Short-term treatment of gastric ulcer

Mario, F. Di; Battaglia, Giuseppe; Leandro, Gioacchino; Grasso, Giovanni; Vianello, Fábio; Vigneri, Sergio

doi:10.1007/bf02088227

Cited by 15 publications

(1 citation statement)

References 55 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Comparison analysis demonstrates the usefulness of PPIs and H 2 RAs in healing artificial ulcers after ESD, while meta-analysis shows significantly higher ulcer healing rates with PPIs than with H 2 RAs [82, 83]. For example, Ye et al [84] reported that active ulcers remained at a higher incidence after four weeks of H 2 RA treatment than of PPI treatment in artificial ulcers.…”

Section: Anti-acid Drugs For Artificial Ulcersmentioning

confidence: 99%

Proton Pump Inhibitor Therapy before and after Endoscopic Submucosal Dissection: A Review

Sugimoto

Jang

Yoshizawa

et al. 2012

Diagnostic and Therapeutic Endoscopy

View full text Add to dashboard Cite

Endoscopic submucosal dissection (ESD) is a novel endoscopic procedure first developed in the 1990s which enables en bloc resection of gastric neoplastic lesions that are difficult to resect via conventional endoscopic mucosal resection. However, given that ESD increases the risk of intra- and post-ESD delayed bleeding and that platelet aggregation and coagulation in artificial ulcers after ESD strongly depend on intragastric pH, faster and stronger acid inhibition via proton pump inhibitors (PPIs) and histamine 2-receptor antagonists (H2RAs) as well as endoscopic hemostasis by thermocoagulation during ESD have been used to prevent ESD-related bleeding. Because PPIs more potently inhibit acid secretion than H2RAs, they are often the first-line drugs employed in ESD treatment. However, acid inhibition after the initial infusion of a PPI is weaker in the early phase than that achievable with H2RAs; further, PPI effectiveness can vary depending on genetic differences in CYP2C19. Therefore, optimal acid inhibition may require tailored treatment based on CYP2C19 genotype when ESD is performed, with a concomitant infusion of PPI and H2RA possibly most effective for patients with the rapid metabolizer CYP2C19 genotype, while PPI alone may be sufficient for those with the intermediate or poor metabolizer genotypes.

show abstract

Section: Anti-acid Drugs For Artificial Ulcersmentioning

confidence: 99%

Proton Pump Inhibitor Therapy before and after Endoscopic Submucosal Dissection: A Review

Sugimoto

Jang

Yoshizawa

et al. 2012

Diagnostic and Therapeutic Endoscopy

View full text Add to dashboard Cite

show abstract

Transjugular intrahepatic portosystemic shunt compared with endoscopic treatment for prevention of variceal rebleeding: A meta-analysis

et al. 1999

Self Cite

View full text Add to dashboard Cite

Endoscopic treatment (ET) is frequently used to prevent variceal rebleeding but this still occurs in about 50% of patients. Recently, transjugular intrahepatic portosystemic shunt (TIPS) has been compared with ET in several trials. Using a meta-analysis, we evaluated randomized trials comparing TIPS to ET assessing prevention of rebleeding, survival, and the effects on resource use and the quality of patients' lives. Medical databases were searched between January 1988 and January 1999 as well as published citations and conference proceedings. Sensitivity analyses for type of publication, methodological quality score, mean duration of follow-up, type of ET, etiology, and severity of liver disease were performed. Eleven randomized trials involving 811 patients fulfilled the selection criteria. The median follow-up ranged from 10 to 32 months. Variceal bleeding is one of the most frequent and severe complications of portal hypertension. 1 It is associated with a high mortality during the acute episode and a high rate of recurrence in the patients who survive. 2 Thus, many studies have focused on therapeutic strategies to decrease the first occurrence of variceal bleeding, to increase survival from the acute episode, and to prevent rebleeding. There is a general consensus that all patients who have previously bled from varices should have secondary therapy to prevent further variceal bleeding. 3 Prevention of rebleeding was obtained initially by surgical portal systemic shunts and more recently by endoscopic treatments (ET) and drugs. 3 Surgical shunts are the most efficacious modality for prevention of rebleeding, but they are associated with an operative mortality, particularly in decompensated cirrhotics, and a high incidence of encephalopathy. 3 Endoscopic sclerotherapy has been shown to significantly reduce the rebleeding rate compared with controls or ␤-blockers and to improve survival compared with controls. 3 The combination of sclerotherapy and ␤-blockers seems to be superior to ␤-blockers alone, but not significantly different than sclerotherapy alone in both prevention of rebleeding and improvement of survival. 3 Results from a meta-analysis showed that surgical shunts were superior to sclerotherapy for prevention of rebleeding, but there was no difference in survival. 3 In the last decade, endoscopic band ligation was introduced and became the ET of choice for prevention of rebleeding in many centers. 4,5 However, rebleeding occurs in about 50% of cirrhotic patients despite ET. 4,6,7 Thus, new therapeutic options are needed.The transjugular intrahepatic portosystemic shunt (TIPS) is a recent therapeutic radiological procedure that involves the creation of a communication between the hepatic vein and an intrahepatic branch of the portal vein, thus decompressing the portal venous system. 8 TIPS is essentially a side-toside portacaval shunt, which does not require surgical intervention and thus has a lower mortality associated with the procedure. 9 Although TIPS was introduced into clinical practice only i...

show abstract

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

Short-term treatment of gastric ulcer

Cited by 15 publications

References 55 publications

Proton Pump Inhibitor Therapy before and after Endoscopic Submucosal Dissection: A Review

Proton Pump Inhibitor Therapy before and after Endoscopic Submucosal Dissection: A Review

Transjugular intrahepatic portosystemic shunt compared with endoscopic treatment for prevention of variceal rebleeding: A meta-analysis

Evidence-based clinical practice guidelines for peptic ulcer disease 2015

Contact Info

Product

Resources

About