Peptic ulcer primary prevention
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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 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]
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.[1][2]
Primary Prevention
Lifestyle changes may help prevent peptic ulcers:
Tips include:
- 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.