and peptic ulcer disease (PUD). One-hundred twenty-six isolates recovered from 14 patients with CG and 13 patients with PUD were analysed. cag pathogenicity island (cagPAI), oipA, vacA, bab gene status and the presence of jhp0926, jhp0945, jhp0947, jhp0949 and jhp0940 genes from the genomic Plasticity Zone (PZ) were taken into accout to investigate intra-host variation. lspA-glmM-RFLP was performed to identify mixed infections. Only one patient was colonised/infected by two ancestrally unrelated strains. Among the 126 isolates, a significant association among cagPAI genotypes, oipA status and vacA alleles was indicated. Complete cagPAI, oipA "on", and vacA s1-m1 variants were significantly found in patients with PUD, without intra-host variations. Isolates from 7/14 patients with CG lacked babA in all chromosomal loci. In contrast, isolates from all or several biopsies of PUD patients carried babA, but in one patient only, the isolates showed positive Lewis b (Leb) binding assay. Considering cagPAI, vacA, oipA, bab genotypes, intra-host variation was also significantly higher in patients with CG. Conversely, a similarly high intra-host variation in almost PZ genes was observed in isolates from patients with CG and PUD. In conclusion, the lowest intra-host variation in cagPAI, oipA, vacA, and bab genes found in patients with PUD suggests the selection of a particular variant along the bacteria-host environment interplay during ulceration development. However, the predominance of this variant may be a refletion of the multifactorial etiology of the disease rather than the cause, as it was also found in patients with CG. The intra-host variation in PZ genes may predict that this genomic region and the other markers of microevolution studied

  18. The Association of Helicobacter pylori Eradication with the Occurrences of Chronic Kidney Diseases in Patients with Peptic Ulcer Diseases

    Science.gov (United States)

    Wang, Jiunn-Wei; Hsu, Chien-Ning; Tai, Wei-Chen; Ku, Ming-Kun; Hung, Tsung-Hsing; Tseng, Kuo-Lun; Yuan, Lan-Ting; Nguang, Seng-Howe; Liang, Chih-Ming; Yang, Shih-Cheng; Wu, Cheng-Kun; Hsu, Pin-I; Wu, Deng-Chyang; Chuah, Seng-Kee

    2016-01-01

    The association of Helicobacter pylori eradication with the occurrence of renal dysfunction in patients with peptic ulcer diseases is still unclear. This study aimed to clarify the relevance of H. pylori eradication to the occurrence of chronic kidney diseases in patients with peptic ulcer diseases. Data that were available from 2000–2011 were extracted from the National Health Insurance Research Database in Taiwan, and all patients with peptic ulcer diseases (n = 208 196) were screened for eligibility. We divided randomly selected patients into an H. pylori eradication cohort (cohort A, n = 3593) and matched them by age and sex to a without H. pylori eradication cohort (cohort B, n = 3593). Subgroup analysis was further performed for H. pylori eradication within ≤ 90 days of the diagnosis date (early eradication, n = 2837) and within 91–365 days (non-early eradication, n = 756). Cox proportional hazards regression analysis was used to estimate the association of H. pylori eradication with the risk of developing chronic kidney diseases and mortality. We observed that there were more patients suffering from chronic kidney disease in cohort B than in the early eradication subgroup of cohort A (8.49% vs. 6.70%, respectively, p = 0.0075); the mortality rate was also higher in cohort B (4.76% vs. 3.70%, respectively, p = 0.0376). Old age, pulmonary disease, connective tissue disorders, and diabetes were risk factors for chronic kidney diseases but early H. pylori eradication was a protective factor against chronic kidney diseases (hazard ratio: 0.68, 95% confidence interval: 0.52–0.88, p = 0.0030), and death (hazard ratio: 0.69, 95% confidence interval: 0.49–0.96, p = 0.0297). In conclusion, our findings have important implications suggesting that early H. pylori eradication is mandatory since it is associated with a protective role against the occurrence of chronic kidney diseases. PMID:27764171

  19. New Understanding of the Etiology and Prevention of Peptic Ulcers in Elderly%老年胃溃疡病因与预防的新认识

    Institute of Scientific and Technical Information of China (English)

    胡燕

    2014-01-01

    老年人胃溃疡是最常见的消化系统疾病之一,当发生并发症后,会严重影响患者生活质量。本文总结了进几年对老年消化性溃疡的病因和预防措施的认识进展。%Peptic ulcer disease in elderly people is a common disorder that af ects mil ions of people worldwide. When complications occur, peptic ulcer disease can have a major impact on quality of life and on the utilisation of the health system. This article summarises the clinical aspects progress of the etiology and preventive measures of peptic ulcer disease.

  20. Body mass index is not associated with reoperation rates in patients with a surgically treated perforated peptic ulcer

    DEFF Research Database (Denmark)

    Duch, Patricia; Møller, Morten Hylander

    2015-01-01

    INTRODUCTION: The aim of the present nationwide Danish cohort study was to examine the association between body mass index (BMI) and reoperation in patients who are sur-gically treated for perforated peptic ulcer (PPU). METHODS: This was a nationwide cohort study of all Danish patients who were...... surgically treated for benign gastric or duodenal PPU between 2011 and 2013. OUTCOME MEASURES: reoperation within 30 days of the primary surgical procedure and 90-day survival. The association between BMI and reoperation are presented as crude and adjusted odds ratios (OR) with 95% confidence intervals (CIs...

  1. Experimental and clinical application of laser doppler flowmetry in gastric and duodenal ulcerative bleedings

    Directory of Open Access Journals (Sweden)

    Afanasieva G.A.

    2011-12-01

    Full Text Available The research goal is to develop a new objective diagnostic method of prerecurrence syndrome that will prognose bleeding recurrence from gastroduodenal ulcers. Materials and methods. Method of laser Doppler flowmetry (LDF of the regional perfusion of tissue has been used. The experimental part has been done on 30 white laboratory rats. Characteristics of regional tissue perfusion in the simulation and laser hemostasis of bleeding have been studied. Gastroduodenal endoscopy has been performed with laser Doppler flowmetry (ELDF in clinical conditions to predict the recurrence of ulcerative bleeding. The prognostic method of gastroduodenal ulcerative bleeding was used in 58 patients hospitalized with such pathology and activity of bleeding Forrest II. Results. The study of microcirculation parameters and experimental hemostasis has showed the possibility of using LDF to measure its performance. Effective hemostasis has been accompanied by a significant decrease in perfusion. On the basis of microcirculation parameters in ulcerative bleeding, medical adrenaline test has been proposed for an objective verification pre-recurrence syndrome. To evaluate the effectiveness of endoscopic hemostasis perfusion has been measured before and after its implementation. Conclusion. ELDF has objectified the prognosis of ulcerative bleeding recurrence, verified pre-recurrence syndrome and evaluated the efficacy of endoscopic hemostasis

  2. Evaluation and management of patients with recurrent peptic ulcer disease after acid-reducing operations: a systematic review.

    Science.gov (United States)

    Turnage, Richard H; Sarosi, George; Cryer, Byron; Spechler, Stuart; Peterson, Walter; Feldman, Mark

    2003-01-01

    This systematic review examines the evidence for commonly employed strategies of managing patients with recurrent ulcer disease after acid-reducing operations. Particular attention is given to recent evidence relating Helicobacter pylori (H. pylori ) and nonsteroidal anti-inflammatory drugs (NSAIDs) to ulcer recurrence after operative therapy. MEDLINE word searches of the literature from 1966 to 2001 identified 895 articles that cross-reference the terms "peptic ulcer disease (PUD)," "surgery," and "recurrence." Articles were selected for systematic review of evidence relating incomplete vagotomy, NSAIDs, and H. pylori to postoperative ulcer recurrence and evidence supporting common medical and surgical strategies. The relationship between incomplete vagotomy and recurrent ulcer disease is suggested by randomized controlled trials and well-designed prospective case series. The evidence that NSAID use is an important pathogenic factor in recurrent ulcer disease includes the relationship between NSAIDs and primary PUD, the occurrence of NSAID-induced ulcers in patients taking proton pump inhibitors, and case series demonstrating virulent ulcer disease in patients taking aspirin despite prior acid-reducing operations. The relationship between H. pylori infection and postoperative ulcer recurrence remains uncertain despite multiple controlled trials and well-designed case series that have documented high rates of H. pylori infection in postoperative patients. The initial management of patients with recurrent ulcer disease after acid-reducing operations consists of a protein pump inhibitor or a histamine-2 receptor antagonist and antibiotics directed at H. pylori, if present. Evidence for this regimen includes prospective randomized trials demonstrating the efficacy of cimetidine in healing ulcers after acid-reducing operations and prospective, randomized studies documenting the efficacy of histamine-2 receptor antagonists and protein pump inhibitors in the management

  3. 浅谈消化性溃疡患者的护理新观点%Introduction to Peptic Ulcer Patient Care New ideas

    Institute of Scientific and Technical Information of China (English)

    杨柳

    2013-01-01

    介绍了消化性溃疡的病因和发病机制、临床表现及治疗。重点阐述了消化性溃疡的一般护理、饮食调理、用药护理、心理护理、并发症的护理、消毒隔离及健康教育。%Introduce the etiology and pathogenesis of peptic ulcer disease, clinical manifestations and treatment. Expounds the peptic ulcer of general nursing, diet nursing, medication nursing, psychological nursing, complication nursing, disinfection, isolation and health education.

  4. Relationship between the acid-suppression efficacy of proton pump inhibitors and CYP2C19 genetic polymorphism in patients with peptic ulcer

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Objective To investigate acid-suppression efficacy of proton pump inhibitors(PPIs) in relation to CYP2C19 genetic polymorphism on patients with peptic ulcer. Methods By an open, randomized and control trial, fifty nine patients with active peptic ulcer were randomly assigned to receive one of three PPIs on a single dose (20 mg of each drug): omeprazole group (n=19), rabeprazole group (n=20) and esomeprazole group (n=20). Intragastric pH was recorded 1 hour before and 24 hours after administration. CYP2C19 g...

  5. An upper gastrointestinal ulcer still bleeding after endoscopy : what comes next?

    NARCIS (Netherlands)

    Craenen, E. M. E.; Hofker, Hendrik; Peters, Frans; Kater, G. M.; Glatman, K. R.; Zijlstra, J. G.

    2013-01-01

    Introduction: Recurrent bleeding from an upper gastrointestinal ulcer when endoscopy fails is a reason for radiological or surgical treatment, both of which have their advantages and disadvantages. Case: Based on a patient with recurrent gastrointestinal bleeding, we reviewed the available evidence

  6. An upper gastrointestinal ulcer still bleeding after endoscopy : what comes next?

    NARCIS (Netherlands)

    Craenen, E. M. E.; Hofker, Hendrik; Peters, Frans; Kater, G. M.; Glatman, K. R.; Zijlstra, J. G.

    Introduction: Recurrent bleeding from an upper gastrointestinal ulcer when endoscopy fails is a reason for radiological or surgical treatment, both of which have their advantages and disadvantages. Case: Based on a patient with recurrent gastrointestinal bleeding, we reviewed the available evidence

  7. Laparoscopic versus Open Omental Patch Repair for Early Presentation of Perforated Peptic Ulcer: Matched Retrospective Cohort Study

    Directory of Open Access Journals (Sweden)

    Daniel Jin Keat Lee

    2016-01-01

    Full Text Available Introduction. The aim of this study was to compare the outcomes between laparoscopic and open omental patch repair (LOPR versus OR in patients with similar presentation of perforated peptic ulcer (PPU. The secondary aim was to evaluate the outcomes according to the severity of peritonitis. Methods. All patients who underwent omental patch repair at two university-affiliated institutes between January 2010 and December 2014 were reviewed. Matched cohort between LOPR and OR groups was achieved by only including patients that had ulcer perforation 21, LOPR is also shown to benefit, particularly resulting in significant shorter LOS (4 days versus 11 days, p<0.01. Conclusion. LOPR offers improved short-term outcomes in patients who present within 48 hours and with perforation size <2 cm. LOPR also proved to be more beneficial in high MPI cases.

  8. [Antisecretory therapy as a component of hemostasis in acute gastroduodenal ulcer bleedings].

    Science.gov (United States)

    Gostishchev, V K; Evseev, M A

    2005-01-01

    Results of antisecretory therapy (pyrenzepin, H(2)-blockers, inhibitors of proton pump, octreotid) in 962 patients with acute gastroduodenal ulcer bleedings (AGDUB) were analyzed over 14-years period. Antisecretory treatment in AGDUB has principally different goals and potential depending on risk of bleeding's recurrence and morphological changes in tissue of gastroduodenal ulcer. Antisecretory therapy is the main treatment in high risk of AGDUB recurrence or before urgent surgery. Intravenous infusion of omeprazol has demonstrated the highest clinical efficacy due to maximal inhibition of gastric secretion and absence of negative influences on oxygen regimen in tissue of ulcer.

  9. Esophagitis in a High H. pylori Prevalence Area: Severe Disease Is Rare but Concomitant Peptic Ulcer Is Frequent

    Science.gov (United States)

    Ponce, Julio; Calvet, Xavier; Gallach, Marta; Ponce, Marta

    2011-01-01

    Background Few data are available on the prevalence of erosive and severe esophagitis in Western countries. Objective To retrospectively determine the prevalence and the factors predicting erosive esophagitis and severe esophagitis in a large series of endoscopies in Spain. Design Retrospective observational study. A multivariate analysis was performed to determine variables predicting severe esophagitis. Setting Databases of 29 Spanish endoscopy units. Patients Patients submitted to a diagnostic endoscopy during the year 2005. Interventions Retrospective review of the databases. Main Outcome Measurements Esophagitis severity (graded according to the Los Angeles classification) and associated endoscopic findings. Results Esophagitis was observed in 8.7% of the 93,699 endoscopies reviewed. Severe esophagitis (LA grade C or D) accounted for 22.5% of cases of the disease and was found in 1.9% of all endoscopies. Incidences of esophagitis and those of severe esophagitis were 86.2 and 18.7 cases per 100,000 inhabitants per year respectively. Male sex (OR 1.89) and advanced age (OR 4.2 for patients in the fourth age quartile) were the only variables associated with severe esophagitis. Associated peptic ulcer was present in 8.8% of cases. Limitations Retrospective study, no data on individual proton pump inhibitors use. Conclusions Severe esophagitis is an infrequent finding in Spain. It occurs predominantly in males and in older individuals. Peptic ulcer disease is frequently associated with erosive esophagitis. PMID:22022373

  10. Esophagitis in a high H. pylori prevalence area: severe disease is rare but concomitant peptic ulcer is frequent.

    Directory of Open Access Journals (Sweden)

    Julio Ponce

    Full Text Available BACKGROUND: Few data are available on the prevalence of erosive and severe esophagitis in Western countries. OBJECTIVE: To retrospectively determine the prevalence and the factors predicting erosive esophagitis and severe esophagitis in a large series of endoscopies in Spain. DESIGN: Retrospective observational study. A multivariate analysis was performed to determine variables predicting severe esophagitis. SETTING: Databases of 29 Spanish endoscopy units. PATIENTS: Patients submitted to a diagnostic endoscopy during the year 2005. INTERVENTIONS: Retrospective review of the databases. MAIN OUTCOME MEASUREMENTS: Esophagitis severity (graded according to the Los Angeles classification and associated endoscopic findings. RESULTS: Esophagitis was observed in 8.7% of the 93,699 endoscopies reviewed. Severe esophagitis (LA grade C or D accounted for 22.5% of cases of the disease and was found in 1.9% of all endoscopies. Incidences of esophagitis and those of severe esophagitis were 86.2 and 18.7 cases per 100,000 inhabitants per year respectively. Male sex (OR 1.89 and advanced age (OR 4.2 for patients in the fourth age quartile were the only variables associated with severe esophagitis. Associated peptic ulcer was present in 8.8% of cases. LIMITATIONS: Retrospective study, no data on individual proton pump inhibitors use. CONCLUSIONS: Severe esophagitis is an infrequent finding in Spain. It occurs predominantly in males and in older individuals. Peptic ulcer disease is frequently associated with erosive esophagitis.

  11. Is peptic ulcer disease a risk factor of postherpetic neuralgia in patients with herpes zoster?

    Science.gov (United States)

    Chen, Jen-Yin; Chang, Chia-Yu; Lan, Kuo-Mao; Sheu, Ming-Jen; Lu, Chin-Li; Hu, Miao-Lin

    2013-11-01

    Postherpetic neuralgia is the most common complication of herpes zoster which is caused by a reactivation of latent varicella zoster virus. The pathogenesis of postherpetic neuralgia may involve peripheral and central mechanisms. Reported risk factors for postherpetic neuralgia include female gender, old age, diminished cell-mediated immunity and nutritional deficiencies. Based on our clinical observation which revealed that peptic ulcer disease (PUD) is one of the common comorbidities in patients with postherpetic neuralgia, we hypothesize that herpes zoster patients with PUD may be at a greater risk for the development of postherpetic neuralgia due to their impaired cellular immunity and depressed nutritional status. Major causes of PUD include Helicobacter pylori infection and usage of ulcerogenic medications. Patients with H. pylori infection may develop T cell dysfunctions and nutritional deficiencies including vitamin C, iron, cobalamin, carotenes and alpha-tocopherol. Ulcerogenic medications such as nonsteroidal anti-inflammatory drugs and steroids have been found not only to be ulcerogenic but also immunosuppressive to T cells. In addition, usage of steroids and nonsteroidal anti-inflammatory drugs may cause deficiencies of alpha-tocopherol, carotenes, cobalamin, iron, zinc and vitamin C. Vitamin C, carotenes and alpha-tocopherol are anti-inflammatory and the major oxidant scavengers in the aqua phase and biomembranes. Deficiencies of these nutrients may induce dysregulated inflammation and oxidative damage leading to neuropathic pain in patients with herpes zoster. Furthermore, nutrient deficiencies including zinc, iron, cobalamin and vitamin C are associated with dysregulation of Ca(v)3.2 T-channels and N-methyl-D-aspartate receptors, upregulation of nitric oxide synthase, the increase of nitric oxide formation and dysfunction of central norepinephrine inhibitory pain pathway. Prospective cohort studies are suggested to test the hypothesis. We further

  12. Platelet aggregation measurement for assessment of hemostasis failure mechanisms in patients with gastroduodenal ulcer bleeding

    Directory of Open Access Journals (Sweden)

    Barinov E

    2013-08-01

    Full Text Available Edward Barinov,1 Oksana Sulaieva,1 Yuriy Lyakch,2 Vitaliy Guryanov,2 Petr Kondratenko,3 Yevgeniy Radenko3 1Department of Histology, Cytology, and Embryology, 2Department of Medical, Biological Physics, Medical Informatics, and Biostatistics, 3Department of Surgery and Endoscopy, M Gorky Donetsk National Medical University, Donetsk, Ukraine Background: The purpose of this study was to identify factors associated with the risk of unsustainable hemostasis in patients with gastric and duodenal ulcer bleeding by in vitro assessment of platelet reactivity using artificial neural networks. Methods: Patients with gastroduodenal ulcers complicated by bleeding were studied. Platelet aggregation was measured using aggregometry with adenosine diphosphate 5 µM, epinephrine 2.5 µM, 5-hydroxytryptophan 10 µM, collagen 1 µM, and thrombin 0.06 NIH Unit/mL as agonists. Multiple logistic regression was used to evaluate the independent relationship between demographic, clinical, endoscopic, and laboratory data and in vitro assessment of platelet reactivity and local parameters of hemostasis in patients with ulcer bleeding. Results: Analysis of platelet aggregation in patients with gastroduodenal ulcer bleeding allowed the variability of platelet response to different agonists used in effective concentration which induces 50% platelet aggregation (EC50 to be established. The relationship between platelet aggregation and the spatial-temporal characteristics of ulcers complicated by bleeding was demonstrated. Adrenoreactivity of platelets was associated with time elapsed since the start of ulcer bleeding and degree of hemorrhage. The lowest platelet response to collagen and thrombin was detected in patients with active bleeding (P< 0.001 and unsustainable recent bleeding (P < 0.01. Decreased adenosine diphosphate-induced platelet aggregation in patients with ulcer bleeding was correlated with the platelet response to thrombin (r = 0.714, P < 0.001 and collagen (r

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

    Science.gov (United States)

    Oleastro, Mónica; Monteiro, Lurdes; Lehours, Philippe; Mégraud, Francis; Ménard, Armelle

    2006-01-01

    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. PMID:16790780

  14. [A Norwegian conference on updating of the treatment of Helicobacter pylori in peptic ulcer. Interessegruppe for Gastroenterologi].

    Science.gov (United States)

    1994-09-10

    Recent data on peptic ulcer and Helicobacter pylori colonization of the ventricle were discussed. Agreement was reached to re-adjust the pharmacological treatment of this condition. All patients for whom antibiotic therapy is considered should be examined by gastroscope. The bacterial agent should be proved by at least one out of several available methods. Two different established regimens are prescribed, either triple therapy with bismuth, metronidazole and tetracycline or double treatment without bismuth, for instance amoxicillin and omeprazole. Clinical control should take place after about eight weeks, with a "breath-test" in the case of duodenal ulcers, or with gastroscopy and a urease test. Many pointed out that treatment aimed at gastric acid reduction is to be preferred in cases of first occurrence of ventricular ulcers. Long-term acid reduction by drugs should not be offered to a patient until an attempt has been made to eradicate existing bacteria. No patient should be operated on before he being given antibacterial treatment. Treatment of non-ulcer dyspepsia with antibiotics has not shown to have an affect.

  15. Research progress in new dosage forms of peptic ulcer drugs%消化性溃疡药物新剂型研究进展

    Institute of Scientific and Technical Information of China (English)

    王坚; 黄绳武

    2012-01-01

    Peptic ulcer is a disease of the digestive system, since the discovery of Helicobacter pylori, the pathogenesis and treatment strategy of peptic ulcer have undergone fundamental changes, the new strategy of treatment of peptic ulcer should be as follows: protection of gastric nucosa, inhibiting of gastric acid and eradication of H. Pylori. There are some prospects for the development of new formulations of peptic ulcer drugs. According to pertinent literature, the preparation technology, clinical application of chewing tablets were reviewed, and to provide the reference for further research.%消化性溃疡为消化系统的多发疾病,自从发现幽门螺杆菌(Helicobacter pylori,Hp)以来,人们对Hp发病机制的认识和治疗策略上都发生了根本性变化.消化性溃疡治疗新策略应该是保护胃黏膜、抑制胃酸、根除Hp,因此,消化性溃疡药物新剂型具有一定的发展前景.本文依据相关综述消化性溃疡药物的新剂型,并介绍各个剂型的制备工艺、临床应用等,为更深入的研究提供参考.

  16. Tratamientos convencionales y medicina alternativa de la úlcera péptica Conventional treatment and herbal medicine for peptic ulcer

    Directory of Open Access Journals (Sweden)

    Ada Ivis Regalado Veloz

    2012-03-01

    Full Text Available Entre las enfermedades que afectan al hombre y provocan alteraciones en su vida individual y social se encuentra la úlcera péptica, muy frecuente en casi todos los países del mundo. La úlcera péptica viene asociada generalmente al consumo de antiinflamatorios no esteroidales o a la infección por Helicobacter pylori, por lo que el tratamiento farmacológico difiere entre un caso u otro. Se tienen en cuenta varios aspectos como: la posibilidad de los fármacos antiulcerosos de interaccionar con otros principios activos y alimentos, además de los efectos no deseados que se presentan; los tratamientos de triples y cuádruples terapias que constituyen una limitante para el paciente por el gran número de medicamentos a administrar; y por último, el actual incremento de la resistencia antibiótica, se hace necesario la búsqueda de otras alternativas para el control de esta enfermedad. Un nuevo camino que brinda grandes posibilidades es la medicina alternativa, es decir, los fitofármacos.Peptic ulcer is one of the diseases affecting humans and causing changes in their individual and social life. It is very common in almost every country in the world. Peptic ulcer is usually associated to the consumption of non-steroidal anti-inflammatory or to Helicobacter pylori infection; hence, the drug treatment differs from one case to another. Various aspects such as the possibility of anti-ulcer drugs to interact with other active ingredients and foodstuffs, the adverse effects, the application of three or four therapies that bother the patient because of the the large number of drugs to be taken, and finally the current increased antibiotic resistance were taken into consideration. It is necessary to search for alternatives to control this disease. The alternative medicine, i.e. the herbal medicine offers new possibilities of treatment.

  17. Efficacy of four kinds of endoscopic therapy on peptic deer bleeding%内镜下四种方法治疗消化性溃疡出血的疗效

    Institute of Scientific and Technical Information of China (English)

    姜英杰; 聂玉强; 李瑜元; 张龙

    2009-01-01

    Objective To evaluate the efficacy of 4 kinds of endoscopic therapy on peptic ulcer bleeding. Methods Three hundred and forty-nine patients with active ulcer bleeding or non-bleeding visible vessels were respectively divided into 4 groups according to endoscopic therapies (adrenaline injection group, titanic clip placement group, argon beam coagulation group and combined treatment group). One hundred and fifty-seven patients were treated to stop bleeding with injection of adrenaline in adrenaline injection group, 46 with titanic clips in titanic clip placement group, 51 with argon beam coagulation in argon beam coagulation group, and 95 patients with combination of injection and argon beam coagulation in combined treatment group. The hemostasis effects were compared among four groups. Results In all the groups, the immediate hemostasis rate was 100%, and effective hemostasis was achieved in 87.9%, 89.1%,86.3% and 91.6% of the patients who underwent adrenaline injection, titanic clip placement, argon beam coagulation and combined treatment respectively, with no statistical difference among the groups (P>0.05). For patients with Forrest Ⅰ a lesions, the effective hemostasis rate with adrenaline injection (55.0%) was significantly lower as compared with other treatment options (P0.05).肾上腺素注射组中,Forrest Ⅰ a患者的有效止血率为55.0%,明显低于其余3组患者(P<0.01).结论 4种内镜下治疗均能有效、安全止血.药物注射对Forrest Ⅰ a患者的止血效果差.

  18. Phenotypic and genotypic characterization of Helicobacter pylori from patients with and without peptic ulcer disease

    DEFF Research Database (Denmark)

    Petersen, A M; Fussing, V; Colding, H

    2000-01-01

    divided into five groups on the basis of upper endoscopic findings: gastric ulcer, duodenal ulcer, gastritis, esophagitis, or normal. The ultrastructural adherence pattern in vivo, autoagglutination, hemagglutination, adhesion to human gastric adenocarcinoma (AGS) cells, and the lipopolysaccharide (LPS...

  19. ENDOSCOPIC DIAGNOSIS AND TREATMENT OF UPPER GASTROINTESTINAL BLEEDING

    Directory of Open Access Journals (Sweden)

    Daniela Benedeto-Stojanov

    2015-06-01

    Full Text Available Upper gastrointestinal bleeding (UGB is a common medical emergency problem with significant morbidity and mortality. The aim of this paper is to establish the incidence of upper gastrointestinal bleeding in relation to sex and age, determine the prevalence of bleeding lesions and perform analysis of bleeding peptic ulcer in relation to the location, age, gender, Forrest classification and the need for endoscopic hemostasis. Thе prospective study included 70 patients with UGB, 42 men and 28 women, mean age 68.64±13.66 years. The diagnosis of bleeding lesions was made exclusively by means of esophagogastroduodenoscopy. Forrest classification was used in the evaluation of the activity of bleeding ulcers of the stomach and duodenum. The largest number of bleeding patients was of male sex (60%. Bleeding most commonly occurred in patients older than 60 years (84.29%. Statistically, female patients were significantly older than patients of male gender (p=0.001. The most common cause of bleeding was peptic ulcer (65.71%. The average age of patients with gastric ulcer was 70.57±15.68 years, with a duodenal ulcer 63.78±16.70 years. In the duodenum, Forrest Ib, IIa and IIb ulcers were usually confirmed, whereas Forrest IIc ulcers were identified in the stomach. Endoscopic hemostasis was required in 55.56% of patients with duodenal and in 23.81% of patients with gastric ulcer. The incidence of UGB is higher in men and it increases with age. The most common cause of bleeding is ulcer disease. Patients with gastric ulcer are older than patients with duodenal ulcer, while both gastric and duodenal ulcers are found in the oldest patients. Duodenal ulcers cause serious bleeding and more often require endoscopic hemostasis.

  20. Clinical features of peptic ulcer in 103 old-aged patients%103例老年消化性溃疡临床特征分析

    Institute of Scientific and Technical Information of China (English)

    李良玉

    2011-01-01

    目的 探讨老年消化性溃疡的临床特征.方法 回顾性分析231例同期收治的消化性溃疡患者的临床资料,分为老年组(n=103)和中青年组(n=128),比较两组溃疡诱发因素、临床表现、溃疡部位及大小、并发症及伴随疾病、治疗和预后情况.结果老年组与中青年组中与非甾体类抗炎药(NSAIDS)有关的溃疡分别为21.4%和6.2%,P<0.01;与家族及精神因素有关的老年组中占7.7%较中青年组的3.1%明显增高,P<0.01.两组节律性腹痛发生率11.7%与26.6%(P<0.01);老年组中有54.4%溃疡发生于胃,而中青年组有28.9%,P<0.01.溃疡发生于十二指肠者老年组中有36例(35.0%),中青年组有83例(64.8%),P<0.01.老年组中溃疡直径小于或等于1 cm的比例(33.0%)较中青年组(60.1%)明显降低(P<0.01).老年组中溃疡直径大于2 cm的比例(22.3%)较中青年组(14.1%)明显升高(P<0.01).老年组出血、癌变、穿孔、梗阻的发生率较中青年组明显增高.老年组死亡率和复发率均高于中青年组.结论老年消化性溃疡临床表现不典型,胃溃疡较多,并发症多发,复发率和死亡率高,因此,临床上应引起高度重视.%Objective To explore the clinical features of peptic ulcer in old aged patients. Methods Totally 231 patients with peptic ulcer were divided into old-aged group (n= 103 ) and young and middle aged group (n= 128 ). The causative factor, clinical manifestation,ulcer locus and size, complication, therapy and prognosis of the two groups were analyzed. Results In the two groups, non-steroid anti-inflammatory drugs( NSAIDS) related ulcer accounted for 21.4% and 6.2%; Family and psychology related ulcer accounted for 7.7% and 3.1%. In the two groups, the incidences of rhythmicity stomachache were 11.7% and 26.6%; incidences of gastrelcosis were 54.4% and 28.9%; incidences of duodenal ulcer were 35.0% and 64.8% (P < 0.01 ). Incidences of bleeding, cancerization, perforation, pyloric

  1. A STUDY ON UPPER GASTROINTESTINAL ENDOSCOPIC FINDINGS IN PATIENTS WITH UPPER GASTROINTESTINAL BLEEDING

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    Salla Surya Prakasa Rao

    2016-10-01

    Full Text Available BACKGROUND Vomiting of blood almost always proximal to the ligament of Treitz is the upper gastrointestinal haemorrhage. The incidence of acute upper gastrointestinal haemorrhage has been estimated to be 50-100 per 1,00,000 person per year, with an annual hospitalization rate of approximately 100 per 1, 00,000 hospital admission. This study is to find out the prevalence of nature of lesion on Upper Gastrointestinal Endoscopy in patients admitted for Gastrointestinal bleeding. (UGI Bleed. MATERIALS AND METHODS Place of Study- Department of General Medicine, Andhra Medical College, Visakhapatnam, India. Type of Study- Prospective study. Period of Study- July 2015 to August 2016. RESULTS The Results Study on Endoscopic Findings in Upper Gastro Intestinal Bleed are 1. The peptic ulcer disease was the most common lesion found on endoscopy with prevalence of 54%. 2. Varices contributes second common lesion, next to peptic ulcer disease in UGI bleed with prevalence of 16%. 3. Minor UGI bleed was the commonest presentation. Majority of lesions (60% presented with minor UGI bleed, 28% lesions presented as moderate UGI bleed. Only 8% presented as major UGI bleed. 4. Varices account for the most common cause for major UGI bleed contributing 50%. 5. Gastric ulcer was commonest lesions accounting for 37 cases (37% among 72 cases having single acid peptic lesions on endoscopy. The second most common is duodenal ulcer (31%. 6. Multiple lesions were found in 10% of cases. Peptic ulcer lesions were found in 20% of total number of varices cases. CONCLUSION Peptic ulcer disease was found to be most common lesion causing UGI bleed, with most common presentation as minor UGI bleed and variceal bleed being most common cause of major UGI bleed.

  2. Effects of killing Helicobacter pylori quadruple therapy on peptic ulcer: A randomized double-blind clinical trial

    Institute of Scientific and Technical Information of China (English)

    Li-Ying Feng; Xi-Xian Yao; Shu-Lin Jiang

    2005-01-01

    AIM: To study the therapeutic efficacy of a Chinese and Western integrated regimen, killing Helicobacter pylori quadruple therapy on H pylori-associated peptic ulcers(PU).METHODS: With prospective and double-blind controlled method, seventy-five active PU patients with H pylori infection were randomized to receive one of the following three regimens: (1) new triple therapy (group A:lansoprazole 30 mg qd, plus clarithromycin 250 mg bid,plus amoxycillin 500 mg tid, each for 10 d); (2) killing Hp quadruple therapy(group B: the three above drugs plus killing H pylori capsule 6 capsules bid for 4 wk) and (3)placebo(group C: gastropine 3 tablets bid for 4 wk).H pylori eradication and ulcer healing quality were evaluated under an endoscope 4 wk after treatment. The patients were followed up for 5 years.RESULTS: Both the healing rate of PU and H pylori eradication rate in group B were significantly higher than those in group C (100% and 96.4% vs 20% and 0%,respectively, P<0.005), but there was no significant difference compared to those in group A (88% and92%, P>0.05). The healing quality of ulcer in group B was superior to that in groups C and A (P<0.05). The recurrence rate of PU in group B (4%) was lower than that in group A (10%) and group C (100%, P<0.01).CONCLUSION: Killing Helicobacter pylori quadruple therapy can not only promote the eradication of H pylori and healing quality of ulcer but also reduce recurrence rate of ulcer.

  3. Interpretation of Japan“Evidence-based Clinical Practice Guidelines for Peptic Ulcer Disease 2015”%日本《消化性溃疡循证临床实践指南(2015年)》解读

    Institute of Scientific and Technical Information of China (English)

    刘文忠

    2016-01-01

    2015年,日本胃肠病学会修订了消化性溃疡循证临床实践指南。修订的内容包括以下几项:出血性胃和十二指肠溃疡、幽门螺杆菌(Hp)根除治疗、非根除 Hp 治疗、药物诱发的溃疡、非 Hp-非非甾体消炎药(NSAID)溃疡和外科手术治疗。该指南详细陈述了上述内容,是我们临床实践中良好的参考材料。为此,本文对该指南作详细解读。%The Japanese Society of Gastroenterology revised the evidence-based clinical practice guidelines for peptic ulcer disease in 2015. The revised guidelines consist of the following items:bleeding gastric and duodenal ulcers, Helicobacter pylori(Hp)eradication therapy and non-eradication therapy,drug-induced ulcer,non-Hp/ non-nonsteroidal anti-inflammatory drug( NSAID)-induced ulcer,and surgical treatment. This guideline describes the abovementioned content in detail and is a good reference for clinical practice. A full interpretation of this guideline was performed in this paper.

  4. Octreotide in the Control of Post-Sclerotherapy Bleeding from Oesophageal Varices, Ulcers and Oesophagitis

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    Spencer A. Jenkins

    1996-01-01

    Full Text Available Bleeding from oesophageal varices, oesophageal ulcers or oesophagitis is occasionally massive and difficult to control. Octreotide, a synthetic analogue of somatostin lowers portal pressure and collateral blood flow including that through varices, increases lower oesophageal sphincter pressure, and inhibits the gastric secretion of acid as well as pepsin. Our current experience suggests it is effective in controlling acute variceal haemorrhage. Therefore we have examined the efficacy of octreotide in the control of postsclerotherapy bleeding from oesophageal varices, oesophageal ulcers and oesophagitis. During the study period 77 patients experienced a significant gastrointestinal bleed (blood pressure 100 beats per min or the need to transfuse 2 or more units of blood to restore the haemoglobin level following injection sclerotherapy of oesophageal varices. The source of bleeding was varices in 42 patients, oesophageal ulcers in 31 and oesophagitis in 4. All patients received a continuous intravenous infusion of octreotide (50 μg/h for between 40–140h. If bleeding was not controlled in the first 12h after commencing octreotide hourly bolus doses (50 μg for 24h were superimposed on the continuous infusion. Haemorrhage was successfully controlled by an infusion of octreotide in 38 of the 42 patients with bleeding from varices, in 30 of 31 patients with oesophageal ulceration, and all patients with oesophagitis. In the 1 patient with persistent bleeding from oesophageal ulceration and in 2 of the 4 with continued haemorrhage from varices, haemostasis was achieved by hourly boluses of 50 μg octreotide for 24h in addition to the continuous infusion. No major complications were associated with octreotide administration. The results of this study clearly indicate that octreotide is a safe and effective treatment for the control of severe haemorrhage after technically successful injection sclerotherapy.

  5. Efficacy of levofloxacin, amoxicillin and a proton pump inhibitor in the eradication of Helicobacter pylori in Brazilian patients with peptic ulcers

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    Fernando Marcuz Silva

    2015-05-01

    Full Text Available OBJECTIVES: The eradication of Helicobacter (H. pylori allows peptic ulcers in patients infected with the bacteria to be cured. Treatment with the classic triple regimen (proton pump inhibitor, amoxicillin and clarithromycin has shown decreased efficacy due to increased bacterial resistance to clarithromycin. In our country, the eradication rate by intention to treat with this regimen is 83%. In Brazil, a commercially available regimen for bacterial eradication that uses levofloxacin and amoxicillin with lansoprazole is available; however, its efficacy is not known. Considering that such a treatment may be an alternative to the classic regimen, we aimed to verify its efficacy in H. pylori eradication. METHODS: Patients with peptic ulcer disease infected with H. pylori who had not received prior treatment were treated with the following regimen: 30 mg lansoprazole bid, 1,000 mg amoxicillin bid and 500 mg levofloxacin, once a day for 7 days. RESULTS: A total of 66 patients were evaluated. The patients’ mean age was 52 years, and women comprised 55% of the sample. Duodenal ulcers were present in 50% of cases, and gastric ulcers were present in 30%. The eradication rate was 74% per protocol and 73% by intention to treat. Adverse effects were reported by 49 patients (74% and were mild to moderate, with a prevalence of diarrhea complaints. CONCLUSIONS: Triple therapy comprising lansoprazole, amoxicillin and levofloxacin for 7 days for the eradication of H. pylori in Brazilian peptic ulcer patients showed a lower efficacy than that of the classic triple regimen.

  6. Solitary tubercular caecal ulcer causing massive lower gastrointestinal bleed: a formidable diagnostic challenge.

    Science.gov (United States)

    Ram, Duvuru; Karthikeyan, Vilvapathy Senguttuvan; Sistla, Sarath Chandra; Ali, Sheik Manwar

    2014-03-06

    Gastrointestinal (GI) haemorrhage is a common surgical emergency accounting for approximately 1% of acute hospital admissions. Lower GI bleed is less common and less severe than upper GI bleed and is usually caused by diverticulosis, neoplasms, angiodysplasia and inflammatory bowel disease. A 51-year-old man presented with massive lower GI bleed. He had no history of tuberculosis. He underwent colonoscopy and an isolated caecal ulcer was noted. Segmental ileocaecal resection was performed and no specific cause was identifiable on histopathology. PCR was performed on this specimen and it was positive for Mycobacterium tuberculosis. This case reports the unusual presentation of tuberculosis as solitary caecal ulcer with massive lower GI bleed and highlights the role of PCR as an adjuvant diagnostic tool for its diagnosis when characteristic histopathological findings are absent.

  7. A rare cause of chronic rectal bleeding in children; solitary rectal ulcer: case report.

    Science.gov (United States)

    Temiz, Abdulkerim; Tander, Burak; Temiz, Muhyittin; Barış, Sancar; Arıtürk, Ender

    2011-03-01

    Solitary rectal ulcer causing lower gastrointestinal bleeding is extremely rare in children. Rare presentation, non-specific symptoms, insufficient experience, and characteristics mimicking other rectal diseases may cause misdiagnosis or delay of diagnosis in some pediatric patients. Here, we report a 10-year-old boy with solitary rectal ulcer diagnosed two years after onset of the symptoms who responded well to the conservative therapy, including high-fiber diet, laxatives, defecation training, and sucralfate enema.

  8. How host regulation of Helicobacter pylori-induced gastritis protects against peptic ulcer disease and gastric cancer.

    Science.gov (United States)

    Dhar, Poshmaal; Ng, Garrett Z; Sutton, Philip

    2016-09-01

    The bacterial pathogen Helicobacter pylori is the etiological agent of a range of gastrointestinal pathologies including peptic ulcer disease and the major killer, gastric adenocarcinoma. Infection with this bacterium induces a chronic inflammatory response in the gastric mucosa (gastritis). It is this gastritis that, over decades, eventually drives the development of H. pylori-associated disease in some individuals. The majority of studies investigating H. pylori pathogenesis have focused on factors that promote disease development in infected individuals. However, an estimated 85% of those infected with H. pylori remain completely asymptomatic, despite the presence of pathogenic bacteria that drive a chronic gastritis that lasts many decades. This indicates the presence of highly effective regulatory processes in the host that, in most cases, keeps a check on inflammation and protect against disease. In this minireview we discuss such known host factors and how they prevent the development of H. pylori-associated pathologies.

  9. Long-term mortality following peptic ulcer perforation in the PULP trial. A nationwide follow-up study

    DEFF Research Database (Denmark)

    Møller, Morten Hylander; Vester-Andersen, Morten; Thomsen, Reimar Wernich

    2013-01-01

    surgically treated for PPU between 1 January 2008 and 31 December 2009. Patients: 117 patients in the intervention group and 512 in the control group. Intervention: a perioperative care protocol based on The Surviving Sepsis Guidelines. Outcome measures: 60-day, 90-day, 180-day, 1-year, and 2-year mortality.......268). After 180 days, the mortality difference was reduced additionally (31% vs. 33%, p = 0.645), and one year postoperatively, a mortality difference was no longer present (36% in both groups, p = 0.993). Two years postoperatively, the mortality rate in the intervention group was 44%, as compared to 40......Abstract Objective. Morbidity and mortality following perforated peptic ulcer (PPU) remain substantial. In the recently published PULP trial, 30-day mortality in patients surgically treated for PPU decreased from 27% to 17% following the implementation of a perioperative care protocol based...

  10. Clinical effects of surgical therapy on peptic ulcer with perforation in elderly patients%手术治疗老年消化性溃疡穿孔的临床疗效

    Institute of Scientific and Technical Information of China (English)

    刘绍群; 曹奕鸥

    2014-01-01

    目的 探讨手术治疗老年消化性溃疡穿孔患者的临床疗效.方法 75例消化性溃疡急性穿孔老年患者,根据治疗方式分为保守治疗组33例和手术治疗组42例.观察2组溃疡愈合情况.术后随访,观察穿孔复发和并发症发生情况.结果 手术治疗组患者死亡3例,保守治疗组1例因大出血转为手术治疗.溃疡愈合率手术治疗组为90.0% (36/40),保守治疗组为84.4% (27/32),2组比较差异无统计学意义(P>0.05);2组患者1年和2年穿孔复发率差异无统计学意义(P>0.05);2组术后消化道出血、幽门梗阻和癌变发生率差异无统计学意义(P>0.05).结论 老年消化性溃疡穿孔治疗应根据患者自身情况选择合适方式.%Objective To explore the effect of surgical therapy on peptic ulcer with perforation in elderly patients.Methods A total of 75 elderly patients with peptic ulcer combined perforation were divided into conservative treatment group (n =33) and surgical treatment group (n =42).The quality of ulcer healing,recurrence of perforation and complication were observed by follow up.Results Three cases was dead from multiple organ failure in surgical treatment.One case in conservation group transferred to surgical therapy as massive haemorrhage.The ulcer healing rate was 90.0% in surgical therapy group and 84.4% in conservation group,with no significant difference (P > 0.05).There was no significant difference in incidence of perforation recurrence between two groups 1 and 2 years after (P > 0.05),so were the incidence of gastrointestinal bleeding,pyloric obstruction cancerization (P > 0.05).Conclusion The treatment for elderly patients with peptic ulcer and perforation should be selected properly.

  11. [Dynamics of production of interleukin-1 by monocytes after hemosorption in patients with peptic ulcer].

    Science.gov (United States)

    Ketlinskiĭ, S A; Zhidkov, K P; Pigareva, N V

    1991-02-01

    The spontaneous and induced production of monokine++-interleukin-1 (IL-1) by the peripheral blood monocytes under the influence of autotransfusions of hemosorbent-treated blood (AHTB) was studied in 22 patients with an unfavorable course of ulcer disease. The spontaneous production of IL-1 was found to grow successively after a course of AHTB in patients with ulcer disease with terms of cicatrization more than 2 weeks. In patients with slow cicatrization of ulcers the IL-1 production did not change.

  12. [Influence of electro-stimulation at auriculo-stomach point in electrogastrogram of peptic ulcer patients].

    Science.gov (United States)

    Cai, G W; Yang, Y; Liang, S Z

    1994-11-01

    Through observation on electrogastrogramm (EGG) with electro-stimulation at Auriculo-Stomach and Auriculo-Heart points and in 60 gastric and duodenal ulcer patients without any treatment as control. Results showed that after electro-stimulation at Stomach point the EGG amplitude of ulcer patients' gastric antrum and corpus was reduced (P 0.05). There were also no effects of three methods on the EGG frequency of ulcer patients' gastric antrum and corpus (P < 0.05). It proves that electro-stimulation at Stomach point has some therapeutic effect to ulcer patients.

  13. [Relapse of bleeding ulcer in a 15 year-old boy with collagenous gastritis].

    Science.gov (United States)

    Haase, Anne-Mette; Kelsen, Jens

    2012-06-18

    Collagenous gastritis (CG) is a rare disorder. Two patient groups are known: 1) Children and young adults, presenting with anaemia and abdominal pain, and 2) adults presenting with watery diarrhoea. In the latter group, CG is frequently associated with collagenous colitis and/or coeliac disease. This case concerns a 15-year-old boy with a bleeding ulcer. The biopsies from corpus ventriculi showed a thickened subepithelial collagen band (> 10 micrometres), and the patient was diagnosed with CG. Ulcers are rarely linked to CG. CG should be considered when ulcers are found in children and young adults.

  14. Application of laparoscopic technique in the treatment of peptic ulcer perforation%腹腔镜技术在消化性溃疡穿孔治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    邓振宇; 邱振雄; 黄振华

    2014-01-01

    Objective:To investigate the application value of Laparoscopic technique in the treatment of peptic ulcer perforation.Methods:Clinical data of patients with peptic ulcer perforation treated by Laparoscopic technique ( observation group) and laparotomy ( control group) were analyzed. And the treatment outcomes of the two groups were compared. Results:There were statistical significance of operation time, intraoperative bleeding volume, postoperative exhaust time, postoperative activity time, incision size, postoperative infection and length of stay, and other indicators between the two groups ( P<0.05) . All the patients obtained effective follow-up visit from 3 to 28 months, and there was no significant complication after the operation. Conclusion:The application of Laparoscopic technique in the treatment of peptic ulcer perforation is safe and reliable, which has minimal trauma, less bleeding, quick recovery, less complication, short hospitalization time. It is an ideal operation method with satisfactory effect.%目的:探讨腹腔镜技术在消化性溃疡穿孔治疗中的应用价值。方法:对应用腹腔镜技术治疗消化性溃疡穿孔的患者(观察组)及开腹手术的患者(对照组)的临床资料进行分析,并对两组治疗效果进行对比。结果:两组患者手术时间、术中出血量、术后排气时间、术后下床活动时间、切口大小、术后切口感染及住院时间等指标比较,差异有统计学意义( P<0.05)。所有患者获得有效随访,随访时间3~28个月,术后未见明显并发症。结论:应用腹腔镜技术治疗消化性溃疡穿孔安全可靠,创伤小,出血少,恢复快,并发症少,住院时间短,是一种理想的手术方法,效果满意。

  15. STROBE-Long-Term Exposure to Ambient Fine Particulate Air Pollution and Hospitalization Due to Peptic Ulcers.

    Science.gov (United States)

    Wong, Chit-Ming; Tsang, Hilda; Lai, Hak-Kan; Thach, Thuan-Quoc; Thomas, G Neil; Chan, King-Pan; Lee, Siu-Yin; Ayres, Jon G; Lam, Tai-Hing; Leung, Wai K

    2016-05-01

    Little is known about the effect of air pollution on the gastrointestinal (GI) system. We investigated the association between long-term exposures to outdoor fine particles (PM2.5) and hospitalization for peptic ulcer diseases (PUDs) in a large cohort of Hong Kong Chinese elderly.A total of 66,820 subjects aged ≥65 years who were enrolled in all 18 Government Elderly Health Service centers of Hong Kong participated in the study voluntarily between 1998 and 2001. They were prospectively followed up for more than 10 years. Annual mean exposures to PM2.5 at residence of individuals were estimated by satellite data through linkage with address details including floor level. All hospital admission records of the subjects up to December 31, 2010 were retrieved from the central database of Hospital Authority. We used Cox regression to estimate the hazard ratio (HR) for PUD hospitalization associated with PM2.5 exposure after adjustment for individual and ecological covariates.A total of 60,273 subjects had completed baseline information including medical, socio-demographic, lifestyle, and anthropometric data at recruitment. During the follow-up period, 1991 (3.3%) subjects had been hospitalized for PUD. The adjusted HR for PUD hospitalization per 10 μg/m of PM2.5 was 1.18 (95% confidence interval: 1.02-1.36, P = 0.02). Further analysis showed that the associations with PM2.5 were significant for gastric ulcers (HR 1.29; 1.09-1.53, P = 0.003) but not for duodenal ulcers (HR 0.98; 0.78 to 1.22, P = 0.81).Long-term exposures to PM2.5 were associated with PUD hospitalization in elder population. The mechanism underlying the PM2.5 in the development of gastric ulcers warrants further research.

  16. The effects of antidepressants on gastric ulcer

    Directory of Open Access Journals (Sweden)

    Mehmet Latif Güneş

    2013-12-01

    Full Text Available In their daily practice, psychiatrists often experience gastriccomplaints in patients beside psychiatric disorders.Peptic ulcer is one of the diseases, which accompanyto psychiatric disorders including mainly depression. Itis shown that antidepressants can inflame the bleedingsincluding gastrointestinal (GI bleedings, while they havepositive effect on ulcer healing. In this review, studies,which conducted about the positive or negative effects ofantidepressant drugs on ulcer treatment were examined.Accordingly; it was found that opipramol, amitriptyline,imipramine that of tricyclic antidepressants was found tobe helpful in healing of the ulcer. It was stated that SelectiveSerotonin Reuptake Inhibitors generally inflamedulcers, exceptionally fluvoxamine and fluoxetine reducedulcer; moclobemide that of monoamine-oxidase inhibitorand tianeptine and mirtazapine that of atypical antidepressantshad positive effect in ulcer healing. To be carefulin choosing the appropriate antidepressant in psychiatricpatients with gastric ulcer is important in the prognosisof both ulcer and depression.Key words: peptic ulcer; depression; antidepressant drugs

  17. Stress ulcer, gastritis, and gastrointestinal bleeding prophylaxis in critically ill pediatric patients: a systematic review.

    Science.gov (United States)

    Reveiz, Ludovic; Guerrero-Lozano, Rafael; Camacho, Angela; Yara, Lina; Mosquera, Paola Andrea

    2010-01-01

    To identify and evaluate the quality of evidence supporting prophylactic use of treatments for stress ulcers and upper gastrointestinal bleeding. Stress ulcers, erosions of the stomach and duodenum, and upper gastrointestinal bleeding are well-known complications of critical illness in children admitted to the pediatric intensive care unit. Studies were identified from the Cochrane Central Register of Controlled Trials, PUBMED; LILACS; Scirus. We also scanned bibliographies of relevant studies. This systematic review of randomized controlled trials assessed the effects of drugs for stress-related ulcers, gastritis, and upper gastrointestinal bleeding in critically ill children admitted to the pediatric intensive care unit. Two reviewers independently extracted the relevant data. Most randomized controlled trials were judged as having unclear risk of bias. When pooling two randomized controlled trials, treatment was significantly more effective in preventing upper gastrointestinal bleeding (macroscopic or important bleeding) compared with no treatment (two studies = 300 participants; relative risk, 0.41; 95% confidence interval, 0.19-0.91; I = 12%). Meta-analysis of two studies found no significant difference in death rates among groups (two randomized controlled trials = 132 participants; relative risk, 1.39; 95% confidence interval, 0.70-2.79; I = 4%). The rate of pneumonia was not significantly different when comparing treatment and no treatment in one study. When comparing ranitidine with no treatment, significant differences were found in the proportion of mechanically ventilated children with normal gastric mucosal endoscopic findings by histologic specimens (one randomized controlled trial = 48 participants; relative risk, 3.53; 95% confidence interval, 1.34-9.29). No significant differences were found when comparing different drugs (omeprazole, ranitidine, sucralfate, famotidine, amalgate), doses, or regimens for main outcomes (deaths, endoscopic findings of

  18. [Autotransfusions of sorbent blood in treating peptic ulcer patients with an unfavorable course].

    Science.gov (United States)

    Uspenskiĭ, V M; Zhidkov, K P; Malygin, A M; Shevchenko, E V

    1990-08-01

    Autotransfusion of sorbent blood was used in the complex treatment of 62 patients with gastric ulcer characterized by an unfavourable course. The course of autotransfusions favoured scarring of the gastric ulcer in 70.9% of patients, normalized the helper/suppressor relations of regulatory subpopulations of T-lymphocytes, normalized the indices of natural killer activity.

  19. Do We Eradicate Helicobacter pylori in Hospitalized Patients with Peptic Ulcer Disease?

    Directory of Open Access Journals (Sweden)

    Frank Wong

    2013-01-01

    Full Text Available BACKGROUND: Helicobacter pylori infection is the most common chronic infection in humans. It is a major contributor to the cause of duodenal and gastric ulcers worldwide. Its eradication has been shown to reduce rates of H pylori-related ulcers as well as other complications such as gastric cancer.

  20. Cerebral air embolism as a complication of peptic ulcer in the gastric tube: case report

    Directory of Open Access Journals (Sweden)

    Suzuki Takahisa

    2011-12-01

    Full Text Available Abstract Background The reported incidence of ulcer formation in the gastric tube in esophageal replacement is rare. Case Presentation This is the first report of a case of cerebral air embolism as a result of spontaneous perforation of an ulcer in the constructed gastric tube into the pulmonary vein during post-operative follow-up in a patient with esophageal cancer. Conclusions Cerebral air embolism is a rare complication of penetrating gastric ulcer, but should be considered in patients with a history of esophagectomy with gastric conduit that present with acute neurologic findings.

  1. Analysis of characteristics of non-Helicobacter pylori and non-NSAID peptic ulcer disease%非幽门螺杆菌非NSAID溃疡临床特征分析

    Institute of Scientific and Technical Information of China (English)

    郑恩典; 倪双双; 林细州; 林晓晓; 叶慈慈; 陈艳; 余颖聪; 郑亮

    2015-01-01

    ), group of NSAID only (group C) and group of Hp positive and NSAID (group D). The proportion of non-Hp and non-NSAID peptic ulcer disease (group A), Gender and ages of these patients were collected. The characteristics of group A, group B, group C and group D were analyzed and compared. Results:Fifty six patients with non-Hp and non-NSAID peptic ulcer disease (group A) were diagnosed and the proportion was 11.8%(56/473). There was no signiifcant difference between group A and other groups in distribution of gender (P>0.05). There was signiifcant difference between group A and group B in distribution of age (P0.05). There was signiifcant difference between group A and group D in gastrointestinal bleeding (P0.05). Conclusion:Non-Hp and non-NSAID peptic ulcer disease has an important proportion among peptic ulcer disease, the patients are old and the tenderness was common. The proportions of fudus of stomach and single ulcer are signiifcant higher than that of the group of Hp positive only. Smoking is one of the possible causes of non-Hp and non-NSAID peptic ulcer disease.

  2. Clinical studies on the use of roxatidine acetate for the treatment of peptic ulcer in Japan.

    Science.gov (United States)

    Inoue, M

    1988-01-01

    Roxatidine acetate is a novel H2-receptor antagonist with a chemical structure different to the earlier drugs of this type. It is a potent inhibitor of histamine-mediated gastric acid secretion and in animal models is 4 to 6 times as potent as cimetidine. In a multicentre double-blind clinical trial of over 700 patients with gastric or duodenal ulcers roxatidine acetate 75 mg twice daily and cimetidine 200mg four times daily produced endoscopically confirmed and subjective and objective healing rates in excess of 90% for both types of ulcer, with no significant difference between the treatments. Roxatidine acetate's efficacy in stomal ulcer (marginal ulcer) and reflux oesophagitis has been confirmed in non-comparative studies of up to 8 weeks' duration. The overall incidence of adverse reactions in 1623 patients treated with roxatidine acetate 75 mg twice daily was 1.7%, with skin rashes and constipation the most frequently reported side effects.

  3. Do patients with non-ulcer dyspepsia respond differently to Helicobacter pylori eradication treatments from those with peptic ulcer disease? A systematic review

    Institute of Scientific and Technical Information of China (English)

    Jia-Qing Huang; Ge-Fan Zheng; Richard H Hunt; Wai-Man Wong; Shiu-Kum Lam; Johan Karlberg; Benjamin Chun-Yu Wong

    2005-01-01

    AIM: It is controversial whether patients with non-ulcer dyspepsia (NUD) respond differently to Helicobacter pylori (H pylori) eradication treatment than those with peptic ulcer disease (PUD). To review the evidence for any difference in H pylori eradication rates between PUD and NUD patients. METHODS: A literature search for full articles and meeting abstracts to July 2004 was conducted. We included studies evaluating the efficacy of a proton pump inhibitor (P) or ranitidine bismuth citrate (RBC) plus two antibiotics of clarithromycin (C), amoxicillin (A), metronidazole (M), or P-based quadruple therapies for eradicating theinfection.RESULTS: Twenty-two studies met the criteria. No significant difference in eradication rates was found between PUD and NUD patients when treated with 7-d RBCCA, 10-d PCA or P-based quadruple therapies. When the 7-d PCA was used, the pooled H pylori eradication rate was 82.1% (431/525) and 72.6% (448/617) for PUD and NUD patients, respectively, yielding a RR of 1.15(95%CI 1.01-1.29). However, the statistically significant difference was seen only in meeting abstracts, but not in full publications.CONCLUSION: There is no convincing evidence to suggest that NUD patients respond to H pylori eradication treatments differently from those with PUD, although a trend exists with the 7-d PCA therapy.

  4. Isocitrate dehydrogenase of Helicobacter pylori potentially induces humoral immune response in subjects with peptic ulcer disease and gastritis.

    Directory of Open Access Journals (Sweden)

    M Abid Hussain

    Full Text Available BACKGROUND: H. pylori causes gastritis and peptic ulcers and is a risk factor for the development of gastric carcinoma. Many of the proteins such as urease, porins, flagellins and toxins such as lipo-polysaccharides have been identified as potential virulence factors which induce proinflammatory reaction. We report immunogenic potentials of isocitrate dehydrogenase (ICD, an important house keeping protein of H. pylori. METHODOLOGY/PRINCIPAL FINDINGS: Amino acid sequences of H. pylori ICD were subjected to in silico analysis for regions with predictably high antigenic indexes. Also, computational modelling of the H. pylori ICD as juxtaposed to the E. coli ICD was carried out to determine levels of structure similarity and the availability of surface exposed motifs, if any. The icd gene was cloned, expressed and purified to a very high homogeneity. Humoral response directed against H. pylori ICD was detected through an enzyme linked immunosorbent assay (ELISA in 82 human subjects comprising of 58 patients with H. pylori associated gastritis or ulcer disease and 24 asymptomatic healthy controls. The H. pylori ICD elicited potentially high humoral immune response and revealed high antibody titers in sera corresponding to endoscopically-confirmed gastritis and ulcer disease subjects. However, urea-breath-test negative healthy control samples and asymptomatic control samples did not reveal any detectable immune responses. The ELISA for proinflammatory cytokine IL-8 did not exhibit any significant proinflammatory activity of ICD. CONCLUSIONS/SIGNIFICANCE: ICD of H. pylori is an immunogen which interacts with the host immune system subsequent to a possible autolytic-release and thereby significantly elicits humoral responses in individuals with invasive H. pylori infection. However, ICD could not significantly stimulate IL8 induction in a cultured macrophage cell line (THP1 and therefore, may not be a notable proinflammatory agent.

  5. Peptic ulcers related to NSAIDs in the elderly%老年人非甾体抗炎药相关性消化性溃疡病

    Institute of Scientific and Technical Information of China (English)

    顾同进

    2003-01-01

    @@ 自1982年澳大利亚学者Warren和Marshall发现胃有幽门螺杆菌(HP)感染后,经多年研究,证实消化性溃疡病(peptic ulcer disease,简称PUD)的发生和复发与HP感染密切相关,称之为HP相关性PUD,将HP根治后,可使PUD治愈,很少复发.

  6. Anaesthesia care for emergency endoscopy for peptic ulcer bleeding. A nationwide population-based cohort study

    DEFF Research Database (Denmark)

    Duch, Patricia; Haahr Raunkjær, Camilla; Møller, Morten Hylander;

    2016-01-01

    describe the prevalence and inter-hospital variation of anaesthesia care in Denmark and identify clinical predictors for choosing anaesthesia care. MATERIAL AND METHODS: This population-based cohort study included all emergency EGDs for PUB in adults during 2012-2013. About 90-day all-cause mortality after...... of the endoscopist. Some 16.7% of the patients undergoing EGD with anaesthesia care died within 90 days after the procedure, compared to 9.8% of the patients who had no anaesthesia care, adjusted OR = 1.51 (95% CI = 1.25-1.83). Comparing the two hospitals with the most frequent (98.6% of al EGDs) and least frequent...... EGD was estimated by crude and adjusted logistic regression. Clinical predictors of anaesthesia care were identified in another logistic regression model. RESULTS: Some 3.056 EGDs performed at 21 hospitals were included; 2074 (68%) received anaesthesia care and 982 (32%) were managed under supervison...

  7. The excess long-term mortality in peptic ulcer bleeding is explained by nonspecific comorbidity

    DEFF Research Database (Denmark)

    Laursen, Stig Borbjerg; Hansen, Jane Møller; Hallas, Jesper

    2015-01-01

    with a matched control cohort from the source population. Predictors of mortality were identified using proportional hazards models. Causes of death were retrieved from death certificates. Long-term mortality was analyzed with adjustment for Charlson comorbidity index (CCI) and average income in residence.......49; p anemia, and smoking were predictors for long-term mortality. The distribution of causes of death was similar in the two cohorts. Conclusion. PUB patients...

  8. Analysis of the clinical characteristics of peptic ulcer disease in elderly persons%老年消化性溃疡的临床特点

    Institute of Scientific and Technical Information of China (English)

    贺文娟

    2015-01-01

    The incidence of the aged patients with peptic ulcer is on the rise in our country. And many aspects, such as pathogenic sites, clinical symptoms, complications and pathological characteristics, have obvious characteristics for this disease. Therefore, it is signiifcant to recognize the clinical characteristics of the aged patients with peptic ulcer correctly and early diagnose and treat for them. In this paper, the author presents his many years clinical experiences, and gives a deep analysis of the clinical characteristics of the aged patients with peptic ulcer.%老年人消化性溃疡的发病率在中国呈现出上升的趋势。且其在发病部位、临床症状、并发症及病理特征等方面均具有明显的特点。因此,正确认识老年人消化性溃疡的临床特点,及早地诊断和治疗老年消化性溃疡具有重要意义。结合自己多年的临床经验,对老年消化性溃疡的临床特点进行了深入的分析。

  9. [Reflections on the marked changes of the prevalence of Helicobacter pylori infection and peptic ulcer disease in the last two decades].

    Science.gov (United States)

    Bohumil, Fixa

    2011-01-01

    A short overview is presented of some of the persistent questions of the relationship of Helicobacter pylori infection and peptic ulcer disease and about the increasing number of patients with idiopathic peptic ulcer disease. The relationship between the decrease of the prevalence of peptic ulcer disease in countries with marked decrease of Helicobacter pylori prevalence in the general population, including the Czech Republic, was discussed. Several possible causes of the decrease in Helicobacter pylori prevalence were noted (improving of socioeconomic conditions, such as low income and poor education, such as poor sanitation and overcrowding, bad hygienic conditions especially during childhood, the marked increase of Helicobacter pylori eradication rate, associated also with an extended therapy by macrolides or other antibiotics (amoxicillin, etc.) used for several conditions, often at a very young age, and sometimes by chance together with proton pump inhibitors, natural loss of the older generation, which had a higher HP-prevalence than the general population, the change of the stomach microbiome, etc.) but with the implication, that the real cause of these deep changes remains indistinctly identified.

  10. Typhoid fever with caecal ulcer bleed: managed conservatively.

    Science.gov (United States)

    Boopathy, Vinoth; Periyasamy, Sivakumar; Alexander, Thomas; Balasubramanian, Padhmini

    2014-03-31

    Typhoid fever is caused by enteroinvasive Gram-negative organism Salmonella typhi. The well-known complications of typhoid fever are intestinal haemorrhage and perforation. In the pre-antibiotic era, these complications were quite common, but in the current antibiotic era the incidence of these complications is on the decline. We report a case of a patient with typhoid fever who developed haematochezia during the hospital stay and was found to have caecal ulcer with an adherent clot on colonoscopy. He was managed successfully with conservative measures without endotherapy and there was no rebleed.

  11. Peptic ulcer disease associated with Helicobacter felis in a dog owner.

    Science.gov (United States)

    De Bock, Manuelle; Van den Bulck, Kathleen; Hellemans, Ann; Daminet, Sylvie; Coche, Jean-Charles; Debongnie, Jean-Claude; Decostere, Annemie; Haesebrouck, Freddy; Ducatelle, Richard

    2007-01-01

    The aim of this study was to investigate the identity of the Helicobacter heilmannii-like bacteria found in the stomach of a human patient suffering from stomach ulcers and her asymptomatic pet dog. An elderly woman was referred for gastroscopy because of right hypochondrial pain, nausea, anorexia and vomiting. Gastric ulcers were observed and histology revealed the presence of multiple H. heilmannii-like bacteria. Multiplex polymerase chain reaction (PCR) identified the bacteria as H. felis. Her pet dog was also examined gastroscopically. Only mild gastric lesions were found but PCR showed the presence of H. felis as well as H. bizzozeronii and Candidatus H. heilmannii. This report associates H. felis infection in humans with severe gastric ulceration. Moreover, the suggestion can be made that the patient contracted H. felis from her dog.

  12. A Rare Cause of Chronic Life Threatening Bleeding in a Girl: The Ulcerated Blind Loops.

    Science.gov (United States)

    Sawant, Abhijeet D; Shah, Rasik; Shah, Nitin; Gupta, Tarun

    2016-01-01

    Ulceration in a blind loop can lead to massive gastrointestinal tract (GIT) bleeding. A 13-year old girl presented with symptomatic melena requiring repeated blood transfusion since childhood. She was an operated case of small bowel atresia in neonatal life. Her upper and lower gastrointestinal endoscopies were normal. Operation showed presence of multiple ulcers in two blind loops (parts of previous side to side anastomosis) and at the anastomotic site. She underwent resection and end-to-end anastomosis of the small bowel leading to complete resolution of melena and anemia.

  13. A Rare Cause of Chronic Life Threatening Bleeding in a Girl: The Ulcerated Blind Loops

    Directory of Open Access Journals (Sweden)

    Abhijeet D Sawant

    2016-04-01

    Full Text Available Ulceration in a blind loop can lead to massive gastrointestinal tract (GIT bleeding. A 13-year old girl presented with symptomatic melena requiring repeated blood transfusion since childhood. She was an operated case of small bowel atresia in neonatal life. Her upper and lower gastrointestinal endoscopies were normal. Operation showed presence of multiple ulcers in two blind loops (parts of previous side to side anastomosis and at the anastomotic site. She underwent resection and end-to-end anastomosis of the small bowel leading to complete resolution of melena and anemia.

  14. Is Childhood Physical Abuse Associated with Peptic Ulcer Disease? Findings from a Population-Based Study

    Science.gov (United States)

    Fuller-Thomson, Esme; Bottoms, Jennifer; Brennenstuhl, Sarah; Hurd, Marion

    2011-01-01

    This study investigated childhood physical abuse and ulcers in a regionally representative community sample. Age, race and sex were controlled for in addition to five clusters of potentially confounding factors: adverse childhood conditions, adult socioeconomic status, current health behaviors, current stress and marital status, and history of…

  15. Analysis the Clinical Treatment of Children With Peptic Ulcer%小儿消化性溃疡的临床治疗分析

    Institute of Scientific and Technical Information of China (English)

    艾君

    2016-01-01

    Objective To explore the clinical treatment method and curative effect of peptic ulcer in children. Methods Selected 24 children with peptic ulcer from January 2014 to July 2015 in our hospital were retrospectively analyzed.Results After targeted drug therapy, 24 cases were cured and discharged, 21 cases of children with ulcers healed completely, 3 cases of patients with ulcer scar formation and wrinkles more concentrated. ConclusionThe clinical symptoms of pediatric peptic ulcer is more complicated, the individual difference is obvious, the doctor should ifrst ifnd out the cause, take appropriate treatment measures, can get better curative effect.%目的:探讨小儿消化性溃疡的临床治疗方法与疗效。方法选取2014年1月~2015年7月我院收治的小儿消化性溃疡24例患儿资料进行回顾性分析。结果经过有针对性的药物治疗,24例患儿均痊愈出院,其中21例溃疡处完全愈合,3例有溃疡瘢痕的形成且皱壁较集中。结论小儿消化道溃疡的临床症状比较复杂,个体差异较明显,医生应先探明病因,采取合适的治疗措施,方可取得较好的疗效。

  16. Giant lipoma of posterior neck with bleeding decubitus ulcer: A rare entity

    Directory of Open Access Journals (Sweden)

    Manish Varma

    2010-01-01

    Full Text Available Giant lipomas are benign soft tissue tumours. They are found relatively rarely on the posterior part of the neck. Bleeding pressure ulcer in this giant tumour is a rare presentation. Surgical interventions in these tumours are very challenging because, sometimes, extension to the spinal cord and malignant change may occur, especially in old age. Knowledge of the anatomy and meticulous surgical techniques are needed for such giant lipomas.

  17. Wavelet-based analysis of gastric microcirculation in rats with ulcer bleedings

    Science.gov (United States)

    Pavlov, A. N.; Rodionov, M. A.; Pavlova, O. N.; Semyachkina-Glushkovskaya, O. V.; Berdnikova, V. A.; Kuznetsova, Ya. V.; Semyachkin-Glushkovskij, I. A.

    2012-03-01

    Studying of nitric oxide (NO) dependent mechanisms of regulation of microcirculation in a stomach can provide important diagnostic markers of the development of stress-induced ulcer bleedings. In this work we use a multiscale analysis based on the discrete wavelet-transform to characterize a latent stage of illness formation in rats. A higher sensitivity of stomach vessels to the NO-level in ill rats is discussed.

  18. Gallbladder cancer manifesting as recurrent common bile duct stone and duodenal ulcer bleeding.

    Science.gov (United States)

    Tsai, Tzung-Jiun; Lai, Kwok-Hung; Hsu, Ping-I; Tsai, Cheng-Chung; Fu, Ting-Ying

    2009-08-01

    Gallbladder cancer (GBC) is an uncommon disease and is usually asymptomatic. Poor prognosis and high mortality rate have been noted in patients with delayed diagnosis. We report a case of locally advanced GBC with duodenum and colon invasion manifesting as bleeding duodenal ulcer and recurrent common bile duct (CBD) stones. The patient was successfully treated with extended surgery. In patients who have multiple recurrence of CBD stones without common risk factors, concomitant biliary tract malignancy should be included in the differential diagnosis.

  19. Clinical Analysis of Relapse Factors for Peptic Ulcer Patients%消化性溃疡复发相关影响因素的临床分析

    Institute of Scientific and Technical Information of China (English)

    郭静尹

    2012-01-01

    目的:分析影响消化性溃疡复发的相关因素.方法:选取于2010年5月至2011年3月期间我院收治的消化性溃疡患者280例进行回顾性分析影响其复发的相关因素.结果:本组280例随访患者中,178例复发,复发率为63.57%.十二指肠球部溃疡的复发率为73.34%;胃溃疡复发率为67.96;复合性溃疡复发率为37.5%.分析结果显示PU复发的6个危险因素:男性、不良生活方式、服NSAIDs、精神因素、春秋季节、未维持用药,两组比较差异均有统计学意义(P<0.05).结论:消化性溃疡的复发与多种因素有关,应有针对的对复发相关危险因素进行预防进而阻止溃疡复发,减少复发率.%Objective:To Analyze the Relapse factors for peptic ulcer patients.Methods:From May 2010 to March 2011,280 cases of patients with peptic ulcer were diagnosed and treated,and follow-ups were conducted to observe the relapse factors for peptic ulcer patients.Results:Among 280 patients with follow-up,there were 178 cases with recurrence and 102 cases with no recurence. The risk factors of relapse are:male,poor eating habits of life,drug factor,mental stress,spring seasonal the ulcer healing.Conclusion:The recurence of peptic ulcer with a variety of factors,should be adopted to maintain a good lifestyle,psychological and behavioral interventions to improve the quality of ulcer healing and decrease the recurrence rate.

  20. Cameron ulcers: an atypical source for a massive upper gastrointestinal bleed.

    Science.gov (United States)

    Kapadia, Samir; Jagroop, Sophia; Kumar, Atul

    2012-09-21

    Cameron lesions represent linear gastric erosions and ulcers on the crests of mucosal folds in the distal neck of a hiatal hernia (HH). Such lesions may be found in upto 50% of endoscopies performed for another indication. Though typically asymptomatic, these may rarely present as acute, severe upper gastrointestinal bleed (GIB). The aim is to report a case of a non-anemic 87-year-old female with history of HH and atrial fibrillation who presented with hematemesis and melena resulting in hypovolemic shock. Repeat esophagogastroduodenoscopy was required to identify multiple Cameron ulcers as the source. Endoscopy in a patient with HH should involve meticulous visualization of hernia neck and surrounding mucosa. Cameron ulcers should be considered in all patients with severe, acute GIB and especially in those with known HH with or without chronic anemia.

  1. Cameron ulcers: An atypical source for a massive upper gastrointestinal bleed

    Institute of Scientific and Technical Information of China (English)

    Samir Kapadia; Sophia Jagroop; Atul Kumar

    2012-01-01

    Cameron lesions represent linear gastric erosions and ulcers on the crests of mucosal folds in the distal neck of a hiatal hernia (HH).Such lesions may be found in upto 50% of endoscopies performed for another indication.Though typically asymptomatic,these may rarely present as acute,severe upper gastrointestinal bleed (GIB).The aim is to report a case of a non-anemic 87-year-old female with history of HH and atrial fibrillation who presented with hematemesis and melena resulting in hypovolemic shock.Repeat esophagogastroduodenoscopy was required to identify multiple Cameron ulcers as the source.Endoscopy in a patient with HH should involve meticulous visualization of hernia neck and surrounding mucosa.Cameron ulcers should be considered in all patients with severe,acute GIB and especially in those with known HH with or without chronic anemia.

  2. The Acute Management of Nonvariceal Upper Gastrointestinal Bleeding

    Directory of Open Access Journals (Sweden)

    Hisham AL Dhahab

    2012-01-01

    Full Text Available Background. The mortality from nonvariceal upper gastrointestinal bleeding is still around 5%, despite the increased use of proton-pump inhibitors and the advancement of endoscopic therapeutic modalities. Aim. To review the state-of-the-art management of acute non variceal upper gastrointestinal bleeding from the presentation to the emergency department, risk stratification, endoscopic hemostasis, and postendoscopic consolidation management to reduce the risk of recurrent bleeding from peptic ulcers. Methods. A PubMed search was performed using the following key words acute management, non variceal upper gastrointestinal bleeding, and bleeding peptic ulcers. Results. Risk stratifying patients with acute non variceal upper gastrointestinal bleeding allows the categorization into low risk versus high risk of rebleeding, subsequently safely discharging low risk patients early from the emergency department, while achieving adequate hemostasis in high-risk lesions followed by continuous proton-pump inhibitors for 72 hours. Dual endoscopic therapy still remains the recommended choice in controlling bleeding from peptic ulcers despite the emergence of new endoscopic modalities such as the hemostatic powder. Conclusion. The management of nonvariceal upper gastrointestinal bleeding involves adequate resuscitation, preendoscopic risk assessment, endoscopic hemostasis, and post endoscopic pharmacological and nonpharmacological treatment.

  3. [OMEPRAZOL VS RANITIDINE IN UPPER DIGESTIVE BLEEDING

    Science.gov (United States)

    Regis R, Regina; Bisso A, Aland; Rebaza, Segundo

    1999-01-01

    Pectic ulcer is the most frequent cause of gastrointestinal bleeding. The homeostatic mechanism of bleeding, and coagulation, does not happen with values of pH less than 5,0. Therefore neutralization of gastric acidity (pH more than 5,0) is a recourse of control, improve the evolution and healing of peptic ulcer and to avoid a new bleeding. The aim of this study was to compare the results of treatment with omeprazole and ranitidine, in 57 patients admitted at emergency room of the Hospital Central de la Polic a Nacional del Per with endoscopic diagnosis of peptic ulcer, using Forrest classification. Patients received omeprazole 40 mg in bolus IV, followed by continuos infusion of 8 mg/hour for 72 hours (group A) or ranitidine 50 mg IV each 8 hours for 72 hours (group B). A new endoscopy was made 72 hours after admission demostrated a succesful therapy in both group. Bleeding stopped in 26/27 patients in group A (96,2%) and in 23/30 patients in group B (76,6%) (pomeprazole IV is more effective than ranitidine IV in the control of UGB because of peptic ulcer and provides a faster healing.

  4. Does recombinant human erythropoietin accelerate correction of post-ulcer-bleeding anaemia? A pilot study

    Institute of Scientific and Technical Information of China (English)

    Spiros D. Ladas; Dimitrios Polymeros; Thomas Pagonis; Konstantinos Triantafyllou; Gregorios Paspatis; Maria Hatziargiriou; Sotirios A.Raptis

    2004-01-01

    AIM: Anaemia caused by acute upper gastrointestinal bleeding is treated with blood transfusion or iron, but patients usually face a two-month recovery period from posthaemorrhage anaemia. This prospective, randomised, open,pilot study was designed to investigate whether recombinant human erythropoietin (Epoetin) therapy accelerate haematocrit increase in the post-bleeding recovery period.METHODS: We studied hospitalised patients admitted because of acute ulcer bleeding or haemorrhagic gastritis,who had a haematocrit of 27-33% and did not receive blood transfusions. One day after the endoscopic confirmation of cessation of bleeding, they were randomised either to erythropoietin (20 000 IU Epoetin alfa subcutaneously, on days 0, 4 and 6) plus iron (100 mg im, on days 1- 6, (G1) or iron only (G2). Haematocrit was measured on days 0, 6, 14,30, 45, and 60, respectively.RESULTS: One patient from G1 and two from G2 were lost to follow-up. Therefore, 14 and 13 patients from G1 and G2respectively were analysed. Demographic characteristics, serum iron, ferritin, total iron binding capacity, reticulocytes, and haematocrit were not significantly different at entry to the study.Median reticulocyte counts were significantly different between groups on day six (G1: 4.0, 3.0-6.4 vsG2: 3.5, 2.1-4.4%,P=0.03) and median haematocrit on day fourteen [G1: 35.9,30.7-41.0 vsG2: 32.5, 29.5-37.0% (median, range), P=0.04].CONCLUSION: Erythropoietin administration significantly accelerates correction of anemia after acute ulcer bleeding.The haematocrit gain is equivalent to one unit of transfused blood two weeks after the bleeding episode.

  5. [Comparative study of 3 drugs (aceglutamide aluminum, zinc acexamate, and magaldrate) in the long-term maintenance treatment (1 year) of peptic ulcer].

    Science.gov (United States)

    Varas Lorenzo, M J; López Martínez, A; Gordillo Bernal, J; Mundet Surroca, J

    1991-08-01

    In a multicentre study, 146 peptic ulcer patients who had recently healed with H2 antagonists (38 gastric, 108 duodenal ulcers) received randomly for a year one of the following mucosal protecting antiulcer drugs: aceglutamide aluminium salt (AAL), zinc acexamate (ZAC) and magaldrate (MAG). Forty six patients received AAL (700 mg bid), 50 patients received ZAC (300 mg at single nocturnal dose) and 50 patients received MAG (800 mg bid). An endoscopic examination was performed at the beginning of the study and 12 months later. Clinical examinations where performed on months 3, 6 and 9, advancing the endoscopical control in case of ulcer symptoms. ZAC showed to be superior to MAG (p less than 0.05, chi-square test) in preventing relapses, with a favourable tendence in front of AAL, but without reaching statistical significance. Its important to mention the high number of withdrawals and the good tolerance of the treatments.

  6. [Principal characteristics of the endoscopic programmed hemostasis in ulcerative gastroduodenal bleedings in patients with high operational-anesthesiological risk].

    Science.gov (United States)

    Timen, L Ia; Trubitsyna, I E; Chikunova, B Z

    2013-01-01

    Application of the endoscopic programmed hemostasis for patients with ulcer gastroduodenal bleedings and with high operational-anesthetic risk provided metabolic rehabilitation (5% solutions of glucose and ascorbic acid) for the purpose of prevention of recurrence of the bleedings which have arisen after a hemostasis at 5.5% of patients.

  7. Endoscopic treatment of non-variceal gastrointestinal bleeding: hemoclips and other hemostatic techniques

    Institute of Scientific and Technical Information of China (English)

    Rossana M. Moura; Jamie S. Barkin

    2000-01-01

    @@ Although the number of hospitalizations for nonvariccal gastrointestinal bleeding has decreased in recent years, acute upper gastrointestinal hemorrhage continues to be a common reason for hospital admission, and peptic ulcers account for at least fifty percent of all cases. Despite the fact that bleeding from ulcers ceases spontaneously in approximately 80% of patients, it is still a diagnosis associated with substantial medical costs and significant morbidity and mortality, the latter ranging between 8 and 14%[1], especially in the elderly.

  8. Seasonal pattern of peptic ulcer hospitalizations: analysis of the hospital discharge data of the Emilia-Romagna region of Italy

    Directory of Open Access Journals (Sweden)

    Serra Mauro

    2010-04-01

    Full Text Available Abstract Background Previous studies have reported seasonal variation in peptic ulcer disease (PUD, but few large-scale, population-based studies have been conducted. Methods To verify whether a seasonal variation in cases of PUD (either compicated or not complicated requiring acute hospitalization exists, we assessed the database of hospital admissions of the region Emilia Romagna (RER, Italy, obtained from the Center for Health Statistics, between January 1998 and December 2005. Admissions were categorized by sex, age (per se in the region. For statistical analysis, the χ2 test for goodness of fit and inferential chronobiologic method (Cosinor and partial Fourier series were used. Results Of the total sample of PUD patients (26,848 [16,795 males, age 65 ± 16 yrs; 10,053 females, age 72 ± 15 yrs, p p p = 0.035, and several subgroups, with nadir in July. Finally, analysis of the monthly prevalence proportions yielded a significant (p = 0.025 biphasic pattern with a main peak in August-September-October, and a secondary one in January-February. Conclusions A seasonal variation in PUD hospitalization, characterized by three peaks of higher incidence (Autumn, Winter, and Spring is observed. When data corrected by monthly admission proportions are analyzed, late summer-autumn and winter are confirmed as higher risk periods. The underlying pathophysiologic mechanisms are unknown, and need further studies. In subjects at higher risk, certain periods of the year could deserve an appropriate pharmacological protection to reduce the risk of PUD hospitalization.

  9. Proinflammatory cytokines and thrombomodulin in patients with peptic ulcer disease and gastric cancer, infected with Helicobacter pylori

    Directory of Open Access Journals (Sweden)

    Mehrdad Haghazali

    2011-01-01

    Full Text Available Backgrounds: Helicobacter pylori infect more than half of the global population. It is suggested to be related with gastritis, peptic ulcer disease (PUD, and gastric cancer. Aims: The aim of this present study was to evaluate proinflammatory cytokines including interleukin 1, 6, 8, 10, and thrombomodulin in H. pylori-infected patients with PUD and gastric cancer. Patients: This cross-sectional study was conducted in Taleghani Hospital on 111 patients with H. pylori infection. Materials and Methods: Patients were divided into three groups of PUD, cancer, and control (normal on endoscopy, according to the results of endoscopy. The serum levels of interleukins 1, 6, 8, and 10 and thrombomodulin was determined using enzyme-linked immunosorbent assay (ELISA technique. H. pylori infection was diagnosed by histological examination of the endoscopic biopsy. Results: One hundred eleven patients were included in the study; 30 as PUD group, 30 as gastric cancer group, and 51 as controls. There was no significant difference between the means of IL-1 and IL-10 levels among the three groups (P = 0.744 and 0.383, respectively. IL-6, IL-8, and thrombomodulin levels were found to be statically different among the three groups (P < 0.05. The level of IL-6, IL-8, and thrombomodulin in cancer group was significantly higher than PUD and control groups (P < 0.05. Conclusion: There is a significant association between H. pylori infection and serum IL-6, IL-8, and thrombomodulin but such relation is not present between H. pylori and IL-1 and IL-10. Immunity response (IL-6, IL-8 and thrombomodulin is more severe in cancer patient than PUD.

  10. Management of Refractory and Recurrent Peptic Ulcer%难治性和复发性消化性溃疡的处理

    Institute of Scientific and Technical Information of China (English)

    刘文忠

    2011-01-01

    Refractory or recurrent peptic ulcer disease is a challenge to clinicians. Optimal management requires the understanding of potential underlying causes of refractory or recurrent cases. Identification and eradication of Helicobacter pylori infection and acid reduction by acid suppressive therapy can heal ulceration as well as prevent recurrences. The causes of refractory or recurrent peptic ulcer and the management strategy were discussed in this article.%难治性或复发性消化性溃疡的治疗对临床医师而言是一种挑战.使其得到最佳处理的重要条件是明确引起难治性或复发性消化性溃疡的潜在因素.幽门螺杆菌感染的识别和根除以及抑酸治疗能使溃疡愈合,并预防溃疡的复发.本文对消化性溃疡病难治或复发的原因和处理策略进行详细讨论.

  11. Accuracy of a rapid 10-minute carbon-14 urea breath test for the diagnosis of Helicobacter pylori-associated peptic ulcer disease

    Energy Technology Data Exchange (ETDEWEB)

    Kao Chiahung (Taichung Veterans General Hospital (Taiwan, Province of China). Dept. of Nuclear Medicine); Wang Shyhjen (Taichung Veterans General Hospital (Taiwan, Province of China). Dept. of Nuclear Medicine); Hsu Chungyuan (Taichung Veterans General Hospital (Taiwan, Province of China). Dept. of Nuclear Medicine); Lin Wanyu (Taichung Veterans General Hospital (Taiwan, Province of China). Dept. of Nuclear Medicine); Huang Chihkua (Taichung Veterans General Hospital (Taiwan, Province of China). Dept. of Gastroenterology); Chen Granhum (Taichung Veterans General Hospital (Taiwan, Province of China). Dept. of Gastroenterology)

    1993-08-01

    Urease in the human gastric mucosa is a marker for infection with Helicobacter pylori (HP), an organism which is associated with peptic ulcer disease. To detect gastric urease, we examined 184 patients (144 males, 40 females; mean age: 49.8[+-]15.6 years) with suspected peptic ulcer disease. Fasting patients were given orally 5 [mu]Ci of carbon-14 labelled urea. For each patient only one breath sample was collected in hyamine at 10 min. The amount of [sup 14]C collected at 10 min was expressed as follows: (DPM/mmol CO[sub 2] collected)/(DPM administered)x100xbody weight (kg). The presence of HP colonization was determined by examination of multiple endoscopic prepyloric antral biopsy specimens subjected to culture or a rapid urease test. For the purpose of this study, HP-positive patients were defined as those with characteristic bacteria as indicated by a positive result of either the culture or the rapid urease test; HP-negative patients were defined as those with negative findings on both the culture and the rapid urease test. Of the 184 cases, 99 (53.8%) were positive for HP infection, and 85 (46.2%), negative. The sensitivity and specificity of the rapid 10 min [sup 14]C-urea breath test for the diagnosis of HP-associated peptic ulcer disease were evaluated by a receiver operating characteristic (ROC) curve with a variable cut-off value from 1.5 to 4.5. When a cut-off value of 1.5 was selected, the sensitivity was 100% and the specificity, 83.5%; when a cut-off value of 4.5 was selected, the sensitivity was 54.5% and the specificity, 97.6%. (orig.)

  12. The vacA i1 genotype of Helicobacter pylori is associated with peptic ulcer and gastric cancer:A meta-analysis

    Institute of Scientific and Technical Information of China (English)

    Juping Rui; Guochang Chen; Boneng Mao; Qi Pan

    2014-01-01

    There are two genotypes of the vacA intermediate region, i1 and i2; however, the association between the genotypes and gastroduodenal disease remains to be elucidated. The aim of this article was to investigate the interaction between the genotypes andH. pylori-associated diseases such as chronic gastritis, peptic ulcer disease (PUD) and gastric cancer.Methods: The meta-analysis was performed in Review Manager 4.2.2.Results: Eleven (ten articles and one abstract) met the inclusion criteria and were included. The i1 genotype increased the risk of PUD (OR = 1.70, 95% CI: 1.24-2.33,P <0.001) and gastric cancer (OR = 3.90, 95% CI: 2.64-5.78,P < 0.001). Sub-analysis showed that the i1 genotype was signifi-cantly associated with gastric ulcers (OR = 2.59, 95% CI: 1.05-6.35,P = 0.040), but not with duodenal ulcers (OR = 1.04, 95%CI: 0.61-1.76,P = 0.90). In addition, the association between the i1 genotype and PUD and GC existed in studies not only from Europe but also Asia, except for the association between the i1 genotype and PUD in Asian population.Conclusion: The vacA i1 genotype is associated with an increased risk of the development of peptic ulcer disease (mainly gastric ulcer) and gastric cancer. In geographical distribution, the association between the i1 genotype and PUD and GC existed in studies not only from Europe but also Asia, except for the association between the i1 genotype and PUD in Asian population.

  13. Equally high prevalences of infection with cagA-positive Helicobacter pylori in Chinese patients with peptic ulcer disease and those with chronic gastritis-associated dyspepsia.

    OpenAIRE

    Pan, Z J; Hulst, R.W. van der; Feller, M.; Xiao, S D; Tytgat, G N; Dankert, J.; Ende, A. van der

    1997-01-01

    Approximately 60% of Helicobacter pylori isolates in the Western world possess the cytotoxin-associated gene A (cagA). cagA-positive H. pylori is found to be associated with peptic ulcer disease (PUD) and gastric adenocarcinoma. To investigate the cagA status of H. pylori isolates from Chinese patients with PUD and chronic gastritis (CG), H. pylori populations from 83 patients, 48 with PUD and 35 with CG, were assessed by two different cagA-specific PCRs, Southern blotting, and colony hybridi...

  14. [The effect of calcium antagonists on the rate of gastric emptying in patients with duodenal peptic ulcer and the dumping syndrome].

    Science.gov (United States)

    Saakian, A G

    1990-10-01

    Comparative evaluation of single-dose finoptin, corinfar and falicor by effect on gastric evacuation was conducted in 33 peptic ulcer and 48 postgastrectomy dumping syndrome patients. Finoptin was found to prolong the evacuation in contrast to corinfar which stimulated it. Nonsignificant delay in gastric evacuation occurred in falicor administration. When designing therapy of cardiovascular diseases associated with gastric evacuation, due consideration should be given to pharmacokinetic action of calcium antagonists and functional status of gastric evacuation. Finoptin is preferable in dumping syndrome, corinfar in slow gastric evacuation. In view of the above corinfar treatment is undesirable in postgastrectomy patients, otherwise they could develop rapid gastric stump evacuation and dumping syndrome.

  15. Glucagonoma, chronic recurrent peptic ulcer disease, and enhanced amylase-creatinine clearance ratio. Report of a case with review of the literature.

    Science.gov (United States)

    Pitchumoni, C S; Thelmo, W; Ahmed, K S; Kumar, A; Davidian, M; Einhorn, R; Adler, J; McCarthy, J

    1979-09-01

    A 53-year-old white woman developed diabetes mellitus, migratory erythema, and anemia, clinical features suggesting the presence of a "glucagonoma." Ten years earlier, after laparotomy and pancreatic biopsy, she had been told that she had an inoperable pancreatic carcinoma. Review of that biopsy together with current hormonal assay now confirms the diagnosis of glucagonoma. The recurrent peptic ulcer in this patient despite high levels of glucagon, a gastric inhibitory agent, is noted but not explained. An enhanced amylase-creatinine clearance ratio supports the notion that glucagon increases the clearances of amylase.

  16. Acid peptic disease in the elderly.

    Science.gov (United States)

    Linder, J D; Wilcox, C M

    2001-06-01

    GERD and peptic ulcer disease are important diseases in the elderly. GERD presents similarly in the elderly and the young, although elderly patients may have less severe symptoms yet more severe mucosal disease and a higher prevalence of BE. Although the prevalence of H. pylori is falling, the elderly remain at risk for peptic ulcer because of the widespread use of NSAIDS. The presentation of peptic ulcer disease in the elderly can be subtle and atypical when compared with younger patients, leading to a delay in diagnosis. Because of comorbidity in the aged, peptic ulcer disease and its complications result in increased morbidity and mortality rates.

  17. [Risk factors influencing the development of gastroduodenal bleeding].

    Science.gov (United States)

    Orobeĭ, Iu A; Lazebnik, L B; Nikolaeva, É I; Selivanova, G B

    2010-01-01

    Bleedings of an ulcerative aetiology are an actual and multiplane problem many years. Obvious communication of the complicated current of a peptic ulcer with various risk factors, such as a tobacco smoking, abusing alcohol, uncontrolled and long reception of ulcerogenic agents (NSAID, anticoagulants etc.), mucosa of stomach H. pylori, is noted by a serious accompanying pathology of other organs and systems. The knowledge of influence of interaction of the facts of risk on development bleedings of an ulcerative aetiology, will allow to develop in due time the complex of medical actions referred on prevention of this terrible complication.

  18. Bleeding diathesis and gastro-duodenal ulcers in inherited cytosolic phospholipase-A2 alpha deficiency.

    Science.gov (United States)

    Faioni, E M; Razzari, C; Zulueta, A; Femia, E A; Fenu, L; Trinchera, M; Podda, G M; Pugliano, M; Marongiu, F; Cattaneo, M

    2014-12-01

    Arachidonic acid (AA), when cleaved from phospholipids by cytosolic phospholipase A2 alpha (cPLA2a), generates eicosanoids, with pro-hemostatic, pro-inflammatory, vasoactive and gastro-protective functions. We describe a patient (27-year-old man) and his twin-sister with early-onset bleeding diathesis and recurrent gastro-intestinal (GI) ulcers. Platelet aggregation/δ-granules secretion by collagen was impaired, but normal by AA; serum levels of thromboxane (Tx) B2 and 12-hydroxyeicosatetraenoic acid, and urinary levels of 11-dehydro-TxB2 were extremely low. Patients were homozygous for 1723G>C transition in PLA2G4A gene, which changed the codon for Asp575 to His. GI ulcers affected 5/14 heterozygous ( 60 years) family members; none had bleeding diathesis. The proband, his sister and mother also had mildly reduced factor XI levels. Platelet messenger RNA expression did not differ among subjects with different PLA2G4A genotypes. Conversely, platelet cPLA2a was undetectable by Western Blotting in the proband and his sister, and decreased in 1723G>C heterozygous subjects, suggesting that the variant is transcribed, but not translated or translated into an unstable protein. We described a syndromic form of deficiency of cPLA2a , characterised by recurrent GI ulcers and bleeding diathesis, associated with mild inherited deficiency of factor XI. Unlike other reported patients with cPLA2a deficiency, these patients had extremely low levels of platelet TxA2 biosynthesis.

  19. Analysis of 513 cases of elderly peptic ulcer disease in clinical manifestation and endoscopies%老年消化性溃疡513例临床与内镜分析

    Institute of Scientific and Technical Information of China (English)

    贺学来

    2012-01-01

    目的 探讨老年消化性溃疡的临床特点及内镜下病变特点.方法 总结该院513例经胃镜确诊的老年消化性溃疡患者的主要临床症状及胃镜检查结果的特点,并与同一时期的中青年消化性溃疡患者的临床症状及胃镜特点比较.结果 与中青年组比较,老年组上腹部反酸、恶心、呕吐、腹胀、呕血、黑便以及无症状发生率高;胃溃疡,尤其胃体溃疡发生率高;伴发疾病发生率高;幽门螺杆菌检测阳性率低.差异显著有统计学意义(P<0.05).结论 老年消化性溃疡临床症状不典型,胃溃疡发病率高,伴发疾病多,幽门螺杆菌阳性率低.%Objective To study the characteristics of the clinical manifestation and endoscopies of elderly peptic ulcer. Method The main clinical symptoms and endoscopies of our hospital 513 elderly peptic ulcer patients diagnosed by endoscopy were summarized and compared to young peptic ulcer patients. Results Rhythmic abdominal pain,fullness,belching,acid reflux in the older group were significantly lower than middle-aged group (P 〈0. 05). The incidence rate of gastric ulcer, especially gastric body ulcer is higher in elderly patients than in young patients ( P 〈 0. 05 ) . There were more concomitant diseases and lower Helicobacter pylori - positive rate in elderly peptic ulcer than other peptic ulcer. Conclusion There were more atypical clinical symptoms, higher gastric ulcer incidence, more concomitant diseases and lower Helicobacter pylori-positive rate in elderly peptic ulcer than other peptic ulcer.

  20. Gallbladder Cancer Manifesting as Recurrent Common Bile Duct Stone and Duodenal Ulcer Bleeding

    Directory of Open Access Journals (Sweden)

    Tzung-Jiun Tsai

    2009-08-01

    Full Text Available Gallbladder cancer (GBC is an uncommon disease and is usually asymptomatic. Poor prognosis and high mortality rate have been noted in patients with delayed diagnosis. We report a case of locally advanced GBC with duodenum and colon invasion manifesting as bleeding duodenal ulcer and recurrent common bile duct (CBD stones. The patient was successfully treated with extended surgery. In patients who have multiple recurrence of CBD stones without common risk factors, concomitant biliary tract malignancy should be included in the differential diagnosis.

  1. Helicobacter pylori lipopolysaccharide:Biological activities in vitro and in vivo, pathological correlation to human chronic gastritis and peptic ulcer

    Institute of Scientific and Technical Information of China (English)

    Yi-Hui Luo; Jie Yan; Ya-Fei Mao

    2004-01-01

    AIM: To determine the biological activity of Helicobacter pylori (Hpylori) lipopolysaccharide (H-LPS) and understand pathological correlation between H-LPS and human chronic gastritis and peptic ulcer.METHODS: H-LPS of a clinical Hpylori strain and LPS of Escherichia coli strain O55:B5 (E-LPS) were extracted by phenol-water method. Biological activities of H-LPS and E-LPS were detected by limulus lysate assay, pyrogen assay,blood pressure test and PBMC induction test in rabbits,cytotoxicity test in NIH 3T3 fibroblast cells and lethality test in NIH mice. By using self-prepared rabbit anti-H-LPS serum as the first antibody and commercial HRP-labeled sheep anti-rabbit sera as the second antibody, H-LPS in biopsy specimens from 126 patients with chronic gastritis (68 cases) or gastric ulcer (58 cases) were examined by immunohistochemistry.RESULTS: Fibroblast cytotoxicity and mouse lethality of H-LPS were weaker than those of E-LPS. But the ability of coagulating limulus lysate of the two LPSs was similar (+/0.5 ng/mL). At 0.5 h after H-LPS injection, the blood pressures of the 3 rabbits rapidly declined. At 1.0 h after H-LPS injection, the blood pressures in 2 of the 3 rabbits fell to zero causing death of the 2 animals. For the other one rabbit in the same group, its blood pressure gradually elevated. At 0.5 h after E-LPS injection, the blood pressures of the three rabbits also quickly declined and then maintained at low level for approximately 1.0 h. At 0.5 h after injection with H-LPS or E-LPS, PBMC numbers of the rabbits showed a remarkable increase. The total positivity rate of H-LPS from 126 biopsy specimens was 60.3%(76/126). H-LPS positivity rate in the biopsy specimens from chronic gastritis (50/68, 73.5%) was significantly higher than that from gastric ulcer (26/58, 44.8%) (X2=10.77,P<0.01). H-LPS positivity rates in biopsy specimens from chronic superficial gastritis (38/48, 79.2%) and chronic active gastritis (9/10, 90.0%) were significantly higher than

  2. Therapeutic angiography for giant bleeding gastro-duodenal artery pseudoaneurysm

    Institute of Scientific and Technical Information of China (English)

    Ram; Elazary; Mahmoud; Abu-Gazala; Avraham; Schlager; Noam; Shussman; Avraham; I; Rivkind; Allan; I; Bloom

    2010-01-01

    We present the case of an 18-year-old female transferred to our center from an outside hospital due to persistent gastrointestinal bleeding. Two weeks prior to her transfer she underwent duodenal omentopexy for a perforated duodenal peptic ulcer. The patient underwent a computed tomography angiogram which identified the source of bleeding as a giant gastroduodenal artery (GDA) pseudoaneurysm. The patient was taken to interventional radiology where successful microcoil embolization was performed. We present ...

  3. Upper gastrointestinal bleeding - state of the art.

    Science.gov (United States)

    Szura, Mirosław; Pasternak, Artur

    2014-01-01

    Upper gastrointestinal (GI) bleeding is a condition requiring immediate medical intervention, with high associated mortality exceeding 10%. The most common cause of upper GI bleeding is peptic ulcer disease, which largely corresponds to the intake of NSAIDs and Helicobacter pylori infection. Endoscopy is the essential tool for the diagnosis and treatment of active upper GI hemorrhage. Endoscopic therapy together with proton pump inhibitors and eradication of Helicobacter pylori significantly reduces rebleeding rates, mortality and number of emergency surgical interventions. This paper presents contemporary data on the diagnosis and treatment of upper gastrointestinal bleeding.

  4. 老年消化性溃疡的临床护理%Analysis of the clinical nursing characteristics of peptic ulcer disease in the elderly

    Institute of Scientific and Technical Information of China (English)

    郑培

    2015-01-01

    近年来,老年患者消化性溃疡发病率呈现出上升趋势。且其在发病部位、病理学特征、临床症状及并发症等方面均具有区别于中青年患者的独特临床特点。全面理解老年人消化性溃疡临床特点,进行积极有效护理对老年人健康具有十分积极的意义。%In recent years, the incidence of the aged patients with peptic ulcer is on the rise in our country. Many aspects, such as pathogenic sites, pathological characteristics, clinical symptoms, and complications have unique characteristics which are different from young and middle-aged patients in this disease. Fully understanding the clinical characteristics of the aged patients with peptic ulcer correctly and developing positive and effective nursing are signiifcant for the health of the elderly.

  5. Clinical and pathological importance of vacA allele heterogeneity and cagA status in peptic ulcer disease in patients from North Brazil

    Directory of Open Access Journals (Sweden)

    Luisa Caricio Martins

    2005-12-01

    Full Text Available We have examined the prevalence of gene cagA and vacA alleles in 129 patients, 69 with gastritis and 60 with peptic ulcer diseases from North Brazil and their relation with histopathological data. vacA and cagA genotype were determined by polymerase chain reaction. Hematoxylin-eosin staining was used for histological diagnosis. 96.6% of the patients were colonized by Helicobacter pylori strains harboring single vacA genotype (nont-mixed infection. Among them, 11.8% had subtype s1a, 67.8% had subtype s1b, and 17% subtype s2. In regard to the middle region analysis, m1 alleles were found in 75.4% and m2 in 21.2% of patients. The cagA gene was detected in 78% patients infected with H. pylori and was associated with the s1-m1 vacA genotype. The H. pylori strains, vacA s1b m1/cagA-positive, were associated with increased risk of peptic ulcer disease and higher amounts of lymphocytic and neutrophilic infiltrates and the presence of intestinal metaplasia. These findings show that cagA and vacA genotyping may have clinical relevance in Brazil.

  6. Toll-Like Receptor 4 Wild Type Homozygozity of Polymorphisms +896 and +1196 Is Associated with High Gastrin Serum Levels and Peptic Ulcer Risk.

    Directory of Open Access Journals (Sweden)

    Vesa-Matti Pohjanen

    Full Text Available Toll-like receptor 4 is a part of the innate immune system and recognizes Helicobacter pylori lipopolysaccharide. The goal of this study was to analyze the role of Toll-like receptor 4 polymorphisms +896 (rs4986790 and +1196 (rs4986791 in the pathogenesis of Helicobacter pylori related gastroduodenal diseases in relation to gastric secretion and inflammation. Toll-like receptor 4 polymorphisms, serum gastrin-17 and pepsinogen I and II concentrations were determined, and gastroscopies with histopathological analyses were performed to 216 dyspeptic patients. As genotype controls, 179 controls and 61 gastric cancer patients were studied. In our study, the Toll-like receptor 4 +896 and +1196 polymorphisms were in total linkage disequilibrium. The homozygous wild types displayed higher gastrin-17 serum concentrations than the mutants (p = 0.001 and this effect was independent of Helicobacter pylori. The homozygous wild types also displayed an increased risk for peptic ulcers (OR: 4.390. Toll-like receptor 4 genotypes did not show any association with Helicobacter pylori positivity or the features of gastric inflammation. Toll-like receptor 4 expression was seen in gastrin and somatostatin expressing cells of antral mucosa by immunohistochemistry. Our results suggest a role for Toll-like receptor 4 in gastric acid regulation and that the Toll-like receptor 4 +896 and +1196 wild type homozygozity increases peptic ulcer risk via gastrin secretion.

  7. Toll-Like Receptor 4 Wild Type Homozygozity of Polymorphisms +896 and +1196 Is Associated with High Gastrin Serum Levels and Peptic Ulcer Risk

    Science.gov (United States)

    Pohjanen, Vesa-Matti; Koivurova, Olli-Pekka; Huhta, Heikki; Helminen, Olli; Mäkinen, Johanna M.; Karhukorpi, Jari M.; Joensuu, Tapio; Koistinen, Pentti O.; Valtonen, Jarno M.; Niemelä, Seppo E.; Karttunen, Riitta A.; Karttunen, Tuomo J.

    2015-01-01

    Toll-like receptor 4 is a part of the innate immune system and recognizes Helicobacter pylori lipopolysaccharide. The goal of this study was to analyze the role of Toll-like receptor 4 polymorphisms +896 (rs4986790) and +1196 (rs4986791) in the pathogenesis of Helicobacter pylori related gastroduodenal diseases in relation to gastric secretion and inflammation. Toll-like receptor 4 polymorphisms, serum gastrin-17 and pepsinogen I and II concentrations were determined, and gastroscopies with histopathological analyses were performed to 216 dyspeptic patients. As genotype controls, 179 controls and 61 gastric cancer patients were studied. In our study, the Toll-like receptor 4 +896 and +1196 polymorphisms were in total linkage disequilibrium. The homozygous wild types displayed higher gastrin-17 serum concentrations than the mutants (p = 0.001) and this effect was independent of Helicobacter pylori. The homozygous wild types also displayed an increased risk for peptic ulcers (OR: 4.390). Toll-like receptor 4 genotypes did not show any association with Helicobacter pylori positivity or the features of gastric inflammation. Toll-like receptor 4 expression was seen in gastrin and somatostatin expressing cells of antral mucosa by immunohistochemistry. Our results suggest a role for Toll-like receptor 4 in gastric acid regulation and that the Toll-like receptor 4 +896 and +1196 wild type homozygozity increases peptic ulcer risk via gastrin secretion. PMID:26161647

  8. Toll-Like Receptor 4 Wild Type Homozygozity of Polymorphisms +896 and +1196 Is Associated with High Gastrin Serum Levels and Peptic Ulcer Risk.

    Science.gov (United States)

    Pohjanen, Vesa-Matti; Koivurova, Olli-Pekka; Huhta, Heikki; Helminen, Olli; Mäkinen, Johanna M; Karhukorpi, Jari M; Joensuu, Tapio; Koistinen, Pentti O; Valtonen, Jarno M; Niemelä, Seppo E; Karttunen, Riitta A; Karttunen, Tuomo J

    2015-01-01

    Toll-like receptor 4 is a part of the innate immune system and recognizes Helicobacter pylori lipopolysaccharide. The goal of this study was to analyze the role of Toll-like receptor 4 polymorphisms +896 (rs4986790) and +1196 (rs4986791) in the pathogenesis of Helicobacter pylori related gastroduodenal diseases in relation to gastric secretion and inflammation. Toll-like receptor 4 polymorphisms, serum gastrin-17 and pepsinogen I and II concentrations were determined, and gastroscopies with histopathological analyses were performed to 216 dyspeptic patients. As genotype controls, 179 controls and 61 gastric cancer patients were studied. In our study, the Toll-like receptor 4 +896 and +1196 polymorphisms were in total linkage disequilibrium. The homozygous wild types displayed higher gastrin-17 serum concentrations than the mutants (p = 0.001) and this effect was independent of Helicobacter pylori. The homozygous wild types also displayed an increased risk for peptic ulcers (OR: 4.390). Toll-like receptor 4 genotypes did not show any association with Helicobacter pylori positivity or the features of gastric inflammation. Toll-like receptor 4 expression was seen in gastrin and somatostatin expressing cells of antral mucosa by immunohistochemistry. Our results suggest a role for Toll-like receptor 4 in gastric acid regulation and that the Toll-like receptor 4 +896 and +1196 wild type homozygozity increases peptic ulcer risk via gastrin secretion.

  9. One-week dual therapy with ranitidine bismuth citrate and clarithromycin for the treatment of Helicobacter pylori infection in Brazilian patients with peptic ulcer

    Institute of Scientific and Technical Information of China (English)

    Maria Aparecida Mesquita; S(o)nia Letícia Silva Lorena; Jazon Romilson Souza Almeida; Ciro Garcia Montes; Fábio Guerrazzi; Luciana T Campos; José Murilo Rubiota Zeitune

    2005-01-01

    AIM: To assess the efficacy and safety of ranitidine bismuth citrate plus clarithromycin given for 1 wk in Brazilian patients with peptic ulcer.METHODS: One hundred and twenty patients with peptic ulcer were randomized in two treatment groups: (1) 1-wk regimen consisting of ranitidine bismuth citrate 400 mg b.i.d. with clarithromycin 500 mg b.i.d. or (2) 2-wk regimen of the same treatment. Eradication of the infection was considered when both the histologic examination and the urease test were negative for the infection 3 mo after treatment.RESULTS: By intention to treat analysis, Helicobacter pylori (H pylori) was eradicated in 73% and 76% of patients, respectively treated for 1 or 2 wk (P>0.05). By per protocol analysis, the eradication rates were 80% and 83%,respectively, in patients treated for 1 or 2 wk (P>0.05). Nine patients (8.2%) reported minor side effects. CONCLUSION: One-week therapy with ranitidine bismuth citrate and clarithromycin is safe, well tolerated and effective for treatment of H pylori infection, andappears to be comparable to the 2-wk regimen in terms of efficacy.

  10. Anti-ulcerogenic activity of aqueous extract of Carica papaya seed on indomethacin-induced peptic ulcer in male albino rats

    Institute of Scientific and Technical Information of China (English)

    Hussein O B Oloyede; Matthew C Adaja; Taofeek O Ajiboye; Musa O Salawu

    2015-01-01

    OBJECTIVE:Carica papaya is an important fruit with its seeds used in the treatment of ulcer in Nigeria. This study investigated the anti-ulcerogenic and antioxidant activities of aqueous extract of Carica papaya seed against indomethacin-induced peptic ulcer in male rats. METHODS:Thirty male rats were separated into 6 groups (A–F) of ifve rats each. For 14 d before ulcer induction with indomethacin, groups received once daily oral doses of vehicle (distil ed water), cimetidine 200 mg/kg body weight (BW), or aqueous extract of C. papaya seed at doses of 100, 150 or 200 mg/kg BW (groups A, B, C, D, E and F, respectively). Twenty-four hours after the last treatment, groups B, C, D, E and F were treated with 100 mg/kg BW of indomethacin to induce ulcer formation. RESULTS:Carica papaya seed extract signiifcantly (P<0.05) increased gastric pH and percentage of ulcer inhibition relative to indomethacin-induced ulcer rats. The extract signiifcantly (P<0.05) decreased gastric acidity, gastric acid output, gastric pepsin secretion, ulcer index and gastric secretion volume relative to group B. These results were similar to that achieved by pretreatment with cimetidine. Speciifc activities of superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase and glucose-6-phosphate dehydrogenase in the extract-treated groups (D, E and F) were increased signiifcantly over the group B (P<0.05). Pretreatment with the seed extract protected rats from the indomethacin-mediated decrease in enzyme function experienced by the group B. Similarly, indomethacin-mediated decrease in reduced glutathione level and indomethacin-mediated increase in malondialdehyde were reversed by Carica papaya extract. CONCLUSION:In this study, pretreatment with aqueous extract of Carica papaya seed exhibited anti-ulcerogenic and antioxidant effects, which may be due to the enhanced antioxidant enzymes.

  11. Gedunin and photogedunin of Xylocarpus granatum show significant anti-secretory effects and protect the gastric mucosa of peptic ulcer in rats.

    Science.gov (United States)

    Lakshmi, V; Singh, N; Shrivastva, S; Mishra, S K; Dharmani, P; Mishra, V; Palit, G

    2010-07-01

    In the present study, the gastroprotective mechanism of Xylocarpus granatum fruit and its active constituents gedunin and photogedunin was investigated. Chloroform fraction (Fr-CHCl(3)) of X. granatum fruit was evaluated against cold restraint (CRU), aspirin (AS), alcohol (AL) and pyloric ligation (PL) induced gastric ulcer models in rats and histamine (HA) induced duodenal ulcer model in guinea pigs. Potential anti-ulcer activity of Fr-CHCl(3) was observed against CRU (58.28%), AS (67.81%), AL (84.38%), PL (65.66%) and HA (61.93%) induced ulcer models. The standard drug omeprazole (10mg/kg, p.o.) showed 68.25% protection against CRU, 57.08% against AS and 69.42% against PL model and 70.79% against HA induced duodenal ulcer. Sucralfate, another standard drug (500 mg/kg, p.o.) showed 62.72% protection in AL induced ulcer model. Fr-CHCl(3) significantly reduced free acidity (51.42%), total acidity (30.76%) and upregulated mucin secretion by 58.37% respectively. Phytochemical investigations of Fr-CHCl(3) yielded gedunin (36%), photogedunin (2%). Further, Fr-CHCl(3) and its compounds gedunin and photogedunin significantly inhibited H(+) K(+)-ATPase activity in vitro with IC(50) of 89.37, 56.86 and 66.54 microg/ml respectively as compared to the IC(50) value of omeprazole (30.24 microg/ml) confirming their anti-secretory activity. Conclusively, Fr-CHCl(3) of Xylocarpus granatum was found to possess anti-ulcerogenic activity which might be due to its anti-secretory activity and subsequent strengthening of the defensive mechanism. This study is the first of its kind to show significant anti-secretory effect of gedunin and photogedunin. Therefore it could act as a potent therapeutic agent against peptic ulcer disease.

  12. 四联疗法治疗难治性消化溃疡的临床研究%QUADRUPLE THERAPY FOR TREATMENT OF REFRACTORY PEPTIC ULCER

    Institute of Scientific and Technical Information of China (English)

    张嘉刚

    2011-01-01

    [目的]探讨四联用药治疗难治性消化性溃疡的临床疗效.[方法]将61例难治性消化性溃疡患者随机分为对照组(n=30)和观察组(n=31),对照组采用口服雷尼替丁(150 mg/次,bid)胶体果胶铋(39/次,tid)、克拉霉素(0.5g/次,bid,不与雷尼替丁同时服用)治疗4周;观察组采用口服埃索美拉唑肠溶片(40 mf/次,bid)、胶体果胶铋(3 粒/次、tid)、克拉霉素(0.5 g,bid)、羟氨苄青霉素(1.0 g,bid)四联疗法治疗,1周后口服埃索美拉唑(40 mg/次,qd)与胶体果胶铋(3粒/次,tid)持续治疗3周.观察两组临床疗效、胃镜下溃疡愈合情况及幽门螺旋杆菌(Hp)的清除率与根除率.[结果]观察组四联用药治疗难治性消化性溃疡的临床总体有效率和胃镜下溃疡愈合总体有效率均为100%,Hp清除率与根除率分别为96.8%和93.5%,均显著高于对照组,两组各项指标比较差异均有统计学意义(P < 0.05).观察物不良反应轻微.[结论]四联用药(埃索美拉唑镬肠溶片、胶体果胶铋、克拉霉素、羟氨青霉素)能有效根除Hp感染,促进溃疡的愈合,对难治性消化性溃疡疗效显著.%[Objective] To investigate the clinical efficacy of quadruple drug treatment in refractory peptic ulcer. [Methods] 61 patients with refractory peptic ulcer were randomly divided into the control group (n = 30) and the observation group (n = 31), the control group was treated with oral ranitidine (150mg/time, bid) , colloidal bismuth pectin (3 capsules/time, tid), clarithromycin (0.5g/time, bid, not with ranitidine while taking) for 4 weeks; observation group was treated with oral administration of esomeprazole enteric-coated tablets (40mg/time, bid) , colloidal bismuth pectin (3 capsules/time, tid) , clarithromycin (0.5g, bid) , amoxicillin ( l.Og, bid) quadruple therapy, after a week of oral esomeprazole (40mg/times, qd) and colloidal bismuth pectin (3/time, tid), continued treatment for 3 weeks. Then observed the clinical

  13. Refractory duodenal ulcer

    Directory of Open Access Journals (Sweden)

    Al Freihi Hussein

    1995-01-01

    Full Text Available Refractory or intractable ulcer is defined as an ulcer that fails to heal completely after eight to twelve weeks, despite appropriate treatment with a modern antiulcer therapy in a compliant patient. Refractory ulcer should be suspected in individuals diagnosed to have peptic ulcer if their symptoms persist longer than usual: occurrence of complications or simply their ulcers fail to heal, since up to 25% of such patients remain asymptomatic. Conditions associated with refractory ulcer include noncompliance, continuous consumption of nonsteroidal anti-inflam-matory drugs, acid hypersecretion, smoking. male gender and other factors with questionable role like advanced age, large ulcer size, prolonged duration of symptoms and the presence of complication like bleeding. Nonpeptic ulcers like tuberculosis, malignancy, Crohn′s disease and primary intestinal lymphoma should always be considered in the differential diagnosis. Colonization with H. pylori which is well-known as a cause of frequent recurrences, has not been linked with refractoriness. Patients with refractory ulcers must undergo thorough re-evaluation including repeated endoscopies, obtaining biopsies for microbiology and histology and determination of serum-gastrin level. Once diseases with identifiable etiologies have been ruled out, aggressive medical management with single or multiple antiulcer drugs should be instituted. Such treatments will virtually heal all refractory ulcers. Surgery should be reserved for patients whose ulcers fail to respond to optimal medical therapy or those who develop com-plications necessitating surgical intervention.

  14. COMPARISON OF RANITIDINE AND PANTOPRAZOLE FOR STRESS ULCER BLEEDING PROPHYLAXIS IN CRITICALLY ILL PATIENTS REQUIRING MECHANICAL VENTILATION

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    Objective To compare the efficacy of Ranitidine and Pantoprazole for the prevention of haemorrhage from stress ulcer among critical care patients. Methods A total of 121 critically ill patients were included in this retrospective study. The choice of pharmacologic stress ulcer prophylaxis were either Ranitidine or Pantoprazole. The primary outcome was the incidence of stress-related significant upper gastrointestinal bleeding, and the secondary outcome was the incidence of hospital acquired pneumonia (HAP)....

  15. Roxatidine acetate. A review of its pharmacodynamic and pharmacokinetic properties, and its therapeutic potential in peptic ulcer disease and related disorders.

    Science.gov (United States)

    Murdoch, D; McTavish, D

    1991-08-01

    Roxatidine acetate is a histamine H2-receptor antagonist which, after almost complete oral absorption (greater than 95%), is rapidly converted to its active metabolite, roxatidine, by esterases in the small intestine, plasma and liver. Roxatidine is a potent inhibitor of basal and stimulated gastric acid secretion in animals and humans and, like most other H2-receptor antagonists, has no anti-androgenic effects and does not interfere with the hepatic metabolism of other drugs. Large-scale trials have shown that roxatidine acetate 150mg per day is as effective as standard doses of cimetidine and ranitidine in the treatment of patients with duodenal or gastric ulcer, and that roxatidine acetate 75mg in the evening is likely to become a 'standard' regimen for the prevention of peptic ulcer recurrence. Preliminary data also suggest that roxatidine acetate may be useful in the treatment of reflux oesophagitis and stomal ulcer, and in the prevention of pulmonary acid aspiration. Roxatidine acetate is an H2-receptor antagonist which has been well tolerated in clinical trials. However, broader experience is required before definitive statements about tolerability relative to other H2-receptor antagonists can be made, and before the role of roxatidine acetate in the treatment of reflux oesophagitis and stomal ulcer, and the prophylaxis of acid aspiration pneumonitis, can be clearly defined.

  16. Upper non-variceal gastrointestinal bleeding - review the effectiveness of endoscopic hemostasis methods

    Science.gov (United States)

    Szura, Mirosław; Pasternak, Artur

    2015-01-01

    Upper non-variceal gastrointestinal bleeding is a condition that requires immediate medical intervention and has a high associated mortality rate (exceeding 10%). The vast majority of upper gastrointestinal bleeding cases are due to peptic ulcers. Helicobacter pylori infection, non-steroidal anti-inflammatory drugs and aspirin are the main risk factors for peptic ulcer disease. Endoscopic therapy has generally been recommended as the first-line treatment for upper gastrointestinal bleeding as it has been shown to reduce recurrent bleeding, the need for surgery and mortality. Early endoscopy (within 24 h of hospital admission) has a greater impact than delayed endoscopy on the length of hospital stay and requirement for blood transfusion. This paper aims to review and compare the efficacy of the types of endoscopic hemostasis most commonly used to control non-variceal gastrointestinal bleeding by pooling data from the literature. PMID:26421105

  17. Upper non-variceal gastrointestinal bleeding-review the effectiveness of endoscopic hemostasis methods

    Institute of Scientific and Technical Information of China (English)

    Miros?aw; Szura; Artur; Pasternak

    2015-01-01

    Upper non-variceal gastrointestinal bleeding is a conditionthat requires immediate medical intervention and has a high associated mortality rate(exceeding 10%). The vast majority of upper gastrointestinal bleeding cases are due to peptic ulcers. Helicobacter pylori infection, non-steroidal anti-inflammatory drugs and aspirin are the main risk factors for peptic ulcer disease. Endoscopic therapy has generally been recommended as the firstline treatment for upper gastrointestinal bleeding as it has been shown to reduce recurrent bleeding, the need for surgery and mortality. Early endoscopy(within 24 h of hospital admission) has a greater impact than delayed endoscopy on the length of hospital stay and requirement for blood transfusion. This paper aims to review and compare the efficacy of the types of endoscopic hemostasis most commonly used to control non-variceal gastrointestinal bleeding by pooling data from the literature.

  18. 腹腔镜与开腹修补消化性溃疡穿孔的临床比较分析%Comparative analysis of laparoscopic and open repair of peptic ulcer perforation clinical

    Institute of Scientific and Technical Information of China (English)

    陈燕青; 葛建国

    2014-01-01

    Objective To compare the clinical effect of open and laparoscopic repair in the treatment of peptic ulcer perforation. Methods 56 cases of peptic ulcer perforation were randomly divided into two groups,28 cases in each group. The control group used open neoplasty,research group usedlaparoscopic repair,comparative analysis of two groups of patients with clinical efficacy. Results The study group patients operative bleeding and postoperative pain score,the exhaust time,hospitalization time and other indicators were significantly lower than the control group,and the incidence of complications is significantly less than the control group,the difference between the two significant,with statistical significance,P<0.05. Conclusion Using laparoscopic repair can effectively reduce operation wound,relieve pain,patients,and has application value and popularization value in clinical practice.%目的:探讨并对比分析开腹与腹腔镜修补术治疗消化性溃疡穿孔的临床效果。方法将56例消化性溃疡穿孔患者随机分为两组,每组28例。对照组采用开腹修补术,研究组采用腹腔镜修补术,对比分析两组患者临床情况和效果。结果研究组患者手术中出血量以及术后疼痛评分、排气时间、住院时间等指标均明显比对照组低,且并发症发生率也明显比对照组少,二者差异具有统计学意义(P<0.05)。结论在消化性溃疡穿孔的临床治疗中,采用腹腔镜修补术可有效减轻手术创伤,缓解疼痛,便于患者的康复,在临床中具有应用和推广价值。

  19. TO COMPARE THE SAFETY AND EFFICACY OF THREE DIFFERENT, PROTON PUMP INHIBITORS OMEPRAZOLE, ESO M EPRAZOLE AND RABEPRAZOLE IN A TRIPLE DRUG REGIMEN IN PATIENTS WITH PEPTIC ULCER DISEASE IN THE ERADICATION OF H. PYLORI INFECTION

    Directory of Open Access Journals (Sweden)

    Margaret Viola

    2015-03-01

    Full Text Available Peptic ulcer disease continues to be issue especially due to its high prevalence in the developing world. Helicobacter pylori ( H. pylori infection associated duodenal ulcers should undergo eradication therapy. There are many regimens offered for H. pylori eradication which include triple , quadruple , or sequential therapy regimens. In our study we planned to see whether these differences in pharmacokinetic properties show any difference in t he efficacy and safety parameters between treatment with omeprazole rabeprazole and esomeprazole in the triple drug regimen for eradication of H.pylori infection in peptic ulcer patients in our hospital Osmania General Hospital / Osmania Medical College , Hyderabad. MATERIALS AND METHODS: A total number of 45 patients were enrolled in the study. Patients with either sex suffering from peptic ulcer defined as ulcer crater of >2.5mm in size by endoscopy. Study Design : It was a randomized double blind , paralle l and comparative study. CONCLUSION: Two weeks after triple drug treatment , H.pylori was negative in 66.7% , 73% and 80% and Rapid urease test was negative in 53% , 60% and 66% in group A , B and C respectively. Endoscopy findings showed significant reduction in size and healing of ulcers in group A , B and C. There was improvement in signs and symptoms by 53 to 80% , after 2 weeks. Hence after therapy with triple drug regimen H.pylori eradication was 66 - 80% and healing of ulcers was 83 – 100% which was higher in Rabeprazole group. At 6 weeks , there was complete relief of signs and symptoms. At the follow up of 10 weeks there was no ulcer recurrence. No adverse effects were noted in all the groups. In conclusion , Triple drug regimen had shown to eradicate H.pylori infection in the treatment of Peptic ulcer. There was healing of ulcers in all the groups which was highly significant. There was no recurrence of peptic ulcer with these regimens in all the groups. However Rabeprazole group patients

  20. 消化性溃疡患者不良生活方式的影响%Influence of bad life style on the patients with peptic ulcer

    Institute of Scientific and Technical Information of China (English)

    李新玲

    2015-01-01

    Objective:To explore the influence of bad life style on the patients with peptic ulcer.Methods:80 patients with peptic ulcer were selected.They were randomly divided into the observation group and the control group with 40 cases in each.The bad life styles of all patients were surveyed.The control group was given general health guidance.The observation group was given healthy lifestyle guidance,including reasonable diet guidance,abstinence,maintaining good state of mind and mood.Results:After treatment,the total effective rate of the observation group was 97.5%,after 6 to 18 months follow-up,the recurrence rate was 7.5%. In the control group,the total effective rate was 80.0%,the recurrence rate was 40.0%.The difference between two groups was statistically significant(P<0.05).Conclusion:Good life style can help digestion,it is beneficial to improve the patient's compliance, reduce the recurrence rate of peptic ulcer.%目的:探讨不良生活方式对消化性溃疡患者的影响.方法:收治消化性溃疡患者80例,随机分成观察组和对照组各40例,对所有患者进行不良生活方式进行调查,对照组进行一般的健康指导,观察组进行健康生活方式的指导,主要包括合理饮食指导、戒酒、保持良好的心态和心情.结果:经过治疗后观察组总有效率97.5%,经过6~18 个月得到随访,复发率 7.5%;对照组总有效率 80.0%,复发率 40.0%,两组比较差异有统计学意义(P<0.05).结论:良好的生活方式可以帮助消化,有利于提高患者的依从性,降低消化性溃疡复发率.

  1. Peptic ulcer perforation of the progress of diagnosis and treatment%消化性溃疡穿孔的诊断和治疗的进展

    Institute of Scientific and Technical Information of China (English)

    游勤建

    2009-01-01

    消化性溃疡(Peptic ulcer,PU)是临床常见病和多发病,全球有1/10的人口在一生中某一时间患过 PU.有研究表明,40~60岁之间人群PU检出率最高,男性患者高于女性患者,吸烟者明显高于非吸烟者, O型血患者明显高于其他血型患者.这些因素之间是否存在一定的关系,比如男女性别差异是否与吸烟有关,还有待于进一步研究.Borody[1]随访根除H pylori的DU患者3年,无论患者吸烟与否,均未发现DU复发.而在不存在 H pylori感染的情况下吸烟似乎并不足以成为一个独立致PU的危险因素.但 Konturek[2]的研究显示H pylori感染、年龄、吸烟均在PU的发病中起重要作用.O型血患者 PU发病率高可能与其容易感染H pylori有关.%Peptic Ulcer (Peptic ulcer, PU) is a common and frequently-occurring disease clinical, there are 1 / 10 of the population at a particular time in their lives suffered from PU. Studies have shown that between 40-60-year-old crowd PU detection rate between the highest, higher than that of female patients with male patients, smokers was significantly higher than non-smokers, O blood type patients was significantly higher than patients with other blood types. Among these factors whether there is a certain relationship, such as whether gender differences in smoking-related, but also to be further studied. Borody [1] follow-up of the eradication of H pylori in DU patients with 3-year, non -On the patients with smoking or not, the DU recurrence were found. And in the absence of H pylori infection in the case of smoking does not appear to warrant an independent risk factor to PU. However, Konturek [2] studies have shown that H pylori infection, age, smoking prevalence in the PU to play an important role. PU in patients with type O blood may be related to high incidence of H pylori infection related to easily.

  2. Consensus and Variable Region PCR Analysis of Helicobacter pylori 3′ Region of cagA Gene in Isolates from Individuals with or without Peptic Ulcer

    Science.gov (United States)

    Rota, Cláudia Augustin; Pereira-Lima, Júlio C.; Blaya, Carolina; Nardi, Nance Beyer

    2001-01-01

    The clinical outcome of Helicobacter pylori infection may be associated with the cagA bacterial genotype. To investigate the cagA status of H. pylori-infected patients and the relationship between cagA and peptic ulcer disease, gastric biopsy specimens from 103 Caucasian patients in Brazil were analyzed by PCR. Since allelic variation in cagA exists and distinct H. pylori subgenotypes may circulate in different regions, PCR using primers for a variable 3′ region of the cagA gene according to a Japanese methodology and for a consensus cagA 3′ region used in Western methods was used for cagA detection. cagA was present in 53 (71%) of 75 H. pylori-positive cases when analyzed by the consensus region method and was associated with duodenal ulcer disease (P = 0.02), but not with gastric ulcer (P = 0.26), when compared to patients with duodenitis or gastritis. The variable region PCR method was able to detect 43 (57%) cagA-positive cases within the same group of H. pylori-positive patients and showed three subtypes of cagA (A, B/D, and C) that were not associated with clinical outcome. However, in 8 (18%) of the cases, more than one subtype was present, and an association between patients with multiple subtypes and disease outcome was observed when compared to patients with isolated subtypes (P = 0.048). cagA was a marker of H. pylori strains for duodenal ulcer disease in our population, and in spite of the differences in the 3′ region of the cagA gene, the Japanese methodology was able to detect the cagA status in most cases. The presence of multiple subgenotypes of cagA was associated with gastric ulcer. PMID:11158115

  3. The history and rationale of using carbonic anhydrase inhibitors in the treatment of peptic ulcers. In memoriam Ioan Puşcaş (1932-2015).

    Science.gov (United States)

    Buzás, György M; Supuran, Claudiu T

    2016-08-01

    Carbonic anhydrase (CA, EC 4.2.1.1) inhibitors (CAIs) started to be used in the treatment of peptic ulcers in the 1970s, and for more than two decades, a group led by Ioan Puşcaş used them for this purpose, assuming that by inhibiting the gastric mucosa CA isoforms, hydrochloric acid secretion is decreased. Although acetazolamide and other sulfonamide CAIs are indeed effective in healing ulcers, the inhibition of CA isoforms in other organs than the stomach led to a number of serious side effects which made this treatment obsolete when the histamine H2 receptor antagonists and the proton pump inhibitors became available. Decades later, in 2002, it has been discovered that Helicobacter pylori, the bacterial pathogen responsible for gastric ulcers and cancers, encodes for two CAs, one belonging to the α-class and the other one to the β-class of these enzymes. These enzymes are crucial for the life cycle of the bacterium and its acclimation within the highly acidic environment of the stomach. Inhibition of the two bacterial CAs with sulfonamides such as acetazolamide, a low-nanomolar H. pylori CAI, is lethal for the pathogen, which explains why these compounds were clinically efficient as anti-ulcer drugs. Thus, the approach promoted by Ioan Puşcaş for treating this disease was a good one although the rationale behind it was wrong. In this review, we present a historical overview of the sulfonamide CAIs as anti-ulcer agents, in memoriam of the scientist who was in the first line of this research trend.

  4. The relationship between the Five-Factor Model personality traits and peptic ulcer disease in a large population-based adult sample.

    Science.gov (United States)

    Realo, Anu; Teras, Andero; Kööts-Ausmees, Liisi; Esko, Tõnu; Metspalu, Andres; Allik, Jüri

    2015-12-01

    The current study examined the relationship between the Five-Factor Model personality traits and physician-confirmed peptic ulcer disease (PUD) diagnosis in a large population-based adult sample, controlling for the relevant behavioral and sociodemographic factors. Personality traits were assessed by participants themselves and by knowledgeable informants using the NEO Personality Inventory-3 (NEO PI-3). When controlling for age, sex, education, and cigarette smoking, only one of the five NEO PI-3 domain scales - higher Neuroticism - and two facet scales - lower A1: Trust and higher C1: Competence - made a small, yet significant contribution (p personality traits that are associated with the diagnosis of PUD at a particular point in time. Further prospective studies with a longitudinal design and multiple assessments would be needed to fully understand if the FFM personality traits serve as risk factors for the development of PUD.

  5. Clinical features and treatment of senile peptic ulcer%老年性消化系溃疡临床特点及治疗体会

    Institute of Scientific and Technical Information of China (English)

    陈秀玲

    2015-01-01

    目的:研究老年性消化系溃疡临床特点及治疗体会。方法:按照随机分号法将我院2013年1月-2014年12月间诊治的110例老年性消化系溃疡患者均分为两组,分析其临床特点,对双号组患者进行常规治疗(对照组),对单号组患者在对照组的基础上加用溃疡散治疗(观察组),对比观察二者的临床治疗效果。结果:在总有效率方面,观察组的94.55%远远高于对照组的80.00%(P<0.05);在不良反应发生率方面,观察组为9.09%,明显低于对照组的20.00%(P<0.05)。结论:老年性消化系溃疡的临床特点主要包括胃溃疡比十二指肠溃疡的发病率高、急性穿孔较多、合并症较多且死亡率高,在常规治疗的基础上加用溃疡散不仅可以显著提高临床治疗效果,而且还能降低不良反应的发生率,值得临床推广使用。%Objective: To study the clinical characteristics and treatment of senile peptic ulcer. Methods: 110 patients, who have the senile peptic ulcer and were treated in our hospital from January 2013 to December 2014, were divided into an obser-vation group and a control group with the random semicolons method. Then their clinical characteristics were analyzed. Routine treatment was implemented to the control group ( patients with the even number) and the patients in the observation group were treated with the ulcer plus routine treatment. The clinical curative effects of the two groups were observed and compared. Results:In terms of overall efficiency, the observation group (94.55%) is much higher than the control group (80.00%) (P<0.05) . The incidence of adverse reactions in the observation group is 9.09%, significantly lower than the control group's 20.00%( P<0.05) . Conclusion: The clinical characteristics of peptic ulcer in the elderly include the higher incidence than duodenal ulcer, more acute perforation, more complications and high mortality rate. The ulcer plus

  6. A therapeutic dose of ketoprofen causes acute gastrointestinal bleeding, erosions, and ulcers in rats.

    Science.gov (United States)

    Shientag, Lisa J; Wheeler, Suzanne M; Garlick, David S; Maranda, Louise S

    2012-11-01

    Perioperative treatment of several rats in our facility with ketoprofen (5 mg/kg SC) resulted in blood loss, peritonitis, and death within a day to a little more than a week after surgery that was not related to the gastrointestinal tract. Published reports have established the 5-mg/kg dose as safe and effective for rats. Because ketoprofen is a nonselective nonsteroidal antiinflammatory drug that can damage the gastrointestinal tract, the putative diagnosis for these morbidities and mortalities was gastrointestinal toxicity caused by ketoprofen (5 mg/kg). We conducted a prospective study evaluating the effect of this therapeutic dose of ketoprofen on the rat gastrointestinal tract within 24 h. Ketoprofen (5 mg/kg SC) was administered to one group of rats that then received gas anesthesia for 30 min and to another group without subsequent anesthesia. A third group was injected with saline followed by 30 min of gas anesthesia. Our primary hypothesis was that noteworthy gastrointestinal bleeding and lesions would occur in both groups treated with ketoprofen but not in rats that received saline and anesthesia. Our results showed marked gastrointestinal bleeding, erosions, and small intestinal ulcers in the ketoprofen-treated rats and minimal damages in the saline-treated group. The combination of ketoprofen and anesthesia resulted in worse clinical signs than did ketoprofen alone. We conclude that a single 5-mg/kg dose of ketoprofen causes acute mucosal damage to the rat small intestine.

  7. Comparison on the effect of laparoscopic and laparotomy in treatment of peptic ulcer perforation%腹腔镜与开腹手术治疗消化性溃疡穿孔的效果对比

    Institute of Scientific and Technical Information of China (English)

    于青松

    2014-01-01

    目的:对比分析腹腔镜与开腹手术治疗消化性溃疡穿孔的手术效果。方法选取2011年1月~2013年1月在本院行腹腔镜穿孔修补术的患者40例作为腹腔镜组,另选择同期在本院行开腹子穿孔修补术的40例患者作为对照组,比较两组患者的手术时间、术中出血量、术后排气时间、住院时间及并发症发生情况。结果腹腔镜组患者的术中出血量明显少于对照组(P<0.01);术后排气时间明显短于对照组(P<0.01)、住院时间短于对照组(P<0.05),腹腔镜组的并发症发生率仅为5.0%,明显低于对照组(P<0.05)。结论腹腔镜胃十二指肠溃疡穿孔修补术较开腹手术能减少术中出血量、降低术后发症发生率、缩短住院时间、促进患者术后的恢复,值得临床推广应用。%Objective To compare the effect of laparoscopic and laparotomy in treatment of peptic ulcer perforation. Methods 40 patients with underwent laparoscopic perforation repair from January 2011 to January 2013 in our hospital were selected as the laparoscopic group,and another 40 patients underwent laparotomy perforation repair were selected as the control group at the same period,the amount of bleeding,operation time,postoperative exhaust time, hospitalization time and incidence rate of complication were compared between the two groups. Results The amount of bleeding in the laparoscopic group was significantly less than that in the control group (P<0.01),the exhaust time of laparoscopic group was significantly shorter than the control group (P<0.01),the hospitalization time of the laparoscopic group was shorter than the control group (P<0.05).The incidence rate of complication of the laparoscopic group (5.0%) was significantly lower than that in the control group (P<0.05). Conclusion Laparoscopic in treatment of peptic ulcer perforation compared with la-parotomy can reduce the amount of bleeding,reduce the complications incidence,shorten the

  8. A 15-year-old boy with abdominal pain, growth retardation, and anemia secondary to Helicobacter pylori-associated peptic ulcer.

    Science.gov (United States)

    Andrianov, Melissa; Rivera, Edgardo; Azzam, Ruba

    2015-03-01

    A 15-year-old boy with abdominal pain, growth retardation, and symptomatic anemia requiring blood transfusion was seen by a gastroenterologist and found to have a large ulcerated, fungating, and actively bleeding mass in his stomach. Initially, the patient was screened for Helicobacter pylori and found to be negative, so there was concern for malignancy after multiple endoscopic procedures. The patient did not respond to initial ulcer treatment and immediately prior to scheduled partial gastrectomy, additional tissue sections from the initial biopsy were stained for H. pylori and rare positive staining organisms were found. The test was positive, and the patient was started empirically on treatment to which he responded and ultimately recovered fully. Gastrectomy was not performed, and following treatment, the ulcer, anemia, and poor growth resolved.

  9. Management of acute nonvariceal upper gastrointestinal bleeding: current policies and future perspectives.

    Science.gov (United States)

    Holster, Ingrid Lisanne; Kuipers, Ernst Johan

    2012-03-21

    Acute upper gastrointestinal bleeding (UGIB) is a gastroenterological emergency with a mortality of 6%-13%. The vast majority of these bleeds are due to peptic ulcers. Nonsteroidal anti-inflammatory drugs and Helicobacter pylori are the main risk factors for peptic ulcer disease. Endoscopy has become the mainstay for diagnosis and treatment of acute UGIB, and is recommended within 24 h of presentation. Proton pump inhibitor (PPI) administration before endoscopy can downstage the bleeding lesion and reduce the need for endoscopic therapy, but has no effect on rebleeding, mortality and need for surgery. Endoscopic therapy should be undertaken for ulcers with high-risk stigmata, to reduce the risk of rebleeding. This can be done with a variety of modalities. High-dose PPI administration after endoscopy can prevent rebleeding and reduce the need for further intervention and mortality, particularly in patients with high-risk stigmata.

  10. Management of acute nonvariceal upper gastrointestinal bleeding: Current policies and future perspectives

    Institute of Scientific and Technical Information of China (English)

    Ingrid Lisanne Holster; Ernst Johan Kuipers

    2012-01-01

    Acute upper gastrointestinal bleeding (UGIB) is a gastroenterological emergency with a mortality of 6%-13%.The vast majority of these bleeds are due to peptic ulcers.Nonsteroidal anti-inflammatory drugs and Helicobacter pylori are the main risk factors for peptic ulcer disease.Endoscopy has become the mainstay for diagnosis and treatment of acute UGIB,and is recommended within 24 h of presentation.Proton pump inhibitor (PPI) administration before endoscopy can downstage the bleeding lesion and reduce the need for endoscopic therapy,but has no effect on rebleeding,mortality and need for surgery.Endoscopic therapy should be undertaken for ulcers with high-risk stigmata,to reduce the risk of rebleeding.This can be done with a variety of modalities.High-dose PPI administration after endoscopy can prevent rebleeding and reduce the need for further intervention and mortality,particularly in patients with high-risk stigmata.

  11. Relationship between the acid-suppression efficacy of proton pump inhibitors and CYP2C19 genetic polymorphism in patients with peptic ulcer

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Obiective To investigate acid-suppression efficacy of proton pump inhibitors(PPls) in relation to CYP2C19 genetic polymorphism on patients with peptic ulcer. Methods By an open, randomized and control trial, fifty nine patients with active peptic ulcer were randomly assigned to receive one of three PPIs on a single dose (20 mg of each drug): omeprazole group (n=19), rabeprazole group (n=20) and esomeprazole group (n=20). lntragastric pH was recorded 1 hour before and 24 hours after administration. CYP2C19 genotype was tested in all patients. Resuits The EMs/PMs ratio of each group was 16/3,17/3 and 17/3, respectively. The total time that intragastric pH>4, time percent pH>4 and median pH in PMs patients were significantly higher than those in EMs patients of omeprazole group (P<0.05). But all these differences were not found in rabeprazole group and esomeprazole group. The pH of nocturnal acid breakthrough (NAB) in both rabeprazole group and esomeprazole group was higher than that of omeprazole group, while there was no significant difference between rabeprazole group and esomeprazole group. Gonclusion The acid-suppression efficacy of omeprazole is highly dependent on CYP2C19 genetic polymorphism, while CYP2C19 genetic polymorphism may have a little influence on the acid-suppression efficacy of rabeprazole and esomeprazole. The acid-suppression action of rabeprazole and esomeprazole is superior to omeprazole, especially on night acid secretion.