Efficacy of Lansoprazole against Peptic Ulcers Induced by Nonsteroidal Anti-Inflammatory Drugs: Endoscopic Evaluation of Ulcer Healing

1997 ◽  
Vol 25 (4) ◽  
pp. 190-195 ◽  
Author(s):  
Y Matsukawa ◽  
Y Tomita ◽  
S Nishinarita ◽  
T Horie ◽  
K Kato ◽  
...  
Keyword(s):  
Ulcer Healing ◽  
Healing Rate ◽  
Eradication Therapy ◽  
Peptic Ulcers ◽  
Endoscopic Evaluation ◽  
Duodenal Ulcers ◽  
Good Healing ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
H Pylori

Beyond the obvious step of limiting use of non-steroidal anti-inflammatory drugs (NSAIDs), the treatment of ulcers induced by NSAIDs remains controversial. We evaluated the efficacy of the proton-pump inhibitor lansoprazole on NSAID-induced ulcers. Ulcers were endoscopically diagnosed in 47 NSAID users. These patients received 30 mg/day lansoprazole, orally, for 6 or 8 weeks (6 weeks for duodenal ulcers and 8 weeks for other ulcers). Ulcer healing was assessed using an established classification system. The presence of immunoglobulin G antibody against Helicobacter pylori was also evaluated. The antibody was present in the sera of 51% of patients (24/47). Most of the ulcers reached scarring stages S1 (healing) or S2 (good healing), and the S2 healing rate was 35%. Two H. pylori seropositive patients did not reach these stages; their ulcers were improved by H. pylori eradication therapy, followed, in one case, by medication with misoprostol. Lansoprazole seemed to be useful for most patients with NSAID-induced ulcers, but a few needed additional treatments.

scholarly journals ETIOPATHOGENESIS OF PEPTIC ULCER: back to the past?

2014 ◽  
Vol 51 (2) ◽  
pp. 155-161 ◽  
Author(s):  
Mariana Barbosa ARAÚJO ◽  
Paulo BORINI ◽  
Romeu Cardoso GUIMARÃES
Keyword(s):  
Peptic Ulcer ◽  
General Population ◽  
Peptic Ulcers ◽  
Data Bases ◽  
Duodenal Ulcers ◽  
The Past ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
H Pylori ◽  
Made In

ObjectivesTo review some aspects of the etiopathogenesis of peptic ulcerous disease especially on the basis of studies on its correlation withHelicobacter pylori (H. pylori).MethodsA search was made in the data bases MEDLINE, LILACS and PubMed, and in Brazilian and foreign books, referring to the incidence and prevalence of infection by H. pylori and of peptic ulcerous disease in various populations of different countries.ResultsIt was observed that the prevalence of H. pyloriinfection is similar in individuals with peptic ulcerous disease and the general population. There are differences between countries with respect to the prevalence of infection and of gastric or duodenal peptic ulcers. In many countries the prevalence of infection by H. pylorishows stability while the prevalence of peptic ulcerous disease is declining. The prevalence of peptic ulcerous disease without H. pylori infection varies between 20% and 56% in occidental countries.DiscussionThe observations might be suggestive of H. pyloribeing only one more factor to be summed together with other aggressive components in the genesis of peptic ulcerous disease. We would therewith be returning to the classic concept that peptic gastric and duodenal ulcers have multifactorial etiology and would result from imbalance between aggressive and defensive factors. The focus of studies should be enriched with the identification of the defensive factors and of other aggressive factors besides the well known H. pylori and non-steroidal anti-inflammatory drugs, since these two aggressors do not exhaust the full causal spectrum.

scholarly journals GASTRIC ULCER AFTER SHORT-TERM NONSTEROIDAL ANTI-INFLAMMATORY DRUGS ADMINISTRATION IN A SMALL CHILD – CASE REPORT

2015 ◽  
Vol 64 (4) ◽  
pp. 403-405
Author(s):  
Ancuta Ignat ◽  
◽  
Gabriela Paduraru ◽  
Angelica Cristina Marin ◽  
Anamaria Ciubara ◽  
...  
Keyword(s):  
Gastric Ulcer ◽  
Eradication Therapy ◽  
Gastric Ulcers ◽  
Upper Gastrointestinal Endoscopy ◽  
Short Term ◽  
Upper Respiratory Infection ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
H Pylori ◽  
Associated Risk Factors

Nonsteroidal anti-inflammatory agents (NSAIDs) produce gastric lesions through two mechanisms: local irritation and systemic action. A 2 year and 10 months old female received NSAID for acute upper respiratory infection for 2 days and she developed coffee ground vomitus one day later. Upper gastrointestinal endoscopy revealed a gastric ulcer. She was negative for H. pylori infection, and she was diagnosed with NSAID – induced acute gastric ulcer in the absence of other causes of gastric ulcer. Gastric ulcers develop very rarely after a short-term administration of NSAIDs, which prompted us to report this case. Balancing the risk and the benefit of eradication therapy, it is indicated, for every patient who must follow a chronic treatment with anti-inflammatory drugs, to look for possible associated risk factors.

scholarly journals Risk of Recurrent Peptic Ulcer Disease in Patients Receiving Cumulative Defined Daily Dose of Nonsteroidal Anti-Inflammatory Drugs

2019 ◽  
Vol 8 (10) ◽  
pp. 1722
Author(s):  
Chih-Ming Liang ◽  
Shih-Cheng Yang ◽  
Cheng-Kun Wu ◽  
Yu-Chi Li ◽  
Wen-Shuo Yeh ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Eradication Therapy ◽  
Case Control ◽  
Defined Daily Dose ◽  
Ulcer Disease ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
H Pylori

The purpose of this population-based case–control study was to clarify the impact of cumulative dosage of nonsteroidal anti-inflammatory drugs (NSAIDs) on recurrent peptic ulcers among chronic users after Helicobacter pylori (H. pylori) eradication. We analyzed data of 203,407 adult peptic ulcer disease (PUD) patients from the National Health Insurance Research Database in Taiwan entered between 1997 and 2013. After matching for age/gender frequencies and the length of follow-up time in a ratio of 1:1, the matched case–control groups comprised 1150 patients with recurrent PUD and 1150 patients without recurrent PUD within 3 years of follow-up. More recurrent PUDs occurred in NSAID users than in the control group (75.30% versus 69.74%; p = 0.0028). Independent risk factors for recurrent PUD included patients using NSAIDs (adjusted OR (aOR): 1.34, p = 0.0040), H. pylori eradication (aOR: 2.73; p < 0.0001), concomitant H2 receptor antagonist (aOR: 1.85; p < 0.0001) and anti-coagulant (aOR: 4.21; p = 0.0242) use. Importantly, in the initial subgroup analysis, the risk ratio of recurrent PUD did not increase in NSAID users after H. pylori eradication compared with that in non-users (p = 0.8490) but a higher risk for recurrent PUD with the increased doses of NSAIDs without H. pylori eradication therapy (aOR: 1.24, p = 0.0424; aOR: 1.47, p = 0.0074; and aOR: 1.64, p = 0.0152 in the groups of ≤28, 29–83, and ≥84 cumulative defined daily doses, respectively). The current study suggested that H. pylori eradication therapy could decrease the risk of recurrent PUD among patients with high cumulative doses of NSAIDs.

Effective Reduction of Gastric Cancer Risk With Regular Use of Nonsteroidal Anti-Inflammatory Drugs in Helicobacter Pylori–Infected Patients

2010 ◽  
Vol 28 (18) ◽  
pp. 2952-2957 ◽  
Author(s):  
Chun-Ying Wu ◽  
Ming-Shiang Wu ◽  
Ken N. Kuo ◽  
Chang-Bi Wang ◽  
Yi-Ju Chen ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Protective Factor ◽  
Nsaid User ◽  
Gastric Ulcers ◽  
Number Needed To Treat ◽  
Peptic Ulcers ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
H Pylori

Purpose Nonsteroidal anti-inflammatory drugs (NSAIDs) play protective roles in gastric carcinogenesis. However, the interaction between NSAIDs and Helicobacter pylori (H pylori) infection and the number needed to treat to prevent gastric cancer remains unclear. Patients and Methods We conducted a nationwide retrospective cohort study based on data from the Taiwan National Health Insurance Database. Hospitalized patients with a primary diagnosis of peptic ulcer disease were selected. Overall, 52,161 patients were divided into non-NSAID user and regular NSAID user cohorts. Standardized incidence ratios (SIRs), cumulative incidences, and hazard ratios (HRs) were calculated. Results Patients with peptic ulcers who never used NSAIDs had higher risk of gastric cancer compared with the general population (SIR, 2.11; 95% CI, 2.07 to 2.15), but regular NSAID use conferred lower risk (SIR, 0.79; 95% CI, 0.77 to 0.81). The protective role of NSAID use was observed in patients with gastric ulcer, but not in patients with non–H pylori-associated duodenal ulcer. On multivariate analysis, regular NSAID use was an independent protective factor for gastric cancer development (HR, 0.79 for each incremental year; P < .001), especially in H pylori-associated patients (HR, 0.52 for each incremental year; P < .001). Among patients with H pylori-infected gastric ulcers, the NNT to prevent a gastric cancer was 50. Conclusion Regular NSAID use may be a feasible way to prevent gastric cancer, at least in patients with gastric ulcers, and especially in H pylori-infected subjects.

scholarly journals Incidence of Duodenal Ulcers and Gastric Ulcers in a Western Population: Back to Where It Started

2009 ◽  
Vol 23 (9) ◽  
pp. 604-608 ◽  
Author(s):  
Marcel JM Groenen ◽  
Ernst J Kuipers ◽  
Bettina E Hansen ◽  
Rob J Th Ouwendijk
Keyword(s):  
Gastric Ulcers ◽  
Bleeding Complications ◽  
Upper Gastrointestinal Endoscopy ◽  
Peptic Ulcers ◽  
Duodenal Ulcers ◽  
Ulcer Disease ◽  
Treatment Regimens ◽  
H Pylori ◽  
Upper Gastrointestinal ◽  
Over Time

BACKGROUND/OBJECTIVES: As recently as 40 years ago, a decline in the incidence of peptic ulcers was observed. The discovery of Helicobacter pylori had a further major impact on the incidence of ulcer disease. Our aim was to evaluate the trends in the incidence and bleeding complications of ulcer disease in the Netherlands.METHODS: From a computerized endoscopy database of a district hospital, the data of all patients who underwent upper gastrointestinal endoscopy from 1996 to 2005 were analyzed. The incidence of duodenal and gastric ulcers, with and without complications, were compared over time.RESULTS: Overall, 20,006 upper gastrointestinal endoscopies were performed. Duodenal ulcers were diagnosed in 696 (3.5%) cases, with signs of bleeding in 158 (22.7%). Forty-five (6.5%) of these ulcers were classified as Forrest I and 113 (16.2%) as Forrest II. Gastric ulcers were diagnosed in 487 cases (2.4%), with signs of bleeding in 60 (12.3%). A Forrest 1 designation was diagnosed in 19 patients (3.9%) and Forrest 2 in 41 patients (8.4%). The incidence of gastric ulcers was stable over time, while the incidence of duodenal ulcers declined.CONCLUSIONS: The incidence of duodenal ulcer disease in the Dutch population is steadily decreasing over time. Test and treatment regimens for H pylori have possibly contributed to this decline. With a further decline in the prevalence of H pylori, the incidence of gastric ulcers is likely to exceed the incidence of duodenal ulcers in the very near future, revisiting a similar situation that was present at the beginning of the previous century.

STUDY OF SPECIFIC PHARMACOLOGICAL ACTIVITY OF SODIUM SALT (4-О-Β-GLUCOPYRANOSYLOXY)-BENZOIC ACID

2016 ◽  
Vol 78 (6-8) ◽  
Author(s):  
Smirnov Ivan ◽  
Murashko Tatyana ◽  
Ivanov Alex ◽  
Bondarev Alex ◽  
Udut Vladimir
Keyword(s):  
Benzoic Acid ◽  
Analgesic Activity ◽  
Sodium Salt ◽  
Analgesic Effect ◽  
Inflammatory Diseases ◽  
Peptic Ulcers ◽  
Chronic Inflammatory Diseases ◽  
Inflammatory Drugs ◽  
Anti Inflammatory

Chronic inflammatory diseases of various genesis are prevalent today. Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to treat pain and inflammation, but their long-term use is associated with complications in the gastrointestinal tract, including peptic ulcers. We synthesized a molecule of sodium salt (4-О-β-glucopyranosyloxy)-benzoic acid. This substance has diuretic and anti-inflammatory activities. It should be noted that most of NSAIDs has analgesic effect. In this connection, the aim of this study was to evaluate the analgesic activity of sodium salt (4-О-β-glucopyranosyloxy)-benzoic acid. We studied analgesic effect in the test “acetic writhing”. Sodium salt (4-О-β-glucopyranosyloxy)-benzoic acid significantly reduces the number of writhing by 14 units during the experiment, as an alternative criterion percent of animals with analgesia was 42.6%. Thus, in the test "acetic writhing" revealed the presence of the analgesic activity have developed drug average severity. 

Chronic gastroduodenal ulcers in patients with diabetes mellitus

2003 ◽  
Vol 49 (1) ◽  
pp. 5-10
Author(s):  
Yu. L. Fedorchenko
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Clinical Course ◽  
Gastrin Level ◽  
Gastric Ulcers ◽  
Peptic Ulcers ◽  
Duodenal Ulcers ◽  
Patients With Diabetes ◽  
H Pylori

The clinical picture, course, and treatment of gastroduodenal ul­cers (GDU) in diabetics were studied. A total of 395 diabetics were examined; GDU were detected in 36. The incidence of gas­tric and duodenal ulcers was similar in patients with insulin-de­pendent diabetes mellitus, while in patients with non-insulin-de- pendent diabetes gastric ulcers predominated. The clinical pic­ture of the disease, gastric acid production, Helicobacter pylori infection, and blood gastrin levels were studied in all patients with ulcers. The efficiency of GDU treatment with quamatel, raniti­dine, and antacids was evaluated. The clinical course of GDU in diabetics was asymptomatic. The highest incidence of H. pylori, infection was observed in patients with type 1 diabetes with con­comitant peptic ulcers. Serum gastrin levels were more frequently increased in patients with type 1 diabetes and duodenal ulcers and normal in patients with type 2 diabetes. Quamatel therapy was highly effective in diabetics with GDU. Ulcers healed in 85% patients and blood gastrin level significantly decreased after 3- week therapy. GDU in diabetics are characterized by specific lo­cation, clinical course, laboratory and instrumental features, which allows a differentiated approach to therapy of these pa­tients.

scholarly journals What Do We Do aboutHelicobacter pylori?

1999 ◽  
Vol 13 (2) ◽  
pp. 143-145 ◽  
Author(s):  
CJ Hawkey
Keyword(s):  
Past History ◽  
Ulcer Disease ◽  
History Of ◽  
Inflammatory Drugs ◽  
Heliobacter Pylori ◽  
Anti Inflammatory ◽  
H Pylori

Heliobacter pyloriand nonsteroidal anti-inflammatory drugs (NSAIDs) cause ulcers by different mechanisms. Under some circumstances, patients infected withH pylorimay be less prone to NSAID-associated ulcers than those who areH pylori-negative. Eradication trials have yielded differing results. However, those who have studied patients who have a past history of ulcer disease and are already established on NSAIDs have shown no benefit fromH pylorieradication.

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