scholarly journals Evidence-based clinical practice guidelines for peptic ulcer disease 2020

2021 ◽  
Author(s):  
Tomoari Kamada ◽  
Kiichi Satoh ◽  
Toshiyuki Itoh ◽  
Masanori Ito ◽  
Junichi Iwamoto ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Clinical Practice ◽  
Practice Guidelines ◽  
Eradication Therapy ◽  
Ulcer Recurrence ◽  
Evidence Based ◽  
Peptic Ulcers ◽  
Ulcer Disease ◽  
History Of ◽  
H Pylori

AbstractThe Japanese Society of Gastroenterology (JSGE) revised the third edition of evidence-based clinical practice guidelines for peptic ulcer disease in 2020 and created an English version. The revised guidelines consist of nine items: epidemiology, hemorrhagic gastric and duodenal ulcers, Helicobacter pylori (H. pylori) eradication therapy, non-eradication therapy, drug-induced ulcers, non-H. pylori, and nonsteroidal anti-inflammatory drug (NSAID) ulcers, remnant gastric ulcers, surgical treatment, and conservative therapy for perforation and stenosis. Therapeutic algorithms for the treatment of peptic ulcers differ based on ulcer complications. In patients with NSAID-induced ulcers, NSAIDs are discontinued and anti-ulcer therapy is administered. If NSAIDs cannot be discontinued, the ulcer is treated with proton pump inhibitors (PPIs). Vonoprazan (VPZ) with antibiotics is recommended as the first-line treatment for H. pylori eradication, and PPIs or VPZ with antibiotics is recommended as a second-line therapy. Patients who do not use NSAIDs and are H. pylori negative are considered to have idiopathic peptic ulcers. Algorithms for the prevention of NSAID- and low-dose aspirin (LDA)-related ulcers are presented in this guideline. These algorithms differ based on the concomitant use of LDA or NSAIDs and ulcer history or hemorrhagic ulcer history. In patients with a history of ulcers receiving NSAID therapy, PPIs with or without celecoxib are recommended and the administration of VPZ is suggested for the prevention of ulcer recurrence. In patients with a history of ulcers receiving LDA therapy, PPIs or VPZ are recommended and the administration of a histamine 2-receptor antagonist is suggested for the prevention of ulcer recurrence.

scholarly journals TWO YEARS FOLLOW UP AFTER ERADICATION THERAPY OF PEPTIC ULCER

2020 ◽  
pp. 28-31
Author(s):  
HASSAN KHUDER RAJAB ◽  
ALI ESMAIL AL-SNAFI
Keyword(s):  
Peptic Ulcer ◽  
Eradication Therapy ◽  
Endoscopic Examination ◽  
Urea Breath Test ◽  
Ulcer Recurrence ◽  
Follow Up Study ◽  
History Of ◽  
Second Year ◽  
H Pylori

Objective: This study was performed to detect the recurrence rate for two years after eradication therapy of peptic ulcer. Methods: Sixty-nine patients included in this study in Kirkuk city from January 2004 to January 2005 as 1st year follow up, and 49 patients from January 2005 to January 2006 as second year follow up study. A urea breath test and re-endoscopic examination were carried out to confirm peptic ulcer recurrence. A questionnaire was prepared to take the history of the disease and other relevant data of each patient. Results: The recurrence was occurred in 6 (8.7%) and 8 patients (16.33%) in the 1st and 2nd years after eradication therapy. Highly risk of recurrence was smoking, age below 50 y and stress in 1st year follow up, and stress was the highly risk in the 2nd year follow up. Conclusion: After triple and quadruple therapy of peptic ulcer, the recurrence is low, However, the possibility of H. pylori resistance should be considered.

scholarly journals Evidence-based clinical practice guidelines for peptic ulcer disease 2015

2016 ◽  
Vol 51 (3) ◽  
pp. 177-194 ◽  
Author(s):  
Kiichi Satoh ◽  
Junji Yoshino ◽  
Taiji Akamatsu ◽  
Toshiyuki Itoh ◽  
Mototsugu Kato ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Clinical Practice ◽  
Peptic Ulcer Disease ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Evidence Based ◽  
Ulcer Disease

Peptic Ulcer Disease

2014 ◽  
pp. 710-718
Author(s):  
Tyler M. Berzin ◽  
Kenneth R. Falchuk
Keyword(s):  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
The United States ◽  
Dietary Factors ◽  
Pathogenic Agent ◽  
Ulcer Disease ◽  
History Of ◽  
Ulcer Complications ◽  
H Pylori

Peptic ulcer disease (PUD) involves the stomach or duodenum and is a significant cause of morbidity and mortality both in the United States and worldwide, with a lifetime prevalence estimated at 5–15%. For a good part of the 20th century PUD was felt to be a condition related to stress and dietary factors. More recently, our understanding of PUD has been advanced by research into the role of gastric acid secretion and the benefits of various classes of antisecretory medications and, perhaps most importantly, in 1984, by Warren and Marshall, who identified Helicobacter pylori (H. pylori) as a pathogenic agent in this disease. Proton pump inhibitor (PPI) therapy and H. pylori eradication regimens have altered the natural history of what once was a chronic disease, and they have also reduced peptic ulcer complications, limiting the need for surgery.

scholarly journals Helicobacter pyloriManagement: How to Improve the Therapeutic Confusion in Practice

2003 ◽  
Vol 17 (suppl b) ◽  
pp. 21B-24B ◽  
Author(s):  
Nicholas J Talley
Keyword(s):  
Peptic Ulcer ◽  
Secondary Care ◽  
Bacterial Resistance ◽  
Peer Group ◽  
Eradication Therapy ◽  
Prescribing Patterns ◽  
Therapeutic Success ◽  
Ulcer Disease ◽  
Treatment Regimens ◽  
H Pylori

There appears to be a disconnect between current guidelines forHelicobacter pyloritesting and treatment, and clinical practice, including physician beliefs and actual prescribing patterns. In particular, there are markedly different approaches in primary and secondary care, and country- specific differences in eradication therapy forH pyloriinfection. Although most physicians do not believe thatH pyloricauses nonulcer dyspepsia, the majority appear to prescribe eradication. Less information is available on the management ofH pyloriinfection and gastroesophageal reflux disease, and more marked differences in attitudes and practice occur in this condition. Even in peptic ulcer disease, where most clinicians both in primary and in secondary care believeH pylorishould be eradicated, there is often a breakdown in the translation of this belief into practice. There is also confusion in terms of treatment regimens applied forH pylorieradication. Eradication regimens are less successful in practice than in clinical trials. Furthermore, a sizable proportion of patients with peptic ulcer remain symptomatic despite cure of the ulcer diathesis, which may undermine confidence. Therapeutic confusion about what to prescribe, side effects limiting compliance, bacterial resistance, and socioeconomic factors may all impair therapeutic success with eradication therapy in practice. Unfortunately, it has been well documented that guidelines alone are likely to have little or no impact in practice. Publication in a journal is unlikely to lead to effective implementation in primary care. On the basis of available evidence, clinical behaviour is most likely changed when guidelines are developed by the peer group of clinicians for whom they were intended, are disseminated through a specific educational program, and are implemented by applying, preferably during the consultation, specific reminders.

scholarly journals RECURRENCE RATE OF HELICOBACTER PYLORI IN PATIENTS WITH PEPTIC ULCER FIVE YEARS OR MORE AFTER SUCCESSFUL ERADICATION

2016 ◽  
Vol 53 (3) ◽  
pp. 152-155 ◽  
Author(s):  
Yuri Costa Farago FERNANDES ◽  
Gabriel da Rocha BONATTO ◽  
Mauro Willeman BONATTO
Keyword(s):  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Recurrence Rate ◽  
Early Recurrence ◽  
Peptic Ulcers ◽  
Ulcer Disease ◽  
Gastroduodenal Mucosa ◽  
H Pylori

ABSTRACT Background Infection with Helicobacter pylori is highly prevalent worldwide, especially in developing countries. Its presence in the gastroduodenal mucosa is related with development of peptic ulcer and other illnesses. The eradication of H. pylori improves mucosal histology in patients with peptic ulcers. Objective This study was aimed to verify if H. pylori recurrence occurs five years or more after confirmed eradication in patients with peptic ulcer. Moreover, we sought to determine the recurrence rate. Methods Retrospective and longitudinal, this study was based on a sample of 201 patients from western Paraná, Brazil. The patients were diagnosed with peptic ulcer disease, in the period of 1990-2000, and followed for five years or more after successful H. pylori eradication. Patients with early recurrence - prior to five years after eradication - were excluded from the sample. Results During an average follow-up of 8 years, 180 patients (89.55%) remained negative, and 21 (10.45%) became positive for H. pylori infection. New ulcers appeared in two-thirds of the patients with H. pylori recurrence. Conclusion The recurrence of H. pylori in patients with peptic ulcer can occur in the long-term - even if the infection had been successfully eradicated and the patients had remained free of recurrence in the first years of follow-up.

The Role of Gastric Acid in Preventing Foodborne Disease and How Bacteria Overcome Acid Conditions†

2003 ◽  
Vol 66 (7) ◽  
pp. 1292-1303 ◽  
Author(s):  
JAMES L. SMITH
Keyword(s):  
Peptic Ulcer ◽  
Acid Secretion ◽  
Peptic Ulcer Disease ◽  
Gastric Acid Secretion ◽  
Gastric Acid ◽  
Gastric Fluid ◽  
The Body ◽  
Peptic Ulcers ◽  
Ulcer Disease ◽  
H Pylori

The secretion of hydrochloric acid by the stomach plays an important role in protecting the body against pathogens ingested with food or water. A gastric fluid pH of 1 to 2 is deleterious to many microbial pathogens; however, the neutralization of gastric acid by antacids or the inhibition of acid secretion by various drugs may increase the risk of food- or waterborne illnesses. Peptic ulcer disease is often treated by decreasing or eliminating gastric acid secretion, and such treatment blocks the protective antibacterial action of gastric fluid. The majority of peptic ulcer disease cases originate from Helicobacter pylori infections. Treatment of H. pylori–induced peptic ulcers with antibiotics reduces the need for drugs that inhibit gastric acid secretion and thereby diminishes the risk of food- and waterborne illness for peptic ulcer disease patients. Many bacterial pathogens, such as Escherichia coli, Salmonella Typhimurium, and H. pylori, can circumvent the acid conditions of the stomach by developing adaptive mechanisms that allow these bacteria to survive in acid environments. As a consequence, these bacteria can survive acidic stomach conditions and pass into the intestinal tract, where they can induce gastroenteritis.

scholarly journals Recent trends in the occurrence of bleeding gastric and duodenal ulcers under the Japanese evidence-based clinical practice guideline for peptic ulcer disease

JGH Open ◽  
2018 ◽  
Vol 2 (6) ◽  
pp. 255-261 ◽  
Author(s):  
Kazunori Nagashima ◽  
Keiichi Tominaga ◽  
Koh Fukushi ◽  
Akira Kanamori ◽  
Takako Sasai ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Clinical Practice ◽  
Peptic Ulcer Disease ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Evidence Based ◽  
Duodenal Ulcers ◽  
Ulcer Disease ◽  
Recent Trends

scholarly journals Peptic Ulcer Disease: A Brief Review of Conventional Therapy and Herbal Treatment Options

2019 ◽  
Vol 8 (2) ◽  
pp. 179 ◽  
Author(s):  
Lucija Kuna ◽  
Jelena Jakab ◽  
Robert Smolic ◽  
Nikola Raguz-Lucic ◽  
Aleksandar Vcev ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Medicinal Plants ◽  
Treatment Options ◽  
Chemical Compounds ◽  
Peptic Ulcers ◽  
H2 Receptor Antagonists ◽  
Ulcer Disease ◽  
Inflammatory Drugs ◽  
H Pylori ◽  
Major Factors

Peptic ulcer is a chronic disease affecting up to 10% of the world’s population. The formation of peptic ulcers depends on the presence of gastric juice pH and the decrease in mucosal defenses. Non-steroidal anti-inflammatory drugs (NSAIDs) and Helicobacter pylori (H. pylori) infection are the two major factors disrupting the mucosal resistance to injury. Conventional treatments of peptic ulcers, such as proton pump inhibitors (PPIs) and histamine-2 (H2) receptor antagonists, have demonstrated adverse effects, relapses, and various drug interactions. On the other hand, medicinal plants and their chemical compounds are useful in the prevention and treatment of numerous diseases. Hence, this review presents common medicinal plants that may be used for the treatment or prevention of peptic ulcers.

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