Proton Pump Inhibitor Treatment Decreases the Incidence of Upper Gastrointestinal Disorders in Elderly Japanese Patients Treated with NSAIDs

Abstract

Objective The Japanese health insurance system approved the use of proton pump inhibitors (PPIs) for the prevention of peptic ulcers in patients using low-dose aspirin (LDA) and/or non-steroidal anti-inflammatory drugs (NSAIDs). However, many orthopedists and physicians do not prescribe PPIs to elderly patients with atrophic gastritis. The aim of this study was to determine whether PPIs are effective in preventing gastrointestinal mucosal injury in elderly Japanese patients with atrophic gastritis. Methods We examined the associations between the use of antiulcer drugs and endoscopic findings in elderly Japanese patients using LDA or NSAIDs. Patients We evaluated 100 patients using LDA and 58 patients using non-aspirin NSAIDs 65 years of age or older. All patients underwent upper GI endoscopy to detect the presence of open ulcers and hemorrhagic lesions and assess the extent of atrophic gastritis. Results Among the patients using LDA, the prevalence of open ulcers was significantly lower in the patients using PPIs than in those using mucosal protective agent only and those not receiving antiulcer treatment (p<0.001). Among the patients using NSAIDs, the patients treated with PPIs exhibited a significantly lower incidence of open ulcers than the patients not receiving antiulcer treatment (p=0.012). Open-type atrophic gastritis was observed in nearly 70% of the patients. Conclusion The use of PPI treatment is advisable in order to prevent the discontinuation of LDA or NSAIDs due to the development of gastrointestinal disorders in elderly patients with atrophic gastritis.

Cost-Effectiveness Analysis of Gastritis Therapy in an Air Force Hospital in Bandung, Indonesia

“…PPIs are the most effective therapy for the full spectrum of acid reflux-related diseases [11]. PPIs are also recommended to decreased gastric acid production and facilitate quick healing [12]. Ulsidex tablets contain sucralfate, which is a base of aluminum saccharose sulfate, which on the surface of the ulcer will form a complex compound with protein, which will prevent the attack of aggressive factors, such as hydrochloric acid, pepsin, and bile.…”

A cross-sectional Study on lifestyle factors influencing gastritis and dyspepsia among international students’ faculty of medical university

“…17 Proton pump inhibitors like omeprazole are also highly suggested to quicken healing and reduce the production of gastric secretion. 18 Histamine blockers (H-2) like ranitidine and cimetidine are also recommended, in addition to antacids, although adverse effects of the use must be taken into consideration. 17 Due to the high antioxidant content of fresh vegetables and fruits they possess an advantageous effect on gastrointestinal mucosa.…”

Esomeprazole use is independently associated with significant reduction of BMD: 1-year prospective comparative safety study of four proton pump inhibitors

“…For most indications, PPIs are used only in the short term (4-8 weeks), with the exception of severe GERD and as concomitant therapy for prevention of NSAID-induced gastrointestinal damage, where they can be used as maintenance therapy for extended periods of time [13]. PPI are recognized as superior to histamine H 2 receptor antagonists in preventing the occurrence of NSAID-induced gastrointestinal lesions, and their use is generally an agreed option to enable patients to continue to use NSAIDs [14][15][16][17].…”