Testing for and eradication of H. pylori infection is inadequately performed in patients with peptic ulcer bleeding

2001 ◽  
Vol 120 (5) ◽  
pp. A729-A729
Author(s):  
D THORBURN ◽  
C OCONNOR ◽  
E FORREST ◽  
J FORREST
Keyword(s):  
Peptic Ulcer ◽  
Ulcer Bleeding ◽  
Peptic Ulcer Bleeding ◽  
H Pylori

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

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Woo Chul Chung ◽  
Eun Jung Jeon ◽  
Kang-Moon Lee ◽  
Chang Nyol Paik ◽  
You Suk Oh ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Clinical Outcomes ◽  
Marginal Ulcer ◽  
Ulcer Bleeding ◽  
Consecutive Series ◽  
Peptic Ulcer Bleeding ◽  
Positive Rate ◽  
Rebleeding Rate ◽  
H Pylori ◽  
Upper Gastrointestinal

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±10.59years versus53.33±16.68years,P=0.01). The initial hemoglobin was lower (8.16±3.05 g/dL versus9.38±2.49 g/dL,P=0.01), and the duration of admission was longer in MUB (7.14±4.10days versus5.90±2.97days,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 withH. pylorimight not appear to play an important role in MUB after gastrectomy.

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

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Duc Trong Quach ◽  
Mai Ngoc Luu ◽  
Toru Hiyama ◽  
Thuy-HuongThi To ◽  
Quy Nhuan Bui ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Infection Rate ◽  
Ulcer Bleeding ◽  
Peptic Ulcer Bleeding ◽  
Urease Test ◽  
Positive Rate ◽  
Group A ◽  
H Pylori ◽  
Group B ◽  
Noninvasive Tests

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.

scholarly journals Accuracy of the Helicobacter pylori diagnostic tests in patients with peptic ulcer bleeding: a systematic review and network meta-analysis

2020 ◽  
Vol 13 ◽  
pp. 175628482096532
Author(s):  
Nóra Vörhendi ◽  
Alexandra Soós ◽  
Marie Anne Engh ◽  
Benedek Tinusz ◽  
Zsolt Szakács ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Diagnostic Tests ◽  
Meta Analysis ◽  
Reference Standards ◽  
Ulcer Bleeding ◽  
Peptic Ulcer Bleeding ◽  
Testing Strategies ◽  
Index Tests ◽  
H Pylori

Introduction: Some studies suggest that the accuracy of Helicobacter pylori diagnostic tests is decreased in peptic ulcer bleeding (PUB). We aimed to assess the accuracy of diagnostic tests for H. pylori in patients with PUB in a diagnostic test accuracy (DTA) network meta-analysis. Methods: A systematic search was carried out in seven databases until November 2019. We collected or calculated true and false positive and negative values, and constructed 2×2 diagnostic contingency tables with reference standards including histology, rapid urease test, urea breath test, serology, stool antigen test, culture, and polymerase chain reaction. We ranked the index tests by the superiority indices (SI) and calculated pooled sensitivity and specificity of each test. Discussion: Our search yielded 40 eligible studies with 27 different diagnostic strategies for H. pylori. In 32 articles, the reference standard was a combination of multiple tests. In 12 studies, the index tests were compared with a single testing method. We analyzed seven networks with the reference standards against a single or a combination of diagnostic index tests. None of the index tests had better diagnostic accuracy (SI between 9.94 and 2.17) compared with the individual index tests as all the confidence intervals included 1. Combined testing strategies had higher sensitivities (0.92–0.62) and lower specificities (0.85–0.46) while single tests proved to have higher specificities (0.83–0.77) and lower sensitivities (0.73–0.42). Conclusion: Use of combined tests may have a rationale in clinical practice due to their higher sensitivities. The differences between the included DTA studies limited the comparison of the testing strategies.

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

2013 ◽  
Author(s):  
Yeong Yeh Lee ◽  
Nordin Noridah ◽  
Syed Abdul Aziz Syed Hassan ◽  
Jayaram Menon
Keyword(s):  
Risk Factors ◽  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Hospital Mortality ◽  
Ulcer Bleeding ◽  
Recurrent Bleeding ◽  
Gi Bleeding ◽  
Peptic Ulcer Bleeding ◽  
H Pylori ◽  
Risk For Bleeding

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 prospective cases in the GI database 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 (34%) and aspirin (22.8%) 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.

Testing for and eradication of H. pylori infection is inadequately performed in patients with peptic ulcer bleeding

2001 ◽  
Vol 120 (5) ◽  
pp. A729
Author(s):  
Douglas Thorburn ◽  
Catherine O'Connor ◽  
Ewan H. Forrest ◽  
John A.H. Forrest
Keyword(s):  
Peptic Ulcer ◽  
Ulcer Bleeding ◽  
Peptic Ulcer Bleeding ◽  
H Pylori

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

2013 ◽  
Author(s):  
Yeong Yeh Lee ◽  
Nordin Noridah ◽  
Syed Abdul Aziz Syed Hassan ◽  
Jayaram Menon
Keyword(s):  
Risk Factors ◽  
Helicobacter Pylori ◽  
Peptic Ulcer ◽  
Hospital Mortality ◽  
Ulcer Bleeding ◽  
Recurrent Bleeding ◽  
Gi Bleeding ◽  
Peptic Ulcer Bleeding ◽  
H Pylori ◽  
Risk For Bleeding

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 prospective cases in the GI database 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 (34%) and aspirin (22.8%) 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.

PEPTIC ULCER BLEEDING IN ELDERLY PATIENTS – WHAT HAS CHANGED OVER A TEN YEAR PERIOD

2020 ◽  
Author(s):  
I Budimir ◽  
M Živković ◽  
M Nikolić ◽  
N Ljubičić ◽  
T Pavić ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Elderly Patients ◽  
Ulcer Bleeding ◽  
Peptic Ulcer Bleeding

EFFICACY OF ENDOSCOPIC HEMOCLIPS AND INTERMITTENT INTRAVENOUS PPI IN PEPTIC ULCER BLEEDING

2019 ◽  
pp. 40-44
Author(s):  
Van Huy Tran ◽  
Duy Lieu Dinh
Keyword(s):  
Peptic Ulcer ◽  
Key Words ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Ulcer Bleeding ◽  
Peptic Ulcer Bleeding ◽  
Forrest Classification

Background: Efficacy of continuous intravenous proton- pump inhibitors (IV PPI) and hemoclips alone was proved, but data about combination of an application of endoscopy clips and intermittent IV PPI in Vietnam was still limited. This study aimed to assess the efficacy of endoscopy hemoclip combined with intermittent IV PPI in the patients of peptic ulcer bleeding. Patients and methods: 34 patients diagnosed as peptic ulcer bleeding, having Forrest classification of Ia, Ib, IIa and IIb, were enrolled. Esomeprazole was administered as 80 mg IV bolus followed by intermittent IV injection of 40 mg/8h during 72h. Results: Immediate hemostasis was achieved in all 34 patients. Only 1 patient (2.9%) had early rebleeding. No severe complications was found in this study. Conclusion: Combination of endoscopy hemoclips and intermittent PPI showed effective, safe in patients of peptic ulcer bleeding. Key words: Peptic ulcer bleeding, intermittent PPI, endoscopy hemoclip

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