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 18 November 2017

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News

NSAIDS and H pylori in peptic ulcer bleeding

In a study in the latest Clinical Gastroenterology & Hepatology, half of all ulcer bleeding was associated with NSAID use, and while 25% were associated with neither H pylori infection nor NSAID use, mortality was substantial.

News image

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Nonsteroidal anti-inflammatory drug use (NSAIDs) and Helicobacter pylori are risk factors for the development of peptic ulcers.

Dr Monique van Leerdam and colleagues from the Netherlands determined the prevalence of NSAID use, H pylori infection, and outcome of peptic ulcer bleeding.

In 2000, data of all 361 patients presenting with peptic ulcer bleeding were prospectively collected in a defined geographical area.

The research team included 14 hospitals, serving a catch area of 1.7 million persons.

The research team obtained follow-up data after a mean of 31 months from 211 patients.

Mortality during follow-up was 29%
Clinical Gastroenterology & Hepatology

The team found that the overall incidence was 22 cases per 100,000 persons.

The mean age of the group was 71 years, 55% were male, and 41% had severe or life-threatening comorbidity.

The researchers noted that NSAIDs were used by 52%, and in only 17% concomitant acid suppressive therapy was given.

H pylori infection was tested in 64% of patients.

Of the patients tested for H pylori, the team noted that 43% were positive.

The researchers reported that 23% of patients were H pylori negative and were not using NSAIDs.

Rebleeding during initial admission occurred in 19%.

Mortality during initial admission was 14%, and was higher during follow-up mortality at 29%.

Dr Leerdam's team concluded, “Half of all ulcer bleeding was associated with NSAID use.”

“Only a minority of NSAID users used concomitant acid suppressive therapy.”

H pylori is not assessed systematically in all patients with ulcer bleeding.”

“Almost a quarter of the ulcers were associated with neither H pylori infection nor NSAID use.”

“Mortality, both during hospitalization and follow-up, was substantial.”

Clin Gastroenterol Hepatol 2005: 3(9): 859-64
14 September 2005

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