Risk Factors of Peptic Ulcer in 4943 Inpatients

Talamini, Giorgio; Tommasi, Marina; Amadei, Valeria; Pajusco, Benedetta; Fratucello, Anna; Lechi, Alessandro; Scroccaro, Giovanna; Vantini, Italo

doi:10.1097/mcg.0b013e3180318ac5

Cited by 15 publications

(6 citation statements)

References 25 publications

(21 reference statements)

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“…We also found a significantly higher prevalence of HP infection in the HAART period, with a prevalence similar to that observed in the general population in Western countries (18–32%) [16,17]. Several hypotheses to explain this can be proposed: higher acidic secretion in patients during the HAART period, contrasting with gastric hypoacidity seen in advanced stages of HIV infection in the pre‐HAART era [18], associated with immune improvement (increased CD4 cell counts) allowing an effective inflammatory response could provide the favourable conditions needed for HP growth [19,20].…”

Section: Discussionsupporting

confidence: 58%

Upper gastrointestinal endoscopic findings in the era of highly active antiretroviral therapy

Nkuize

Wit

Muls³

et al. 2010

HIV Medicine

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Background The current literature suggests that there has been a decrease in opportunistic diseases among HIV‐infected patients since the widespread introduction of highly active antiretroviral therapy (HAART) in 1995. Objectives The aim of the study was to investigate the impact of HAART and CD4 lymphocyte count on diseases of the upper gastrointestinal (UGI) tract, digestive symptoms, and endoscopic and histological observations. Methods A review of 706 HIV‐infected patients who underwent GI endoscopy was undertaken. The cohort was divided into three groups: group 1 (G1), pre‐HAART, consisting of 239 patients who underwent endoscopy between January 1991 and December 1994; group 2 (G2), early HAART, consisting of 238 patients who underwent endoscopy between January 1999 and December 2002; and group 3 (G3), recent HAART, consisting of 229 patients who underwent endoscopy between January 2005 and December 2008. Parameters studied included age, gender, opportunistic chemoprophylaxis, antiretroviral therapies, CD4 cell counts, symptoms, observations at the first UGI endoscopy and histology. Results When G1, G2 and G3 were compared, significant increases were seen over time in the following parameters: the percentage of women, the mean CD4 cell count, and the frequencies of reflux symptoms, gastroesophageal reflux disease (GERD), inflammatory gastropathy, gastric ulcer and Helicobacter pylori (HP) infection. Significant decreases were seen in the frequencies of the administration of anti‐opportunistic infection prophylaxis, odynophagia/dysphagia, acute/chronic diarrhoea, candida oesophagitis, nonspecific oesophageal ulcer and Kaposi sarcoma. No significant change was observed in the other parameters, i.e. digestive bleeding, duodenal ulcer and inflammatory duodenopathy. Conclusion These results suggest a correlation between the improvement of immunity as a result of more efficient antiviral therapy and the decrease in the frequency of digestive diseases in AIDS, mainly opportunistic pathologies. However, HP infection, reflux symptoms and GERD have increased in the HAART era.

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Section: Discussionsupporting

confidence: 58%

Upper gastrointestinal endoscopic findings in the era of highly active antiretroviral therapy

Nkuize

Wit

Muls³

et al. 2010

HIV Medicine

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“…pylori is a sufficient, yet not a necessary cause of peptic ulcer (PU) and inflammation of the gastric mucosa [4,5]. The decreasing prevalence of H. pylori challenges its role as the major risk factor for PU disease in Western countries [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

The natural course of Helicobacter pylori infection on endoscopic findings in a population during 17 years of follow-up: the Sørreisa gastrointestinal disorder study

et al. 2009

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The natural course of Helicobacter pylori (H. pylori) is poorly understood, as most research in the field has been on patient populations. We studied the natural course of H. pylori and its associations to morphological changes of the gastric mucosa, peptic ulcer, and reflux oesophagitis in a prospective cohort study of subjects with and without dyspepsia. A total of 361 adults (201 men/160 women, mean age 41/42 years) in Sørreisa municipality, Norway who in 1987 were subjected to upper endoscopy and assessed for gastrointestinal symptoms and H. pylori status were followed up in 2004. H. pylori was strongly associated with neutrophilic (odds ratio [OR] 23.79; 95% confidence interval [CI] 11.64:48.61) and mononuclear infiltration (OR 9.43; CI 5.12:17.36), moderately with atrophy of the antrum (OR 1.98; CI 1.17:3.34), but not with atrophy of the gastric body or intestinal metaplasia. Elimination of H. pylori was associated with regression of gastric inflammation and atrophy, whereas intestinal metaplasia progressed. H. pylori was positively associated with peptic ulcer (OR 2.69; CI 1.2:6.02) but not significantly negatively associated with oesophagitis (OR 0.62; CI 0.35:1.09). This is the first prospective study including endoscopic findings of subjects without dyspepsia, to show that the impact of H. pylori on gastric atrophy is only modest, and that eliminating H. pylori does not cause regression of intestinal metaplasia. However, inflammation of the gastric mucosa regresses after H. pylori elimination. H. pylori is only a moderate risk factor for peptic ulcer, and other explanatory factors deserve more attention.

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“…Talamini G et al found that smoking was not related to APD which is in line with the findings of the present study. 12 They also noted that drinking was also not related to APD, but authors found a strong association between alcohol use and APD. On multivariate analysis, the authors found that only NSAID use was strongly predicting the duodenal ulcer.…”

Section: Discussionmentioning

confidence: 98%

Prevalence and risk factors of acid peptic ulcer disease at a tertiary care hospital

Chavan

Bhaktavatsalam

2018

Int J Adv Med

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Background: In day to day practice, at outpatient department of General Medicine, at Mahavir Institute of Medical Sciences, Vikarabad, Telangana, India authors are coming across a significant number of patients with acid peptic disease (APD). This prompted us to carry out the present study. The objective is to study the prevalence, risk factors of acid peptic disease and to give suitable recommendationsMethods: Present study was hospital based cross sectional study carried out at outpatient department of General Medicine for a period of ten months from June 2017 to March 2018 among 307 outpatients.Results: The prevalence of acid peptic disease was found to be very high in the present study i.e. 38.1%. This was very high compared to the available literature. The prevalence of acid peptic disease was significantly associated with increasing age, lower social class, alcohol use, tea use and NSAID use. Acid peptic disease was not found to be associated with sex, residence, literacy, smoking, coffee intake, and obesity.Conclusions: Prevalence of acid peptic disease was found to be very high in the present study. Hence there is a need to institute the preventive and control measures to bring down the prevalence. At the same time the people in the surroundings should be made aware of this health problems and its risk factors.

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Risk Factors of Peptic Ulcer in 4943 Inpatients

Abstract: In inpatients, PPIs are associated with a reduced risk of duodenal ulcer, whereas NSAIDs are associated with an increased risk. Gastric ulcer was not associated with any increased or degreased risk with the 2 above-mentioned variables.

Cited by 15 publications

References 25 publications

Upper gastrointestinal endoscopic findings in the era of highly active antiretroviral therapy

Upper gastrointestinal endoscopic findings in the era of highly active antiretroviral therapy

The natural course of Helicobacter pylori infection on endoscopic findings in a population during 17 years of follow-up: the Sørreisa gastrointestinal disorder study

Prevalence and risk factors of acid peptic ulcer disease at a tertiary care hospital

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