Role of Helicobacter pylori infection and nonsteroidal anti-inflammatory drug use in bleeding peptic ulcers in Japan

Ootani, Hibiki; Iwakiri, Ryuichi; Shimoda, Ryo; Nakahara, Shin; Amemori, Sadahiro; Fujise, Takehiro; Kikkawa, Atsushi; Tsunada, Seiji; Sakata, Hiroyuki; Fujimoto, Kazuma

doi:10.1007/s00535-005-1720-y

Cited by 52 publications

(54 citation statements)

References 23 publications

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“…Secondly, endoscopic studies were not appropriately done on the high risk patients who were expected to have higher complication rates of organic diseases. Patients over the age of 55, and those treated with NSAIDs or LDA are known to have a higher risk for organic diseases, such as peptic ulcers and reflux esophagi- (16)(17)(18)(19). In addition, older patients have a higher risk of developing esophago-gastric cancer (20,21).…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Japanese Patients with Chronic Gastritis and Comparison with Functional Dyspepsia Defined by ROME III Criteria: Based on the Large-Scale Survey, FUTURE Study

Kinoshita

Chiba

2011

Intern. Med.

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Objective To clarify the clinical characteristics of patients diagnosed with chronic gastritis in Japan, a large scale clinical survey of patients with chronic upper gastrointestinal symptoms was conducted. Patients diagnosed with functional dyspepsia (FD) according to the ROME III criteria were selected from among patients with chronic gastritis and the clinical characteristics of patients with FD and those with chronic gastritis were compared. Patients and MethodsPatients with upper abdominal symptoms and diagnosed with chronic gastritis were enrolled in the study. Their main complaints, duration of symptoms, clinical characteristics, mental state, and results of endoscopic examinations, if available, were prospectively surveyed. Quality of life (QOL) impairment caused by abdominal symptoms was also surveyed using the Izumo QOL scale. Results A total of 9,125 patients with a clinical diagnosis of chronic gastritis were enrolled in the survey. Of those, approximately 60% had more than 2 symptoms and QOL impairment was greater in cases with multiple symptoms. Endoscopic examinations were performed in 2,946 cases (32.3% of enrolled patients), during which gastric and/or esophageal carcinoma was found in only 0.2%, though organic diseases were found in 6.2%. Endoscopic examinations were not done for patients with high risks of organic diseases. Of patients with organic diseases excluded by an endoscopic examination, only 362 (12.3% of patients who underwent an endoscopy) were diagnosed with FD according to the ROME III criteria, mainly because of short symptom duration. There were no remarkable differences in regard to clinical characteristics, including symptoms and mental state, between patients with chronic gastritis and those with FD. Conclusion Clinical characteristics of patients with chronic gastritis were similar to those with FD, except for shorter symptom duration.

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Section: Discussionmentioning

confidence: 99%

Characteristics of Japanese Patients with Chronic Gastritis and Comparison with Functional Dyspepsia Defined by ROME III Criteria: Based on the Large-Scale Survey, FUTURE Study

Kinoshita

Chiba

2011

Intern. Med.

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“…The present study was conducted using continuously accumulated data obtained from our earlier studies (10,11) and reflects the current Japanese situation in terms of the prevalence of bleeding peptic ulcers; i.e., this study focused on elderly patients with bleeding ulcers. In this study, drugs, H. pylori infection, sex and comorbidities were identified to be contributing factors for bleeding gastroduodenal ulcers in elderly patients, suggesting a close relationship between low-dose aspirin use and comorbidities.…”

Section: Discussionmentioning

confidence: 99%

Low-dose Aspirin and Comorbidities are Significantly Related to Bleeding Peptic Ulcers in Elderly Patients Compared with Nonelderly Patients in Japan

et al. 2014

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Objective The present study was conducted using data accumulated from our earlier study of bleeding peptic ulcers, focusing on elderly patients. Methods A total of 461 patients with bleeding peptic ulcers underwent emergency endoscopy at Saga Medical School Hospital between 1999 and 2011. Risk factors for bleeding peptic ulcers were compared between two groups: an elderly group (! 65 years old) and a nonelderly group (<65 years old). The relationship between drug use and age was examined using multiple logistic regression models. In the elderly group, the factors were compared between Period I (1999Period I ( -2005 and Period II (2006II ( -2011. Results The proportion of men and the incidence of Helicobacter pylori infection were lower in the elderly group than in the nonelderly group. The use of low-dose aspirin, antithrombotic drugs and corticosteroids, but not nonsteroidal anti-inflammatory drugs, was higher in the elderly group. A multiple logistic regression analysis of prescribed medications indicated that low-dose aspirin was more frequently used in the elderly group. The rate of comorbidities was higher and the hemoglobin levels were lower in the elderly group. The rates of rebleeding within one week and death within one month did not differ in the elderly group. Compared with that observed in Period I, the incidence of Helicobacter pylori infection was decreased and the rate of comorbidities was increased in Period II. Conclusion This study indicates that factors related to bleeding peptic ulcers in elderly patients have shifted from Helicobacter pylori infection to comorbidities associated with low-dose aspirin, suggesting a close relationship between low-dose aspirin therapy and comorbidities in elderly patients with peptic ulcers.

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“…During the last decade, PU bleeding did not significantly change (2,5,14), but the incidence increased in patients older than 75 years of age (15). In last decade, usage of non-steroidal anti-inflamatory drugs (NSAID) also increased, especially in the increasing elderly population (16,17). The use of NSAIDs is associated with an increased risk of bleeding ulcers (18,19).…”

Section: Original Articlementioning

confidence: 99%

Peptic ulcer complications requiring surgery: What has changed in the last 50 years in Turkey

Güzel

Kahramanca²,

Seker³

et al. 2014

Turk J Gastroenterol

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Background/Aims: The incidence and prevalence of peptic ulcer disease has decreased in recent years, but it is not so easy to make the same conclusion when complications of peptic ulcer are taken into consideration. The aim of this study is to determine the time trends in complicated peptic ulcer disease and to state the effects of H2 receptor blockers, proton pump inhibitors (PPI), and H. pylori eradication therapies on these complications. Materials and Methods: This study retrospectively evaluated the patients who were operated on for complications (perforation, bleeding, and obstruction) of peptic ulcer for the last 50 years. Patients were grouped into four groups (G1-G4) according to the dates in which H2 receptor blockers, PPIs, and eradication regimens for H. pylori were introduced The time periods that were studied were: (G1) 1962-1980, (G2) 1981-1990, (G3) 1991-1997, and (G4) 1998-2012. Results: In total, 2953 patients were operated on for complications of peptic ulcer disease, of which 86% of the patients were male. In G1, perforation and obstruction were significantly the most frequent complications (p<0.001), followed by bleeding. In groups G2 and G3, obstruction was still the most frequent complication requiring surgery (p<0.001). In G2 and G3, obstruction was followed by perforation and bleeding, respectively. In G4, perforation was significantly the most frequent complication (p<0.001). Conclusion: From 1962 to 1990 obstruction was the most common complication requiring surgery. In the last decade, perforation became the most common complication. In contrast to reports in the literature, bleeding was the least common complication requiring surgery in Turkey.

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Role of Helicobacter pylori infection and nonsteroidal anti-inflammatory drug use in bleeding peptic ulcers in Japan

Abstract: NSAID use contributed to bleeding ulcers in 28.4% of patients; thus, low-dose aspirin or on-demand NSAID use may cause bleeding ulcers. There were only two (1.7%) confirmed cases of H. pylori-negative, non-NSAID ulcers.

Cited by 52 publications

References 23 publications

Characteristics of Japanese Patients with Chronic Gastritis and Comparison with Functional Dyspepsia Defined by ROME III Criteria: Based on the Large-Scale Survey, FUTURE Study

Characteristics of Japanese Patients with Chronic Gastritis and Comparison with Functional Dyspepsia Defined by ROME III Criteria: Based on the Large-Scale Survey, FUTURE Study

Low-dose Aspirin and Comorbidities are Significantly Related to Bleeding Peptic Ulcers in Elderly Patients Compared with Nonelderly Patients in Japan

Peptic ulcer complications requiring surgery: What has changed in the last 50 years in Turkey

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