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 24 November 2017

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News

Acute upper GI bleeding and nonsteroidal anti-inflammatory drugs

Recent users of NSAIDs are more likely to bleed from duodenal ulcers and to have Helicobacter pylori infection, find researchers in the April issue of Endoscopy.

News image

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In this study, researchers from Greece, compared the users and nonusers of nonsteroidal anti-inflammatory drugs (NSAIDs) presenting with upper GI bleeding. The team examined clinical, endoscopic, and outcome differences.

They assessed 330 consecutive patients who presented with clinical manifestations of upper GI bleeding. These patients underwent urgent endoscopy after clinical assessment, within 12 hours of admission.

The team divided patients into 2 groups, depending on whether they had a positive or negative history of recent NSAID use.

Helicobacter pylori infection was significantly more common in NSAID users.
Endoscopy

Urgent endoscopy followed by endoscopic hemostasis and/or biopsy was performed by 1 endoscopist, who was blinded to the patients’ clinical status.

The researchers found that baseline characteristics, estimated severity of upper GI bleeding, and outcome did not differ between the 2 groups.

However, the team found that NSAID users bled from an ulcer more frequently than nonusers. While the latter more often had a history of peptic ulcer or upper GI bleeding.

The research team determined that bleeding ulcers were mostly duodenal in the NSAID group and gastric in the non-NSAID group.

In addition, Helicobacter pylori infection was significantly more common among NSAID users.

The team also found that the NSAID group included a greater proportion of alcohol abusers, who bleed mainly from erosive gastritis.

Dr Adamopoulos’s team concluded, “Recent NSAID users were found to bleed from [predominantly duodenal] ulcers…and to have H. pylori infection more frequently than upper GI bleeders with a negative history of NSAID consumption”.

“Alcohol abuse was also more common among NSAID users”.

The severity of bleeding and the outcome did not differ between the 2 groups”.

Endoscopy 2003; 35(4): 327-32
01 April 2003

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