Preventing Recurrent Upper Gastrointestinal Bleeding in Patients with<i>Helicobacter pylori</i>Infection Who Are Taking Low-Dose Aspirin or Naproxen

Chan, Francis K.L.; Chung, Sheng-Ying; Suen, Bing Yee; Lee, Yuk Tong; Leung, Wai Keung; Leung, Vyl; Wu, Justin Che Yuen; Lau, James Y.; Hui, Yui; Lai, Moon Sing; Chan, Henry Lik Yuen; Sung, Joseph J.Y.

doi:10.1056/nejm200103293441304

Cited by 574 publications

(340 citation statements)

References 18 publications

Supporting

Mentioning

305

Contrasting

Unclassified

Order By: Relevance

“…Among those taking LDA, especially references with respect to the probability of recurrent bleeding, the eradication of H. pylori is equivalent to treatment with omeprazole [131].…”

Section: Commentmentioning

confidence: 99%

Evidence-based clinical practice guidelines for peptic ulcer disease 2015

et al. 2016

View full text Add to dashboard Cite

The Japanese Society of Gastroenterology (JSGE) revised the evidence-based clinical practice guidelines for peptic ulcer disease in 2014 and has created an English version. The revised guidelines consist of seven items: bleeding gastric and duodenal ulcers, Helicobacter pylori (H. pylori) eradication therapy, non-eradication therapy, drug-induced ulcer, non-H. pylori, non-nonsteroidal anti-inflammatory drug (NSAID) ulcer, surgical treatment, and conservative therapy for perforation and stenosis. Ninety clinical questions (CQs) were developed, and a literature search was performed for the CQs using the Medline, Cochrane, and Igaku Chuo Zasshi databases between 1983 and June 2012. The guideline was developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Therapy is initially provided for ulcer complications. Perforation or stenosis is treated with surgery or conservatively. Ulcer bleeding is first treated by endoscopic hemostasis. If it fails, surgery or interventional radiology is chosen. Second, medical therapy is provided. In cases of NSAID-related ulcers, use of NSAIDs is stopped, and anti-ulcer therapy is provided. If NSAID use must continue, the ulcer is treated with a proton pump inhibitor (PPI) or prostaglandin analog. In cases with no NSAID use, H. pylori-positive patients receive eradication and anti-ulcer therapy. If first-line eradication therapy fails, second-line therapy is given. In cases of non-H. pylori, non-NSAID ulcers or H. pyloripositive patients with no indication for eradication therapy, non-eradication therapy is provided. The first choice is PPI therapy, and the second choice is histamine 2-receptor antagonist therapy. After initial therapy, maintenance therapy is provided to prevent ulcer relapse.

show abstract

“…Among those taking LDA, especially references with respect to the probability of recurrent bleeding, the eradication of H. pylori is equivalent to treatment with omeprazole [131].…”

Section: Commentmentioning

confidence: 99%

Evidence-based clinical practice guidelines for peptic ulcer disease 2015

et al. 2016

View full text Add to dashboard Cite

show abstract

“…In this scenario, using a proton pump inhibitor is better than simply eradicating the bacteria (19) . The best protection for the patient in these cases is to apply both, namely, the proton pump inhibitor and eradicating H pylori (20) .…”

Section: Statement 24mentioning

confidence: 99%

“…The best approach in these cases, besides eradicating H pylori, is to indicate the maintenance use of proton pump inhibitors (19,114) .…”

Section: Statement 24mentioning

confidence: 99%

3rd BRAZILIAN CONSENSUS ON Helicobacter pylori

Coelho

Maguinilk

Zaterka³

et al. 2013

Arq. Gastroenterol.

View full text Add to dashboard Cite

Significant progress has been obtained since the Second Brazilian Consensus Conference on Helicobacter pylori Infection held in 2004, in São Paulo, SP, Brazil, and justify a third meeting to establish updated guidelines on the current management of H. pylori infection. The Third Brazilian Consensus Conference on H pylori Infection was organized by the Brazilian Nucleus for the Study of Helicobacter, a Department of the Brazilian Federation of Gastroenterology and took place on April 12-15, 2011, in Bento Gonçalves, RS, Brazil. Thirty-one delegates coming from the five Brazilian regions and one international guest, including gastroenterologists, pathologists, epidemiologists, and pediatricians undertook the meeting. The participants were allocated in one of the five main topics of the meeting: H pylori, functional dyspepsia and diagnosis; H pylori and gastric cancer; H pylori and other associated disorders; H pylori treatment and retreatment; and, epidemiology of H pylori infection in Brazil. The results of each subgroup were submitted to a final consensus voting to all participants. Relevant data were presented, and the quality of evidence, strength of recommendation, and level of consensus were graded. Seventy per cent and more votes were considered as acceptance for the final statement. This article presents the main recommendations and conclusions to guide Brazilian doctors involved in the management of H pylori infection.

show abstract

“…In addition, studies conducted in Hong Kong and the US have revealed that both H pylori eradication [3] and PPI treatment [4] are useful in preventing the recurrence of hemorrhagic peptic ulcers induced by low-dose aspirin. In Japan, however, the administration of PPIs, H2RAs and prostaglandins for the prevention of peptic ulcers induced by NSAIDs and low-dose aspirin is not covered by medical insurance, although the use of these drugs for the treatment of peptic ulcers is covered.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of anti-ulcer drugs for the prevention and treatment of peptic ulcers induced by low doses of aspirin

Nakashima

Ota²,

Arai³

et al. 2009

WJG

View full text Add to dashboard Cite

AIM:To investigate the usefulness of anti-ulcer drugs for the prevention and treatment of low-dose aspirininduced peptic ulcer. METHODS:Upper gastrointestinal endoscopy was performed in 68 patients receiving daily low-dose aspirin (81 or 100 mg/day). The endoscopic findings were classified according to the Lanza score, and the scores were compared between groups categorized according to the concomitant use of anti-ulcer drugs and the types of drugs used. In another study, 31 hemorrhagic peptic ulcer patients who had been receiving low-dose aspirin were enrolled. The patients were randomly classified into the proton pump inhibitor (PPI)-treated group and the H2 receptor antagonist (H2RA)-treated group. The administration of low-dose aspirin was continued concomitantly, and endoscopic examinations were performed 8 wk later. RESULTS:The Lanza scores (mean ± SD) of the gastro-mucosal lesions were 1.0 ± 1.9 and 1.9 ± 2.3 in 8 and 16 patients receiving prevention therapy with a PPI and an H2RA, respectively. Both scores were significantly smaller than the scores in 34 patients who were not receiving prevention therapy (4.7 ± 1.0) and in 10 patients receiving cytoprotective anti-ulcer drugs (4.3 ± 1.6). In the prospective study, 18 and 13 patients received a PPI and an H2RA, respectively. Endoscopic examinations revealed that the tissue in the region of the gastro-mucosal lesions had reverted to normal in all patients in the PPI-treated group and in 12 patients (92%) in the H2RA-treated group; no significant differences were observed between the groups. CONCLUSION: H2RA therapy was effective for both the prevention and treatment of low-dose aspirininduced peptic ulcer, similar to the effects of PPIs, while cytoprotective anti-ulcer drugs were ineffective in preventing ulceration.

show abstract

Preventing Recurrent Upper Gastrointestinal Bleeding in Patients withHelicobacter pyloriInfection Who Are Taking Low-Dose Aspirin or Naproxen

Cited by 574 publications

References 18 publications

Evidence-based clinical practice guidelines for peptic ulcer disease 2015

Evidence-based clinical practice guidelines for peptic ulcer disease 2015

3rd BRAZILIAN CONSENSUS ON Helicobacter pylori

Usefulness of anti-ulcer drugs for the prevention and treatment of peptic ulcers induced by low doses of aspirin

Contact Info

Product

Resources

About