Modern Clinical and Epidemiological Features and New Technological Possibilities in the Treatment of Bleeding Gastroduodenal Ulcers

The aim of this research was to study the current clinical and epidemiological features of ulcerative gastroduodenal bleeding (GDB) and to evaluate the outcomes of using new technological approaches in patients with bleeding from acute (symptomatic) and chronic (peptic ulcer disease) gastroduodenal ulcers (GDUs). Methods and Results: The present study involved 221 patients with bleeding GDUs. Depending on the source of bleeding, all patients were divided into 2 groups. Group 1 included 143 patients with acute symptomatic GDUs; Group 2 consisted of 78 patients with peptic ulcer disease complicated by bleeding. In the complex treatment of patients of all the studied groups, an individual approach was used that included the innovative technologies of endoscopic cytoprotective treatment of GDB, based on the combined use of traditional means of EH in combination with the use of endoscopic pneumoinsufflation of biologically active drainage sorbent of a new generation Aseptisorb-D and powdered hemostatic Zhelplastan. Our analysis showed that acute symptomatic GDUs prevailed in the structure of GDB – 143(64.7%) patients; PUD complicated by bleeding was diagnosed in 78(35.3%) cases. The use of new technological approaches, including cytoprotective treatment of bleeding defects with biologically active draining sorbents of a new generation in combination with local hemostatics in the complex therapy of patients with ulcerative GDB, has significantly improved the results of treatment, which is confirmed by high rates of final hemostasis (95.0%), indicators of the effectiveness of primary EH in type FIA-IB (93.1%) and prevention of recurrence of FIIA-IIB bleeding (92.5%), with a low frequency of repeated bleeding (4.07%), emergency surgeries (2.7%), and mortality (3.2%). Conclusion: Currently, in the structure of ulcerative GDB, acute symptomatic GDUs are the most common – 64.7%, and the share of PUD complicated by bleeding accounts for 35.3% of cases only. PUD and GDUs complicated by bleeding have certain clinical and epidemiological features, which must be taken into account when treating these patients. Symptomatic GDUs are more difficult to treat, which shows the need to develop new complex technologies for their treatment.

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THE STATE AND ROLE OF ESOPHAGUS, STOMACH, INTESTINAL MICROBIOTA IN PATIENTS WITH ULCER DISEASE, CHRONIC GASTRITIS, ESOPHAGITIS

Russian Clinical Laboratory Diagnostics ◽

10.18821/0869-2084-2020-65-1-42-49 ◽

2020 ◽

Vol 65 (1) ◽

pp. 42-49

Author(s):

V. M. Chervinets ◽

A. Yu. Mironov ◽

Yu. V. Chervinets ◽

S. N. Bazlov

Keyword(s):

Peptic Ulcer ◽

Peptic Ulcer Disease ◽

Mucous Membrane ◽

Chronic Gastritis ◽

Low Frequency ◽

Duodenal Mucosa ◽

Pathological Process ◽

Quantitative Composition ◽

Ulcer Disease ◽

Opportunistic Bacteria

The microflora of 64 biopsies taken during fibrogastroduodenoscopy of the mucous membrane of the esophagus, stomach and duodenum in healthy volunteers and 1120 samples obtained from the same parts of the digestive tract in patients with esophagitis, chronic gastritis and peptic ulcer disease were studied. The patients ranged in age from 18 to 62 years. Traditional bacteriological method was used to isolate and identify microorganisms. Staphylococcus spp., Streptococcus spp., Lactobacillus spp., Bacteroides spp., Stomatococcus spp., Enterobacteriaceae, Corynebacterium spp., Micrococcus spp., Neisseria spp., Veilonella spp. were isolated from biopsies of healthy respondents in an average amount from 3.2 to 4.68 lg CFU/g. H.pylori was found in 60% (5.66 lg CFU/g) in the esophagus, in 33.3% of cases (5.12 lg CFU/g) from the fundal part of the stomach, in 44.4% (5.25 lg CFU/g) from the antral part of the stomach, in 5.5% (4.2 lg CFU/g) in the duodenal mucosa. In samples obtained from the inflamed and eroded mucous membrane of the esophagus, stomach and duodenum, opportunistic bacteria of the genera Klebsiella, Enterobacter, Proteus, Pseudomonas, Peptococcus, Actinomyces, yeast fungi of the genus Candida etc. were detected in an amount exceeding 4 lg CFU/g. H. pylori isolated in 6.3-16.7% of patients (4.25-4.6 lg CFU/g) and did not dominate in relation to other microorganisms, and in most cases had a low frequency of its occurrence. In patients with the recurrence of peptic ulcer disease, exacerbation of chronic gastritis and esophagitis, dysbiosis was developed, characterized by an increase in the species and quantitative composition of opportunistic microflora, an increase in its enzymatic and cytotoxic activity, which can contribute to the maintenance of inflammatory and necrotic processes and inhibit the elimination of the pathological process.

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Seasonal Pattern of Peptic Ulcer Perforation in Central Anatolia

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/501 ◽

2021 ◽

Vol 10 (31) ◽

pp. 2451-2455

Author(s):

Fatih Dal ◽

Ugur Topal

Keyword(s):

Peptic Ulcer ◽

Peptic Ulcer Disease ◽

Large Scale ◽

Female Gender ◽

Central Anatolia ◽

Peptic Ulcer Perforation ◽

Ulcer Disease ◽

Ulcer Perforation ◽

Significant Difference ◽

Group 2

BACKGROUND Previous studies have reported seasonal variations in peptic ulcer disease (PUD), but only few large-scale, population-based studies have been conducted in this regard. In this study, we wanted to present the seasonal relationship of peptic ulcer perforation admissions, seasonal variation of its incidence, modes of surgical management, the seasonal distribution of postoperative severe complications and the patient outcome. METHODS This is a retrospective cohort study. Patients hospitalized for peptic ulcer perforation between 1st January 2008 and 1st January 2020 were included in the study. The patients were divided into two groups according to postoperative complication status as Group1 - Clavien Dindo < 3 and Group 2 - Clavien Dindo > 3. Age, gender and seasonal periods were compared. In addition, patients were divided into three groups according to age as 18 – 40 yrs., 40 - 60 yrs. and over 60 yrs. The gender and complication status of the patients were also evaluated in seasonal groups. RESULTS 135 patients participated in our study. Group 1 constituted of 107 patients and Group 2 constituted of 28 patients. Admission to the hospital due to peptic ulcer perforation was most common in spring (29.6 %) and summer (29.6 %). Twenty - eight patients had Clavien - Dindo 3 or more complications. The mean age was higher in Group 2 (70.78 vs 50.2 P : 0.001) as well as female gender dominancy (60.7 % vs 29.9 %). In Group 2 winter months were more frequent (46,5 % vs 21.5 %); however, there was no significant difference between the seasons and the complication groups. In Group 2, female gender was more common in winter (21.7 % vs 69.2 % P:0.005) and autumn season (31.3 % vs 100 % P : 0.027). CONCLUSIONS In our study, we found an increased incidence of peptic ulcer perforation in spring and summer. For patients at higher risk, an appropriate pharmacological treatment can be arranged to reduce the risk of perforation during the risky season. KEY WORDS Peptic Ulcer Disease, Seasonal Change, Complication

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Peptic ulcer disease: changes it has undergone over the past 50 years

Clinical Medicine (Russian Journal) ◽

10.30629/0023-2149-2020-98-8-583-587 ◽

2021 ◽

Vol 98 (8) ◽

pp. 583-587

Author(s):

A. A. Sheptulin ◽

S. S. Kardasheva ◽

A. A. Kurbatova

Keyword(s):

Peptic Ulcer ◽

Peptic Ulcer Disease ◽

Eradication Therapy ◽

Ulcer Disease ◽

Gastroduodenal Ulcers ◽

The Past ◽

Anti Inflammatory ◽

Ulcerative Lesions ◽

H Pylori

This review considers the main changes in our understanding of the etiology of peptic ulcer disease (PUD), its treatment and prevention. It is emphasized that the discovery of H. pylori infection and the implementation of eradication therapy did not solve all the issues related to PUD. Further investigation is needed to study the pathogenesis of idiopathic gastroduodenal ulcers, as well as ulcerative lesions of the stomach and duodenum, caused by various medications (non-steroidal anti-inflammatory drugs in particular).

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POTENTIAL BENEFIT OF CURCUMIN ADJUVANT THERAPY TO THE STANDARD H. PYLORI ERADICATION THERAPY IN PATIENTS WITH PEPTIC ULCER DISEASE

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2017.v10i5.17462 ◽

2017 ◽

Vol 10 (5) ◽

pp. 313 ◽

Cited By ~ 1

Author(s):

Manal Khalid Abdulridha

Keyword(s):

Peptic Ulcer ◽

Adjuvant Therapy ◽

Peptic Ulcer Disease ◽

Triple Therapy ◽

Significant Elevation ◽

Ulcer Disease ◽

Tnf Α ◽

Total Antioxidant ◽

Group 2 ◽

H Pylori

Objective: This study was designed to explore the benefit of curcumin as adjuvant therapy to the standard H pylori eradication triple therapy in both duodenal and gastric ulcers patients. Methods: The present study enrolled 40 patients newly diagnosed endoscopically with peptic ulcer disease to be allocated into group1 treated with standard H. pylori eradication triple therapy, and group2 patients treated with curcumin (500mg) capsules three times daily for 14 day as adjuvant to standard triple therapy. Stool antigen test, immunoglobulin M serology test, tumor necrosis factor-alpha (TNF-α), interleukin 1 beta (IL1β), and total antioxidant capacity (T-AOC) are measured at the baseline and after 6 weeks of treatment.Results: The result showed that the use of curcumin as adjuvant therapy produced highly significant improvement in healing efficacy which was significantly distinguished in duodenal ulcer patients compared to gastric ulcer groups 2 patients (p <0.05), along with highly significant reduction in pro inflammatory IL1β level in group 2 patients(p<0.01). After 6 weeks of treatment there was highly significant elevation in level of TNF- α in groups 1 (p value <0.01), though, group 2 patients presented with non significant elevation in TNF-α level. Moreover, the total antioxidant capacity was improved with curcumin adjuvant therapy, though non- significant, compared to group 1patients who showed reduction in total antioxidant capacity.Conclusion: This study revealed that addition of curcumin as adjuvant therapy produced improvement in ulcer healing efficacy, and controlled the inflammatory and oxidative stress process induced by H pylori infection.Keywords: Peptic ulcer disease, Curcumin, H. pylori infection, inflammation and oxidation markers.

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The Association ofHelicobacter pyloriInfection and Nonsteroidal Anti-Inflammatory Drugs in Peptic Ulcer Disease

Canadian Journal of Gastroenterology ◽

10.1155/2006/175217 ◽

2006 ◽

Vol 20 (4) ◽

pp. 277-280 ◽

Cited By ~ 37

Author(s):

Juan Carlos Zapata-Colindres ◽

Sergio Zepeda-Gómez ◽

Aldo Montaño-Loza ◽

Edgar Vázquez-Ballesteros ◽

José de Jesús Villalobos ◽

...

Keyword(s):

Peptic Ulcer ◽

Peptic Ulcer Disease ◽

Bleeding Peptic Ulcer ◽

The Other ◽

Ulcer Disease ◽

Group 3 ◽

Anti Inflammatory ◽

Group 2 ◽

H Pylori ◽

Group 1

BACKGROUND AND AIM: Peptic ulcer disease (PUD) affects 10% of the world population.Helicobacter pyloriinfection and the use of a nonsteroidal anti-inflammatory drug (NSAID) are the principal factors associated with PUD. The aim of the present study was to evaluate a cohort of patients with PUD and determine the association betweenH pyloriinfection and NSAID use.PATIENTS AND METHODS: The medical charts of patients with endoscopic diagnosis of PUD were retrospectively reviewed from September 2002 to August 2003. Patients were divided into three groups according to ulcer etiology:H pyloriinfection (group 1); NSAID use (group 2); and combinedH pyloriinfection and NSAID use (group 3).RESULTS: One hundred two patients were evaluated: 36 men (35.3%) and 66 women (64.7%). Forty patients hadH pyloriinfection, 43 had used NSAIDs and 15 had combinedH pyloriinfection and NSAID use; four patients with ulcers secondary to malignancy were excluded. The frequency of women was significantly higher in group 2 (P=0.01). The mean age of patients in group 1 was significantly lower than in the other two groups (P=0.003). PUD developed earlier in group 3 than in group 2 (5.0±4.7 months versus 1.4±2.1 months, respectively, P=0.018). Thirty-two patients (32.7%) had bleeding peptic ulcer. Group 2 had a higher risk of bleeding peptic ulcer than the other two groups (P=0.001).CONCLUSIONS: The development of PUD was observed earlier in the combinedH pyloriand NSAID group than in patients with only NSAID use. This suggests a synergic effect between the two risks factors in the development of PUD.

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