Changing Clinical Pattern of Gastric Ulcer: Are Anti-Inflammatory Drugs Involved?

Jolobe, Oscar M.P.; Montgomery, R. D.

doi:10.1159/000199027

Cited by 24 publications

(2 citation statements)

References 14 publications

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“…[1][2][3][4][5][6][7][8][9][10] NSAIDs and Helicobacter pylori infection are thought to be the two most important exogenous factors in gastric and duodenal ulcer disease. The relative frequency of H pylori and NSAIDs as the cause of peptic ulcers varies and is, at least in part, correlated to the prevalence of H pylori infection and the use of NSAIDs in a population, 11 as well as to the expertise in identifying the presence of H pylori infection.…”

mentioning

confidence: 99%

The histopathology of non-steroidal anti-inflammatory drug induced gastroduodenal damage: correlation with Helicobacter pylori, ulcers, and haemorrhagic events

Frezza¹,

Gorji

Melato

2001

Journal of Clinical Pathology

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Aims-The spectrum of microscopic lesions resulting from the chronic use of non-steroidal anti-inflammatory drugs (NSAIDs), known as chemical gastritis, remains unclear, and the variable prevalence reported in diVerent studies makes this issue a matter of lively debate. The aim of this study was to evaluate the prevalence and importance of chemical gastritis in patients regularly taking NSAIDs. Owing to the high prevalence of Helicobacter pylori infection, particularly in subjects over 60 years of age, and in view of a possible association with damage, the presence of H pylori infection in the same tissue sample was also determined in all patients. Methods-One hundred and ninety seven subjects were enrolled, 118 of whom were receiving chronic treatment with NSAIDs and 79 of whom were controls, pair matched for age, sex, and clinical symptoms (ulcer-like dyspepsia or upper digestive tract haemorrhage). Antral biopsies taken during upper gastroduodenal endoscopy were assessed for chemical gastritis according to a modified version of Dixon's score, and for helicobacter correlated chronic active gastritis, according to the updated Sydney system. Results-Chemical gastritis was identified in 11 patients taking NSAIDs (9%) and in four controls (5%) (p < 0.05). Helicobacter pylori was detected in 53 patients taking NSAIDs (45%) and in 34 controls (43%). Patients taking NSAIDs had a significantly higher number of erosions and ulcers and worse endoscores than controls. The presence of H pylori did not appear to increase histological damage, ulcer prevalence, or haemorrhagic events. Conclusions-Chemicalgastritis is present in a limited number of patients regularly taking NSAIDs, and is not strongly correlated with NSAID induced damage. In many cases of peptic ulcer or upper gastrointestinal bleeding in patients taking NSAIDs, the presence of chemical gastritis or H pylori infection cannot solely account for the development of mucosal damage. The chronic use of non-steroidal antiinflammatory drugs (NSAIDs) is a common cause of gastroduodenal erosions and peptic ulcers resulting, in many cases, in fatal haemorrhage.

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confidence: 99%

The histopathology of non-steroidal anti-inflammatory drug induced gastroduodenal damage: correlation with Helicobacter pylori, ulcers, and haemorrhagic events

Frezza¹,

Gorji

Melato

2001

Journal of Clinical Pathology

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“…The risks of ulcer complications with NSAID use are considerably higher over the age of 60 (16,23,30,34). NSAID use may increase the tendency of ulcers to bleed and in a recent study was associated with over half the hemorrhages in women over 70 years (35). Prospective data have shown a specific association between NSAID use and ulcers presenting with bleeding rather than pain (34).…”

Section: The 'Influence' Of Nsaidsmentioning

confidence: 92%

Peptic Ulcer Disease in the Elderly

Gilinsky

1988

Scandinavian Journal of Gastroenterology

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Gilinsky NH. Peptic ulcer disease in the elderly. Scand J Gastroenterol 1988, 23 The elderly are a growing minority; they comprise approximately 12% of the population hut consume an increasing proportion of health care resources. Disease in the aged is unique in many ways, demanding special attention and study. This is particularly evident with regard to peptic ulceration, which is a more serious disorder in the elderly than in younger individuals, often presenting in an atypical manner and having a greater propensity to complications. Management traditionally tends to be conservative, enthusiasm often being tempered by the presence of frailty and associated disease. Despite technologic and pharmacologic advances, the elderly continue to account for a disproportionate number of deaths from this disorder. This paper will review the peculiarities of peptic ulcer disease of the elderly and examine currently emerging trends which may influence evolving management policies.

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Major upper gastrointestinal tract bleeding. Relation to the use of aspirin and other nonnarcotic analgesics

Levy¹

1988

Archives of Internal Medicine

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Changing Clinical Pattern of Gastric Ulcer: Are Anti-Inflammatory Drugs Involved?

Cited by 24 publications

References 14 publications

The histopathology of non-steroidal anti-inflammatory drug induced gastroduodenal damage: correlation with Helicobacter pylori, ulcers, and haemorrhagic events

The histopathology of non-steroidal anti-inflammatory drug induced gastroduodenal damage: correlation with Helicobacter pylori, ulcers, and haemorrhagic events

Peptic Ulcer Disease in the Elderly

Major upper gastrointestinal tract bleeding. Relation to the use of aspirin and other nonnarcotic analgesics

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