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The Korean Journal of Gastroenterology... Jun 2016Non-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.... (Review)
Review
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.
Topics: Aging; DNA Virus Infections; Diphosphonates; Helicobacter Infections; Humans; Peptic Ulcer; Stress, Psychological; Substance-Related Disorders; Tuberculosis
PubMed: 27312831
DOI: 10.4166/kjg.2016.67.6.313 -
The Korean Journal of Gastroenterology... Nov 2020Nonsteroidal anti-inflammatory drugs (NSAID) are some of the most commonly prescribed medications in clinical practice. The long-term use of NSAIDs is one of the main... (Review)
Review
Nonsteroidal anti-inflammatory drugs (NSAID) are some of the most commonly prescribed medications in clinical practice. The long-term use of NSAIDs is one of the main causes of peptic ulcers and the increased risk of upper gastrointestinal tract complications, such as perforation and bleeding. Thus, the prevention of NSAID-induced peptic ulcers is an important clinical issue. Previous studies have evaluated various strategies for preventing ulcers in patients requiring prolonged NSAID use. The Korean clinical practice guidelines have been published recently based on the evidence of the currently available data. This review describes the strategies for the prevention of peptic ulcers due to NSAID. An assessment of the risk factors for peptic ulcers from NSAID is recommended to identify patients who should be considered for primary prophylaxis. The risk of NSAID-induced peptic ulcers can be reduced by the concomitant use of proton pump inhibitors (PPI), misoprostol, and histamine-2 receptor antagonists. Selective cyclooxygenase-2 inhibitors can be used with caution due to concerns regarding cardiovascular toxicity. Attempts should be made to use the lowest dose and shortest duration of the NSAID.
Topics: Anti-Inflammatory Agents, Non-Steroidal; Anti-Ulcer Agents; Histamine H2 Antagonists; Humans; Peptic Ulcer; Pharmaceutical Preparations; Proton Pump Inhibitors; Risk Factors
PubMed: 33234769
DOI: 10.4166/kjg.2020.139 -
Beijing Da Xue Xue Bao. Yi Xue Ban =... Feb 2022To explore the relationship between high altitude polycythemia (HAPC) and peptic ulcer bleeding, in order to provide the evidence for the clinical diagnosis and...
OBJECTIVE
To explore the relationship between high altitude polycythemia (HAPC) and peptic ulcer bleeding, in order to provide the evidence for the clinical diagnosis and treatment of peptic ulcer disease in Tibet of China.
METHODS
A retrospective case-control study was conducted. Patients who hospitalized in the Department of Gastroenterology with the diagnosis of peptic ulcer bleeding from January 1, 2015 to April 30, 2021 in Tibet Autonomous Region People's Hospital were enrolled in the case group, and patients who hospitalized in the Department of Urology without tumor and without the history of peptic ulcer and gastrointestinal bleeding during the same period were selected as the control group. In the study, 1 ∶ 1 case matching was conducted between the two groups according to the gender, age (±2 years), ethnic group (Tibetan, Han), and the residence altitude level (grouped by < 4 000 m or ≥4 000 m), and 393 cases were included in the case group and the control group respectively. All the patients had lived in Tibet with the altitude >2 500 m for more than 1 year, and with age ≥ 18 years. The risk factors of peptic ulcer bleeding (place of residence, smoking, alcohol, the use of NSAIDs/anticoagulants, and combined with chronic diseases, such as HAPC, hypertension, diabetes mellitus, heart disease, hyperlipidemia, cerebrovascular disease, chronic lung disease, joint disease) were analyzed and compared between the two groups.
RESULTS
There were 28 (7.1%) patients with HAPC in the case group, and 5 (1.3%) in the control group. The incidence of HAPC in the case group was significantly higher than those in the control group, < 0.001, and the value was 5.953. Multivariate Logistic regression analysis showed that HAPC (=5.270, 95%: 1.806-15.380), living in cities and towns (=2.369, 95%: 1.559-3.602), alcohol (=3.238, 95%: 1.973-5.317) and the use of NSAIDs/anticoagulants (=20.584, 95%: 2.639-160.545) were the independent risk factors for peptic ulcer bleeding in Tibet. After adjusting for the possible confounding factors, such as living in cities and towns, alcohol, and the use of NSAIDs/anticoagulants, HAPC was associated with an increased risk of peptic ulcer bleeding in Tibet, and the value was 5.270.
CONCLUSION
HAPC was associated with a significantly increased risk of peptic ulcer bleeding in Tibet. Patients with HAPC and peptic ulcer should be diagnosed and treated actively, in order to avoid gastrointestinal bleeding and other serious complications.
Topics: Adolescent; Altitude; Case-Control Studies; Humans; Peptic Ulcer; Polycythemia; Retrospective Studies; Risk Factors
PubMed: 35165484
DOI: 10.19723/j.issn.1671-167X.2022.01.025 -
FEMS Immunology and Medical Microbiology May 2005Helicobacter pylori infection is the major cause of gastroduodenal pathologies, but only a minority of infected patients develop chronic and life threatening diseases,... (Review)
Review
Helicobacter pylori infection is the major cause of gastroduodenal pathologies, but only a minority of infected patients develop chronic and life threatening diseases, as peptic ulcer, gastric cancer, B-cell lymphoma, or autoimmune gastritis. The type of host immune response against H. pylori is crucial for the outcome of the infection. A predominant H. pylori-specific Th1 response, characterized by high IFN-gamma, TNF-alpha, and IL-12 production associates with peptic ulcer, whereas combined secretion of both Th1 and Th2 cytokines are present in uncomplicated gastritis. Gastric T cells from MALT lymphoma exhibit abnormal help for autologous B-cell proliferation and reduced perforin- and Fas-Fas ligand-mediated killing of B cells. In H. pylori-infected patients with autoimmune gastritis cytolytic T cells infiltrating the gastric mucosa cross-recognize different epitopes of H. pylori proteins and H+K+ ATPase autoantigen. These data suggest that peptic ulcer can be regarded as a Th1-driven immunopathological response to some H. pylori antigens, whereas deregulated and exhaustive H. pylori-induced T cell-dependent B-cell activation can support the onset of low-grade B-cell lymphoma. Alternatively, H. pylori infection may lead in some individuals to gastric autoimmunity via molecular mimicry.
Topics: Autoimmune Diseases; Cytokines; Helicobacter Infections; Helicobacter pylori; Humans; Lymphoma, B-Cell, Marginal Zone; Peptic Ulcer; Stomach Neoplasms; T-Lymphocytes
PubMed: 15866204
DOI: 10.1016/j.femsim.2004.10.013 -
BMJ (Clinical Research Ed.) Feb 1998
Review
Topics: Helicobacter Infections; Helicobacter pylori; Humans; Peptic Ulcer; Stress, Psychological
PubMed: 9501720
DOI: 10.1136/bmj.316.7130.538 -
Annals of African Medicine 2023Peptic ulcer disease (PUD) is common worldwide. Its incidence and prevalence have been declining in recent years in developed countries, and a similar trend has been...
BACKGROUND
Peptic ulcer disease (PUD) is common worldwide. Its incidence and prevalence have been declining in recent years in developed countries, and a similar trend has been observed in many parts of Africa including Nigeria.
AIM
This study aimed to provide an endoscopic update on PUD in the Northern Savannah of Nigeria and compare with past reports from the region and recent reports from Nigeria, Africa, and the rest of the world.
METHODS
Upper gastrointestinal endoscopy records of consecutive patients diagnosed with PUD between January 2014 and September 2022 at an endoscopy unit of a tertiary institution in North-West Nigeria were retrieved and demographic data, types of peptic ulcer, and their characteristics were extracted and analyzed.
RESULTS
Over a 9-year period, 171/1958 (8.7%) patients were diagnosed with PUD: mean age 48.8 years (range 14-85), 68.4% male, and 70% >40 years. 59.6% were gastric ulcers (GU), 31.6% duodenal ulcers (DU), and 8.8% were both. The mean age of patients with GU was slightly higher than those with DU (49.9 years vs. 46.6 years, P = 0.29); patients aged <40 years were significantly more likely to be diagnosed with DU than GU (54.7% vs. 33.9%, P = 0.016) while those >40 years significantly more GU than DU (74.6% vs. 54.7%, P = 0.016). There were no significant gender differences between GU and DU.
CONCLUSION
The prevalence and pattern of PUD in Northern Savannah of Nigeria have changed - patients were predominantly male and older, and GU predominated.
Topics: Humans; Male; Middle Aged; Adolescent; Young Adult; Adult; Aged; Aged, 80 and over; Female; Prevalence; Nigeria; Peptic Ulcer; Stomach Ulcer; Duodenal Ulcer
PubMed: 38358140
DOI: 10.4103/aam.aam_144_22 -
Langenbeck's Archives of Surgery Nov 2023The aim of this study was to compare weight loss and gastroesophageal reflux disease (GERD) remission after one-anastomosis gastric bypass (OAGB) versus Roux-en-Y... (Meta-Analysis)
Meta-Analysis Review
One-anastomosis gastric bypass (OAGB) versus Roux-en-Y gastric bypass (RYGB) as revisional procedures after failed laparoscopic sleeve gastrectomy (LSG): systematic review and meta-analysis of comparative studies.
INTRODUCTION
The aim of this study was to compare weight loss and gastroesophageal reflux disease (GERD) remission after one-anastomosis gastric bypass (OAGB) versus Roux-en-Y gastric bypass (RYGB) as revisional procedures after laparoscopic sleeve gastrectomy (LSG).
METHODS
In PubMed, Embase, and Cochrane Library, a search was performed using the terms "Roux-en-Y gastric bypass versus one anastomosis gastric bypass," "revisional surgery," and "sleeve gastrectomy." Only original articles in English language comparing OAGB and RYGB were included. No temporal interval was set. The primary outcome measure was weight loss (%TWL). The secondary endpoints were leak, bleeding, marginal ulcer, and GERD. PRISMA flowchart was used. Differences in continuous and dichotomous outcome variables were expressed as mean difference (MD) and risk difference (RD) with 95% CI, respectively. Heterogeneity was assessed by using I statistic.
RESULTS
Six retrospective comparative articles were included in the present meta-analysis. Weight loss analysis showed a MD = 5.70 (95% CI 4.84-6.57) in favor of the OAGB procedure with a statistical significance (p = 0.00001) and no significant statistical heterogeneity (I = 0.00%). There was no significant RD for leak, bleeding, or marginal ulcer after the two revisional procedures. After conversion to OAGB, remission from GERD was 68.6% (81/118), and it was 80.6% (150/186) after conversion to RYGB with a RD = 0.10 (95% CI -0.04, 0.24), no statistical significance (p = 0.19), and high heterogeneity (I = 96%). De novo GERD was 6.3% (16/255) after conversional OAGB, and it was 0.5% (1/180) after conversion to RYGB with a RD = -0.23 (95% CI -0.57, 0.11), no statistical significance (p = 0.16), and high heterogeneity (I = 92%).
Topics: Humans; Gastric Bypass; Obesity, Morbid; Retrospective Studies; Reoperation; Gastroesophageal Reflux; Gastrectomy; Peptic Ulcer; Weight Loss; Laparoscopy
PubMed: 37980292
DOI: 10.1007/s00423-023-03175-x -
British Journal of Hospital Medicine... Jul 2023A considerable portion of the world's population practices fasting, for religious purposes like Ramadan or to adopt a healthier lifestyle such as intermittent fasting.... (Review)
Review
A considerable portion of the world's population practices fasting, for religious purposes like Ramadan or to adopt a healthier lifestyle such as intermittent fasting. During this period, individuals undergo metabolic changes that alter their internal environment. The literature was analysed to identify a possible relationship between fasting and the development of -induced peptic ulcers. This found that fasting does not affect the incidence of peptic ulcers, and studies that saw an increase in the incidence were not significant. However, remodelling of the gastric environment and increases in concentrations of were recorded. There is no relationship between fasting and the risk of developing -induced peptic ulcers, suggesting that individuals with uncomplicated ulcers are not at risk of developing further ulcers and can participate in fasts provided they take the recommended measures.
Topics: Humans; Helicobacter pylori; Ulcer; Intermittent Fasting; Peptic Ulcer; Incidence; Helicobacter Infections
PubMed: 37490435
DOI: 10.12968/hmed.2022.0369 -
Canadian Journal of Surgery. Journal... Oct 2000Since the causative role of Helicobacter pylori in peptic ulcer and gastritis was established, a number of advances have been made. Helicobacter virulence factors have... (Review)
Review
Since the causative role of Helicobacter pylori in peptic ulcer and gastritis was established, a number of advances have been made. Helicobacter virulence factors have been identified, the changes it causes in gastric acid secretion has been elucidated, and the entire genome of H. pylori has been mapped. Multiple lines of evidence indicate a strong link between the bacterium and noncardia gastric cancer. The infection can be confidently diagnosed by noninvasive serologic tests and the urea breath test. Triple therapy is almost always curative, and the infection almost never recurs in Canadian adults, but eradicating the bacteria in the absence of peptic ulcer only rarely leads to resolution of dyspepsia. New studies suggest that treating Helicobacter may increase the risk of peptic esophagitis and adenocarcinoma of the esophagus and cardia.
Topics: Anti-Bacterial Agents; Drug Therapy, Combination; Gastritis; Helicobacter Infections; Helicobacter pylori; Humans; Peptic Ulcer; Precancerous Conditions; Risk Factors; Stomach Neoplasms; Virulence
PubMed: 11045091
DOI: No ID Found -
Chirurgia (Bucharest, Romania : 1990) Dec 2023Helicobacter pylori, a gram-negative bacterium, has been identified as a major contributor to gastrointestinal diseases, ranging from gastritis and peptic ulcers to more... (Review)
Review
Helicobacter pylori, a gram-negative bacterium, has been identified as a major contributor to gastrointestinal diseases, ranging from gastritis and peptic ulcers to more severe complications such as gastric adenocarcinoma and mucosa-associated lymphoid tissue (MALT) lymphoma. While pharmacological eradication therapies have been successful in managing H. pylori-associated diseases, the implications of this bacterium on surgical interventions remain a topic of ongoing research and clinical consideration. This comprehensive review aims to elucidate the intricate surgical implications of H. pylori infection. Recent data on the well-known relationship between and the development of gastroduodenal diseases, including peptic ulcers and gastric cancer, is analyzed. Concurrently, Helicobacter pylori infection may have a role in promoting colonic carcinogenesis and, more interestingly, it has also been linked to biliary tract cancers. The review highlights the evolving landscape of H. pylori management in the context of surgical interventions, accentuating the need for further research to delineate optimal strategies for preoperative screening, eradication therapies, and their impact on surgical outcomes and long-term patient prognosis. Comprehending the surgical ramifications of H. pylori infection remains crucial, emphasizing the significance of interdisciplinary approaches and ongoing research effort aimed at enhancing patient care.
Topics: Humans; Helicobacter Infections; Helicobacter pylori; Treatment Outcome; Peptic Ulcer; Gastritis; Stomach Neoplasms; Lymphoma, B-Cell, Marginal Zone
PubMed: 38228590
DOI: 10.21614/chirurgia.2023.v.118.i.6.p.568