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Yuan XG, Xie C, Chen J, Xie Y, Zhang KH, Lu NH. Control of gastric acid secretion in health and disease. Effect of smoking on gastric histology in Helicobacter pylori-positive gastritis. Koivisto TT, Voutilainen ME, Farkkila MA. Predictors of duodenal ulcer healing and relapse. Sonnenberg A, Muller-Lissner SA, Vogel E, et al. A prospective study of alcohol, smoking, caffeine, and the risk of duodenal ulcer in men. 17(4):328-35.Īldoori WH, Giovannucci EL, Stampfer MJ, Rimm EB, Wing AL, Willett WC. Moderate and high affinity serotonin reuptake inhibitors increase the risk of upper gastrointestinal toxicity. Spironolactone use and the risk of upper gastrointestinal bleeding: a population-based case-control study. Gastrointestinal bleeding in children following ingestion of low-dose ibuprofen. 21(12):1411-8.īerezin SH, Bostwick HE, Halata MS, Feerick J, Newman LJ, Medow MS. Meta-analysis: role of Helicobacter pylori eradication in the prevention of peptic ulcer in NSAID users. Vergara M, Catalan M, Gisbert JP, Calvet X. Geographical referencing learning resources: Townsend deprivation index. ReStore, National Centre for Research Methods. Risk of uncomplicated peptic ulcer disease in a cohort of new users of low-dose acetylsalicylic acid for secondary prevention of cardiovascular events. Ruigomez A, Johansson S, Nagy P, Martin-Perez M, Rodriguez LA. Risk factors for NSAID-associated upper GI clinical events in a long-term prospective study of 34 701 arthritis patients.
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Laine L, Curtis SP, Cryer B, Kaur A, Cannon CP. Helicobacter pylori duodenal colonization is a strong risk factor for the development of duodenal ulcer. Causes of mortality in patients with peptic ulcer bleeding: a prospective cohort study of 10,428 cases.
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Sung JJ, Tsoi KK, Ma TK, Yung MY, Lau JY, Chiu PW. Lansoprazole reduces ulcer relapse after eradication of Helicobacter pylori in nonsteroidal anti-inflammatory drug users-a randomized trial. Lansoprazole for the prevention of recurrences of ulcer complications from long-term low-dose aspirin use. proton pump inhibitors on 72-h intragastric pH in bleeding peptic ulcer. American College of Gastroenterology guideline on the management of Helicobacter pylori infection. In this setting, if H pylori is absent, consider a secondary cause of duodenal ulcer, such as Zollinger-Ellison syndrome. Patients with refractory ulcers may continue receiving once-daily PPI therapy indefinitely. If H pylori eradication is not achieved despite repeat treatment, maintenance antisecretory therapy should be recommended. High-risk patients include those with recurrent ulcers and those with complicated or giant ulcers. Maintenance treatment with antisecretory medications (eg, H2 blockers, PPIs) for 1 year is indicated in high-risk patients. Antacids or a GI cocktail (typically an antacid with an anesthetic such as viscous lidocaine and/or an antispasmodic) may be used as symptomatic therapy in the ED. The recommended primary therapy for H pylori infection is proton pump inhibitor (PPI)–based triple therapy. For patients who must continue with their NSAIDs, PPI maintenance is recommended to prevent recurrences even after eradication of H pylori. Discontinuation of NSAIDs is paramount, if it is clinically feasible. Both classes are available in intravenous or oral preparations.
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Acid suppression is the general pharmacologic principle of medical management of acute bleeding from a peptic ulcer, using histamine-2 receptor antagonists (H2RAs) and proton pump inhibitors (PPIs). The goals of pharmacotherapy are to eradicate H pylori infection, to reduce morbidity, and to prevent complications in patients with peptic ulcers. ACG H Pylori Infection Guidelines (2017).ASGE Guidelines for Sedation and Anesthesia in Gastrointestinal Endoscopy (2018).Perforated and Bleeding Peptic Ulcer Clinical Practice Guidelines (2020).