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The Western Journal of Medicine Mar 2002
Topics: Dyspepsia; Gastroesophageal Reflux; Helicobacter Infections; Helicobacter pylori; Humans; Peptic Ulcer
PubMed: 11897730
DOI: No ID Found -
Journal of Traditional Chinese Medicine... Mar 2009
Topics: Drugs, Chinese Herbal; Humans; Peptic Ulcer
PubMed: 19514194
DOI: 10.1016/s0254-6272(09)60036-4 -
British Journal of Clinical Pharmacology Aug 2017The efficacy of proton pump inhibitors (PPIs) has been demonstrated for bleeding peptic ulcers but the route of administration remains controversial. Several studies... (Comparative Study)
Comparative Study Meta-Analysis Review
BACKGROUND AND AIMS
The efficacy of proton pump inhibitors (PPIs) has been demonstrated for bleeding peptic ulcers but the route of administration remains controversial. Several studies have demonstrated that high-dose oral PPIs are as effective as intravenous PPIs in reducing recurrent bleeding. However, current guidelines recommend intravenous PPIs after endoscopic treatment. Previous data based on numbers that were too small to enable a firm conclusion to be reached suggested that oral and intravenous PPIs had equivalent efficacy. We undertook a meta-analysis to compare oral and intravenous PPIs in patients with bleeding peptic ulcers after endoscopic management.
METHODS
A literature search was undertaken using MEDLINE, EMBASE and the Cochrane Library, between 1990 and February 2016, to identify all randomized controlled trials (RCTs) that assessed the efficacy of PPIs administered by different routes. Nine RCTs, involving 1036 patients, were analysed. Outcomes were: recurrent bleeding, blood transfusion requirement, duration of hospital stay, a need for repeat endoscopy, surgery and 30-day mortality.
RESULTS
There were no differences in the rebleeding rates [odds ratio (OR) 0.93, 95% confidence interval (CI) 0.60, 1.46; P = 0.77], need for surgery (OR 0.77, 95% CI 0.25, 2.40; P = 0.65), need for repeat endoscopy (OR 0.69, 95% CI 0.39, 1.21; P = 0.19), need for blood transfusion [(MD) -0.03, 95% CI -0.26, 0.19; P = 0.76], duration of hospital stay (MD -0.61, 95% CI -1.45, 0.23; P = 0.16) or 30-day mortality (OR 0.89, 95% CI 0.27, 2.43; P = 0.84) according to the route of administration.
CONCLUSIONS
Oral PPIs represent better value for money, with clinical efficacy equivalent to intravenous PPIs.
Topics: Administration, Intravenous; Administration, Oral; Anti-Ulcer Agents; Endoscopy, Gastrointestinal; Humans; Peptic Ulcer; Peptic Ulcer Hemorrhage; Proton Pump Inhibitors; Recurrence; Treatment Outcome
PubMed: 28181291
DOI: 10.1111/bcp.13258 -
The Medical Clinics of North America Jul 1991Primary duodenal ulcer disease occurs in children of all ages, but is most often seen in those over 10 years. As in the adult, it often pursues a chronic course. Primary... (Review)
Review
Primary duodenal ulcer disease occurs in children of all ages, but is most often seen in those over 10 years. As in the adult, it often pursues a chronic course. Primary gastric ulcer is seen in children under 6 years, is more unusual, and does not tend to recur. Stress ulcers are seen most often in infants and in critically ill children and are asymptomatic until the complications of hemorrhage or perforation appear. Drug-related ulcers are being seen more frequently as the use of nonsteroidal anti-inflammatory agents increases. With the use of new therapeutic agents, management has been simplified and surgical intervention has become a rarity. Helicobacter pylori is now a recognized cause of antral gastritis and ulceration in the child.
Topics: Child; Diagnosis, Differential; Humans; Peptic Ulcer
PubMed: 2072794
DOI: 10.1016/s0025-7125(16)30419-9 -
British Medical Journal Sep 1951
Topics: Disease; Frontal Lobe; Humans; Peptic Ulcer; Stomach Ulcer
PubMed: 14869653
DOI: 10.1136/bmj.2.4731.580 -
BMJ (Clinical Research Ed.) Oct 2001
Review
Topics: Duodenal Ulcer; Gastric Acid; Gastric Mucosa; Helicobacter Infections; Helicobacter pylori; Humans; Microscopy, Electron; Peptic Ulcer; Smoking; Sodium Chloride, Dietary; Stomach Neoplasms; Stomach Ulcer
PubMed: 11679389
DOI: 10.1136/bmj.323.7319.980 -
Asian Journal of Surgery Feb 2023
Topics: Humans; Duodenal Ulcer; Peptic Ulcer Perforation
PubMed: 36055888
DOI: 10.1016/j.asjsur.2022.08.001 -
California Medicine Mar 1956The Billroth I gastric resection, with and without vagotomy, was used in 20 selected cases of peptic ulcer. Vagotomy and pyloroplasty is considered the operation of...
The Billroth I gastric resection, with and without vagotomy, was used in 20 selected cases of peptic ulcer. Vagotomy and pyloroplasty is considered the operation of first choice for duodenal ulcer. The cases for Billroth I resections were selected from cases not suitable for pyloroplasty. Operations for peptic ulcer which preserve the gastrointestinal continuity are considered to be physiologically superior. Vagotomy and pyloroplasty, and Billroth I gastric resection both qualify in this regard. The postoperative digestive symptoms after Billroth I gastric resection in the present series were minimal, which tends to confirm this theoretical superiority.
Topics: Duodenal Ulcer; Gastrectomy; Gastroenterostomy; Humans; Peptic Ulcer; Vagotomy
PubMed: 13304669
DOI: No ID Found -
Gastroenterologie Clinique Et Biologique Apr 2004The use of treatments to heal or to prevent nonsteroidal anti-inflammatory drugs (NSAIDs) associated gastroduodenal lesions is based on replacement of mucosal... (Review)
Review
The use of treatments to heal or to prevent nonsteroidal anti-inflammatory drugs (NSAIDs) associated gastroduodenal lesions is based on replacement of mucosal prostaglandin deficiency or inhibition of acid secretion. Four-week acid suppression by proton pump inhibitors (PPI) with 7-day eradication triple therapy in Helicobacter pylori positive patients is effective in healing gastric and duodenal ulcer upon discontinuation of NSAIDs. In the event NSAIDs must be continued, PPIs (omeprazole 20 mg, lansoprazole 30 mg, pantoprazole 40 mg) are more effective than H2-blockers and cytoprotective agents (sucralfate, misoprostol) to heal mucosal lesions. In long-term prevention studies, omeprazole 20 mg, lansoprazole 15 mg, and pantoprazole 20 mg significantly reduce gastric and duodenal ulcer rates. Misoprostol 800 microg is as effective as PPIs for preventing symptomatic and complicated gastric ulcers, but less effective to prevent duodenal ulcer, with a high rate of adverse effects such as diarrhea. Helicobacter pylori eradication in infected patients decrease the risk of NSAIDs-associated lesions but is less effective than concomitant antisecretory treatment. Current data from comparative studies of PPIs vs ranitidine or misoprostol are in favor of the PPIs as well tolerated and effective drugs in the prophylaxis of NSAIDs-related gastroduodenal lesions in high-risk patients.
Topics: Anti-Inflammatory Agents, Non-Steroidal; Humans; Misoprostol; Peptic Ulcer; Proton Pump Inhibitors
PubMed: 15366678
DOI: 10.1016/s0399-8320(04)95282-7 -
BMC Gastroenterology Oct 2004Guidelines for management of peptic ulcer patients after the treatment are largely directed to detection of H. pylori infection using only non-invasive tests. We... (Comparative Study)
Comparative Study
BACKGROUND
Guidelines for management of peptic ulcer patients after the treatment are largely directed to detection of H. pylori infection using only non-invasive tests. We compared the diagnostic value of non-invasive and endoscopy based H. pylori tests in a late post-treatment setting.
METHODS
Altogether 34 patients with dyspeptic complaints were referred for gastroscopy 5 years after the treatment of peptic ulcer using a one-week triple therapy scheme. The endoscopic and histologic findings were evaluated according to the Sydney classification. Bacteriological, PCR and cytological investigations and 13C-UBT tests were performed.
RESULTS
Seventeen patients were defined H. pylori positive by 13C-UBT test, PCR and histological examination. On endoscopy, peptic ulcer persisted in 4 H. pylori positive cases. Among the 6 cases with erosions of the gastric mucosa, only two patients were H. pylori positive. Mucosal atrophy and intestinal metaplasia were revealed both in the H. pylori positive and H. pylori negative cases. Bacteriological examination revealed three clarithromycin resistant H. pylori strains. Cytology failed to prove validity for diagnosing H. pylori in a post-treatment setting.
CONCLUSIONS
In a late post-treatment setting, patients with dyspepsia should not be monitored only by non-invasive investigation methods; it is also justified to use the classical histological evaluation of H. pylori colonisation, PCR and bacteriology as they have shown good concordance with 13C-UBT. Moreover, endoscopy and histological investigation of a gastric biopsy have proved to be the methods with an additional diagnostic value, providing the physician with information about inflammatory, atrophic and metaplastic lesions of the stomach in dyspeptic H. pylori positive and negative patients. Bacteriological methods are suggested for detecting the putative antimicrobial resistance of H. pylori, aimed at successful eradication of infection in persistent peptic ulcer cases.
Topics: Bacteriological Techniques; Biopsy; Breath Tests; Diagnostic Techniques, Digestive System; Follow-Up Studies; Gastroscopy; Helicobacter Infections; Helicobacter pylori; Histological Techniques; Humans; Peptic Ulcer; Polymerase Chain Reaction
PubMed: 15507141
DOI: 10.1186/1471-230X-4-27