Pharmacological Therapy of Peptic Ulcer

Background/Aims: Helicobacter pylori eradication promotes healing and prevents recurrence of H. pylori associated peptic ulcer disease (PUD). However it is unclear whether H. pylori eradication therapy commenced on the initial course of treatment is more effective compared to therapy at a later course of treatment. We evaluated the optimal commencement time of eradication of H. pylori in patients with hemorrhagic PUD. Materials and Methods: Between June 2002 through July 2013, a total of 486 patients who had hemorrhagic PUD were retrospectively evaluated. After exclusion, 79 patients who received H. pylori eradication therapy were assessed. Results: Thirty patients with duodenal ulcer (38%) and 49 patients with gastric ulcer (62%) were enrolled. The overall eradication rate were 96.2%. The eradication rates of early eradication vs. late eradication (divided by standards of 3 days after diagnosis of PUD) were 94.3% vs. 100%, and was not significantly different (P=0.55). Conclusions: According to our study, medication commencement time does not have an effect on the eradication rate of H. pylori infection in patients with hemorrhagic PUD.

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Pharmacologic Management of Nonvariceal Upper Gastrointestinal Bleeding

Kim

2016

Korean J Helicobacter Up Gastrointest Res

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Acute non-variceal upper gastrointestinal bleeding, the most common etiology of which is peptic ulcer disease, remains a persistent challenge despite a reduction in both its incidence and mortality. Both pharmacologic and endoscopic techniques have been developed to achieve hemostasis, with varying degrees of success. Among the pharmacologic therapies, proton pump inhibitor (PPI) remains the mainstay of treatment with potent acid suppression. Maintenance of the intragastric pH level above 6 by the administration of PPI prevents hemolysis caused by acid or pepsin and thereby promotes aggregation of platelets. Intragastric acid suppression can be achieved more effectively with continuous intravenous infusion of PPI after intravenous bolus injection. A high dose intravenous PPI is effective in reducing the risk of rebleeding, the need for surgery and repeated endoscopy. However, data regarding non-high dose intravenous PPIs are limited. In the future, novel PPIs and potassium-competitove acid blocker are in the area of interest. Combination therapy with the use of endoscopic hemostatic treatment and intravenous PPI administration is known to result in the best outcome for non-variceal upper gastrointestinal bleeding.

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Pharmacological Therapy of Peptic Ulcer

Cited by 4 publications

References 32 publications

Comparative analysis of the risk of osteoporotic fractures with proton pump inhibitor use and histamine-2 receptor antagonist therapy in elderly women: A nationwide population-based nested case-control study

Comparative analysis of the risk of osteoporotic fractures with proton pump inhibitor use and histamine-2 receptor antagonist therapy in elderly women: A nationwide population-based nested case-control study

The Optimal Commencement Time ofHelicobacter pyloriEradication in Bleeding Peptic Ulcer Disease

Pharmacologic Management of Nonvariceal Upper Gastrointestinal Bleeding

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