Peptic ulcer primary prevention: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Peptic ulcer}} | {{Peptic ulcer}} | ||
{{CMG}}; {{AE}} {{GRN}} {{MKK}} | |||
==Overview== | |||
''[[Helicobacter pylori]]'' eradication has been proved as the most cost-effective strategy for primary prevention of [[NSAID]]-associated [[peptic ulcer]], especially for patients above the age of 50 years. | |||
==Primary Prevention== | ==Primary Prevention== | ||
Lifestyle changes may help prevent peptic ulcers:<ref name="pmid15948807">{{cite journal| author=Vergara M, Catalán M, Gisbert JP, Calvet X| title=Meta-analysis: role of Helicobacter pylori eradication in the prevention of peptic ulcer in NSAID users. | journal=Aliment Pharmacol Ther | year= 2005 | volume= 21 | issue= 12 | pages= 1411-8 | pmid=15948807 | doi=10.1111/j.1365-2036.2005.02444.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15948807 }} </ref><ref name="pmid18021578">{{cite journal| author=Leontiadis GI, Sreedharan A, Dorward S, Barton P, Delaney B, Howden CW et al.| title=Systematic reviews of the clinical effectiveness and cost-effectiveness of proton pump inhibitors in acute upper gastrointestinal bleeding. | journal=Health Technol Assess | year= 2007 | volume= 11 | issue= 51 | pages= iii-iv, 1-164 | pmid=18021578 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18021578 }} </ref> | |||
* Avoid [[aspirin]], [[ibuprofen]], [[naproxen]], and other [[NSAID]]s. Try [[acetaminophen]] instead. If you must take such medicines, talk to your doctor first | |||
* Don't smoke or chew tobacco | |||
* Limit alcohol to no more than two drinks per day | |||
Patients on long-term NSAID therapy and with the following risk factors, present an elevated risk of gastrointestinal bleeding and perforation:<ref name="pmid19240698">{{cite journal| author=Lanza FL, Chan FK, Quigley EM, Practice Parameters Committee of the American College of Gastroenterology|title=Guidelines for prevention of NSAID-related ulcer complications. | journal=Am J Gastroenterol | year= 2009 | volume= 104 | issue= 3 | pages= 728-38 | pmid=19240698 | doi=10.1038/ajg.2009.115 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19240698 }} </ref><ref name="pmid18836135">{{cite journal| author=Bhatt DL, Scheiman J, Abraham NS, Antman EM, Chan FK, Furberg CD et al.| title=ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use: a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents. | journal=Circulation | year= 2008 | volume= 118 | issue= 18 | pages= 1894-909 | pmid=18836135 | doi=10.1161/CIRCULATIONAHA.108.191087 |pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18836135 }} </ref> | Patients on long-term NSAID therapy and with the following risk factors, present an elevated risk of gastrointestinal bleeding and perforation:<ref name="pmid19240698">{{cite journal| author=Lanza FL, Chan FK, Quigley EM, Practice Parameters Committee of the American College of Gastroenterology|title=Guidelines for prevention of NSAID-related ulcer complications. | journal=Am J Gastroenterol | year= 2009 | volume= 104 | issue= 3 | pages= 728-38 | pmid=19240698 | doi=10.1038/ajg.2009.115 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19240698 }} </ref><ref name="pmid18836135">{{cite journal| author=Bhatt DL, Scheiman J, Abraham NS, Antman EM, Chan FK, Furberg CD et al.| title=ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use: a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents. | journal=Circulation | year= 2008 | volume= 118 | issue= 18 | pages= 1894-909 | pmid=18836135 | doi=10.1161/CIRCULATIONAHA.108.191087 |pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18836135 }} </ref> | ||
*History of ulcer complication | *History of [[ulcer]] complication | ||
*History of ulcer disease (non-bleeding) | *History of [[ulcer]] disease (non-bleeding) | ||
*Dual antiplatelet therapy | *Dual antiplatelet therapy | ||
*Concomitant anticoagulant therapy | *Concomitant [[anticoagulant]] therapy | ||
*<nowiki>≥60 years</nowiki> | *<nowiki>≥60 years</nowiki> | ||
*Corticosteroid use | *[[Corticosteroid]] use | ||
*[[Dyspepsia]] | *[[Dyspepsia]] | ||
*[[GERD]] symptoms | *[[GERD]] symptoms | ||
*''[[Helicobacter pylori]]'' | *''[[Helicobacter pylori]]'' infection | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
{{WH}} | |||
{{WS}} | |||
[[Category:Gastroenterology]] | [[Category:Gastroenterology]] | ||
[[Category:Needs overview]] | [[Category:Needs overview]] | ||
Latest revision as of 23:37, 29 July 2020
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Peptic ulcer Microchapters |
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Diagnosis |
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Treatment |
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Surgery |
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Case Studies |
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2017 ACG Guidelines for Peptic Ulcer Disease |
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Guidelines for the Indications to Test for, and to Treat, H. pylori Infection |
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Guidlines for factors that predict the successful eradication when treating H. pylori infection |
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Guidelines to document H. pylori antimicrobial resistance in the North America |
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Guidelines for evaluation and testing of H. pylori antibiotic resistance |
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Guidelines for when to test for treatment success after H. pylori eradication therapy |
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Guidelines for penicillin allergy in patients with H. pylori infection |
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Peptic ulcer primary prevention On the Web |
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American Roentgen Ray Society Images of Peptic ulcer primary prevention |
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Risk calculators and risk factors for Peptic ulcer primary prevention |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Guillermo Rodriguez Nava, M.D. [2] Manpreet Kaur, MD [3]
Overview
Helicobacter pylori eradication has been proved as the most cost-effective strategy for primary prevention of NSAID-associated peptic ulcer, especially for patients above the age of 50 years.
Primary Prevention
Lifestyle changes may help prevent peptic ulcers:[1][2]
- Avoid aspirin, ibuprofen, naproxen, and other NSAIDs. Try acetaminophen instead. If you must take such medicines, talk to your doctor first
- Don't smoke or chew tobacco
- Limit alcohol to no more than two drinks per day
Patients on long-term NSAID therapy and with the following risk factors, present an elevated risk of gastrointestinal bleeding and perforation:[3][4]
- History of ulcer complication
- History of ulcer disease (non-bleeding)
- Dual antiplatelet therapy
- Concomitant anticoagulant therapy
- ≥60 years
- Corticosteroid use
- Dyspepsia
- GERD symptoms
- Helicobacter pylori infection
References
- ↑ Vergara M, Catalán M, Gisbert JP, Calvet X (2005). "Meta-analysis: role of Helicobacter pylori eradication in the prevention of peptic ulcer in NSAID users". Aliment Pharmacol Ther. 21 (12): 1411–8. doi:10.1111/j.1365-2036.2005.02444.x. PMID 15948807.
- ↑ Leontiadis GI, Sreedharan A, Dorward S, Barton P, Delaney B, Howden CW; et al. (2007). "Systematic reviews of the clinical effectiveness and cost-effectiveness of proton pump inhibitors in acute upper gastrointestinal bleeding". Health Technol Assess. 11 (51): iii–iv, 1–164. PMID 18021578.
- ↑ Lanza FL, Chan FK, Quigley EM, Practice Parameters Committee of the American College of Gastroenterology (2009). "Guidelines for prevention of NSAID-related ulcer complications". Am J Gastroenterol. 104 (3): 728–38. doi:10.1038/ajg.2009.115. PMID 19240698.
- ↑ Bhatt DL, Scheiman J, Abraham NS, Antman EM, Chan FK, Furberg CD; et al. (2008). "ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use: a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents". Circulation. 118 (18): 1894–909. doi:10.1161/CIRCULATIONAHA.108.191087. PMID 18836135.