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British Medical Journal Apr 1958
Topics: Parasympatholytics; Peptic Ulcer
PubMed: 13523221
DOI: No ID Found -
The Keio Journal of Medicine Jun 2003
Review
Topics: Gastritis; Helicobacter Infections; Helicobacter pylori; Humans; Japan; Peptic Ulcer
PubMed: 12862358
DOI: 10.2302/kjm.52.80 -
Annals of Surgery Apr 2016This study aimed to assess risk factors for developing marginal ulcer (MU) after gastric bypass (GBP) surgery for obesity. (Observational Study)
Observational Study
OBJECTIVE
This study aimed to assess risk factors for developing marginal ulcer (MU) after gastric bypass (GBP) surgery for obesity.
BACKGROUND
MU is a common and potentially serious complication of GBP surgery, little is known about its etiology.
METHODS
This population-based cohort study of GBP in 2006-2011 evaluated MU in relation to diabetes, hyperlipidemia, hypertension, chronic obstructive pulmonary disease (COPD), ulcer history, use of proton pump inhibitors (PPIs), aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), and selective serotonin reuptake inhibitors (SSRIs). Multivariable Cox proportional hazard regression models estimated hazard ratios (HRs) and 95% confidence intervals (CIs), adjusted for confounding.
RESULTS
Among 20,294 GBP patients, diabetes and peptic ulcer history entailed statistically significantly increased risk of MU (HR = 1.26, 95% CI 1.03-1.55 and HR = 2.70, 95% CI 1.81-4.03), although hyperlipidemia, hypertension, and COPD did not. PPI users had an increased HR of MU (HR = 1.37, 95% CI 1.17-1.60). Aspirin and NSAID consumption less than or equal to median entailed decreased HRs of MU (HR = 0.56, 95% CI 0.37-0.86 and HR = 0.30, 95% CI 0.24-0.38), although aspirin and NSAID users more than median had an increased risk and no association with MU, respectively (HR = 1.90, 95% CI 1.41-2.58 and HR = 0.90, 95% CI 0.76-1.87). The use of SSRI less than or equal to median had a decreased risk of MU (HR = 0.50, 95% CI 0.37-0.67), although use more than median entailed increased HR (HR = 1.26, 95% CI 1.01-1.56).
CONCLUSIONS
Diabetes and peptic ulcer history seem to be risk factors for MU, but not hyperlipidemia, hypertension, or COPD. Limited doses of aspirin, NSAIDs, and SSRIs might not increase the risk, although higher doses of aspirin do. The association with PPI could be due to confounding by indication.
Topics: Adult; Aged; Aged, 80 and over; Female; Follow-Up Studies; Gastric Bypass; Humans; Male; Middle Aged; Obesity; Peptic Ulcer; Postoperative Complications; Proportional Hazards Models; Registries; Risk Factors; Treatment Outcome
PubMed: 26106845
DOI: 10.1097/SLA.0000000000001300 -
Journal of Gastroenterology Jan 2007The discovery of Helicobacter pylori has already changed the natural history of peptic ulcer disease, with most patients being cured at their first presentation.... (Review)
Review
The discovery of Helicobacter pylori has already changed the natural history of peptic ulcer disease, with most patients being cured at their first presentation. Similarly, the incidence of gastric cancer and other diseases related to H. pylori are likely to be greatly reduced in the near future. Isolation of the spiral intragastric bacterium H. pylori totally reversed the false dogma that the stomach was sterile, and it taught us that chronic infectious disease can still exist in modern society. Helicobacter pylori's unique location, persistence, and evasion of the immune system offer important insights into the pathophysiology of the gut. Also, the fact that it was overlooked for so long encourages us to think "outside the box" when investigating other diseases with obscure etiologies. We should consider such provocative scientific ideas as bridges to the future disease control.
Topics: Animals; Anti-Inflammatory Agents, Non-Steroidal; Gastric Mucosa; Gastritis; Gastroesophageal Reflux; Helicobacter Infections; Helicobacter pylori; Humans; Japan; Lymphoma, B-Cell, Marginal Zone; Peptic Ulcer; Stem Cells; Stomach Neoplasms
PubMed: 17322988
DOI: 10.1007/s00535-006-1990-z -
American Journal of Surgery Jul 2024Marginal ulcer (MU) is one of the postoperative complications of pancreaticoduodenectomy (PD), which needs particular attention in postoperative treatments.
BACKGROUND
Marginal ulcer (MU) is one of the postoperative complications of pancreaticoduodenectomy (PD), which needs particular attention in postoperative treatments.
METHODS
The data of 190 patients who underwent PD and follow-up gastroscopic review due to upper GI symptoms within two years were retrospectively analyzed. The incidence of MU and risk factors were analyzed based on personal history, surgical procedure, past medical history, postoperative complications, and other relevant indicators.
RESULTS
The proportion of MU in patients who underwent endoscopic follow-up for upper gastrointestinal symptoms in the postoperative period in this cohort was 10.5% (20/190). Advanced age (69y vs. 59y, P = 0.012), alcohol consumption (20% vs. 8.2%, P = 0.03), and cigarette smoking (35% vs. 14.7%, P = 0.022) were associated with an increased incidence of MU. Longer surgery time (276.5min vs. 240min, P = 0.049), postoperative bleeding (10% vs. 1.8%, P = 0.030), and failure to take antacid regularly postoperatively (75% vs. 97.1%, P = 0.000) would increase the risk of MU; taking antacid regularly was an independent protective factor for postoperative anastomotic ulceration (OR: 0.091, CI: 0.022-0.383, P = 0.001).
CONCLUSION
Advanced age, alcohol consumption, smoking, longer operation time, or postoperative extraluminal hemorrhage are associated with MU. Regular use of antacids is an independent protective factor against the development of MU.
Topics: Humans; Male; Pancreaticoduodenectomy; Female; Middle Aged; Risk Factors; Incidence; Aged; Retrospective Studies; Postoperative Complications; Adult; Peptic Ulcer; Aged, 80 and over; Alcohol Drinking; Stomach Ulcer
PubMed: 38369416
DOI: 10.1016/j.amjsurg.2024.02.025 -
BMC Surgery Apr 2020Perforation of a marginal peptic ulcer after pancreaticoduodenectomy (PD) can lead to severe conditions, although its clinical features have not been well reported. In...
BACKGROUND
Perforation of a marginal peptic ulcer after pancreaticoduodenectomy (PD) can lead to severe conditions, although its clinical features have not been well reported. In this article, we present three cases of marginal peptic ulcer perforation after PD that we experienced in our institute and attempt to clarify its appropriate treatment and prevention.
CASE PRESENTATION
Marginal ulcer perforation confirmed with computed tomography and/or surgical exploration occurred in 3 (1.8%) of 163 consecutive patients who underwent PD (including 160 patients who underwent a total or subtotal stomach-preserving procedure) at our institution. The three patients (one man and two women) had a median age of 77 (65-79) years. Two of these patients had a medical history of duodenal peptic ulcer. All three patients had biliary neoplasms. Two of the patients underwent subtotal stomach-preserving PD with antro-jejunal anastomosis, and the other patient underwent pylorus-preserving PD with duodenal jejunostomy. The perforation occurred with a sudden and severe onset of abdominal pain 34, 94, and 1204 days, respectively, after the PDs. At the time of the perforation, all of the patients had been withdrawn from postoperative prophylactic antipeptic ulcer agents, with the cessation periods ranging from 12 to 1008 days. In addition, all the patients were in fasting conditions for 1 to 13 days just before the perforation. Surgical treatment with direct suturing of the perforated ulcer was performed for two patients, while conservative therapy was performed for one patient. Their primary treatment courses were satisfactory. Chronic antisecretory agent therapy was prescribed for 562, 271, and 2370 days, respectively, from marginal ulcer perforation, and no ulcer recurrence was noted in any of the patients.
CONCLUSIONS
Lack of antisecretory therapy and fasting were considered an essential cause of marginal peptic ulcer perforation after PD. In addition, unlike the native duodenum, the jejunal limb used for reconstruction to a preserved stomach may be at increased risk of ulceration. Chronic permanent administration of antisecretory agents and fasting avoidance are desirable for patients who have undergone stomach-preserving PD to prevent marginal ulcer perforation.
Topics: Aged; Anastomosis, Surgical; Duodenal Ulcer; Female; Humans; Male; Pancreaticoduodenectomy; Peptic Ulcer; Peptic Ulcer Perforation; Postoperative Period
PubMed: 32306934
DOI: 10.1186/s12893-020-00743-6 -
PloS One 2012Although the iceA (induced by contact with epithelium) allelic types of Helicobacter pylori have been reported to be associated with peptic ulcer, the importance of iceA... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Although the iceA (induced by contact with epithelium) allelic types of Helicobacter pylori have been reported to be associated with peptic ulcer, the importance of iceA on clinical outcomes based on subsequent studies is controversial. The aim of this study was to estimate the magnitude of the risk for clinical outcomes associated with iceA.
METHODS
A literature search was performed using the PubMed and EMBASE databases for articles published through April 2011. Published case-control studies examining the relationship between iceA and clinical outcomes (gastritis, peptic ulcer, including gastric ulcer and duodenal ulcer, and gastric cancer) were included.
RESULTS
Fifty studies with a total of 5,357 patients were identified in the search. Infection with iceA1-positive H. pylori increased the overall risk for peptic ulcer by 1.26-fold (95% confidence interval [CI], 1.09-1.45). However, the test for heterogeneity was significant among these studies. Sensitivity analysis showed that the presence of iceA1 was significantly associated with peptic ulcer (odds ratio [OR] = 1.25, 95% CI = 1.08-1.44). The presence of iceA2 was inversely associated with peptic ulcer (OR = 0.76, 95% CI = 0.65-0.89). The presence of iceA was not associated with gastric cancer. Most studies examined the cagA status; however, only 15 studies examined the correlation and only 2 showed a positive correlation between the presence of cagA and iceA1.
CONCLUSION
Our meta-analysis confirmed the importance of the presence of iceA for peptic ulcer, although the significance was marginal.
Topics: Antigens, Bacterial; Bacterial Proteins; Case-Control Studies; Duodenal Ulcer; Gastritis; Gene Expression Regulation, Bacterial; Genotype; Helicobacter Infections; Helicobacter pylori; Humans; Peptic Ulcer; Prognosis; Stomach Neoplasms
PubMed: 22279585
DOI: 10.1371/journal.pone.0030354 -
World Journal of Gastroenterology Nov 2004To 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...
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 (chi(2) = 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.
Topics: Adolescent; Adult; Age Distribution; Child; China; Databases, Factual; Duodenal Ulcer; Employment; Environment; Female; Gastroscopy; Humans; Incidence; Male; Middle Aged; Peptic Ulcer; Sex Distribution
PubMed: 15484323
DOI: 10.3748/wjg.v10.i22.3377 -
American Journal of Public Health Jun 1985We report the incidence of peptic ulcers (duodenal, pyloric canal, gastric, and combined) verified by radiologic, endoscopic, or surgical evidence in a large Health...
We report the incidence of peptic ulcers (duodenal, pyloric canal, gastric, and combined) verified by radiologic, endoscopic, or surgical evidence in a large Health Maintenance Organization (HMO) in Los Angeles, California. For members age 15 and above, the peptic ulcer incidence rate was 0.86 per 1,000 person-years (p-y) (males 1.10, females 0.63). The male to female sex ratio was 1.7. Two hundred twenty-two duodenal, 17 pyloric canal, 89 gastric, and 21 combined first-time diagnosed ulcer cases were located. For duodenal and pyloric canal ulcer, the incidence rate for members age 15 and above was 0.58 per 1,000 p-y (males 0.76, females 0.40). For gastric ulcer, the incidence rate for members age 15 and above was 0.21 per 1,000 p-y (males 0.23, females 0.18). The combined ulcer rate was 0.05 per 1,000 p-y (males 0.07, females 0.02). Gastric ulcer rates were two times higher in 1980 than in 1977. Peptic ulcer age-specific incidence rates increased with age. Incidence rates were much lower than those reported in previous studies, but the gastric to duodenal ulcer ratio and the age and sex relation to ulcer incidence were similar to those previously reported.
Topics: Adolescent; Adult; Aged; Aging; California; Duodenal Ulcer; Female; Gastroscopy; Health Maintenance Organizations; Humans; Male; Medical Records; Middle Aged; Peptic Ulcer; Radiography; Sex Factors
PubMed: 4003625
DOI: 10.2105/ajph.75.6.625 -
Critical Care (London, England) Mar 2014
Review
Topics: Animals; Critical Illness; Humans; Peptic Ulcer; Prevalence; Stomach Ulcer; Stress, Psychological; Treatment Outcome
PubMed: 25029573
DOI: 10.1186/cc13780