Gastrointestinal bleeding due to peptic ulcers and erosions - a prospective observational study (BLUE study).
CONCLUSIONS: The incidence of upper gastrointestinal bleeding due to peptic ulcers and erosions was found to be lower than previously demonstrated in comparable studies, but the overall mortality rate was unchanged. The consumption of risk medication was high, and only a few patients had used prophylactic PPIs. Concurrent H. pylori infection was present in only one-third of the patients. CLINICAL TRIAL REGISTRATION: Bleeding Ulcer and Erosions Study 'BLUE Study', ClinicalTrials.gov Identifier. NCT03367897. PMID: 32931710 [PubMed - as supplied by publisher]
Peptic ulcer disease (PUD) is a common cause of acute upper gastrointestinal (GI) bleeding with a significant impact on healthcare costs in the United States.1 Helicobacter pylori is a main risk factor for PUD, with high rates of rebleeding (27% to 81%) that have been shown to be reduced to less than 5% with eradication therapy.2 Guidelines recommend that all patients with PUD be tested for H pylori and if positive undergo treatment and subsequent testing to confirm eradication.3 In a recent study by Hung et al, 81% of inpatients presenting with upper GI bleeding due to PUD were tested for H pylori, an improvement from
Nonvariceal upper gastrointestinal bleeding (NVUGIB) is commonly due to bleeding from peptic ulcers. The major causes of peptic ulcers are Helicobacter pylori infection and medications. At the time of its identification as a cause of peptic ulcers, H pylori was associated with 60% to 80% of gastric ulcers and more than 90% of duodenal ulcers. However, over time the prevalence of H pylori has progressively declined. In a recent study performed in outpatient endoscopy centers in the United States, only 17% of peptic ulcers were associated with H pylori infection.
Guidelines recommend testing patients with peptic ulcer disease for Helicobacter pylori infection. We sought to identify factors associated with adherence to testing for H pylori in patients hospitalized for bleeding ulcers and to evaluate whether performing these tests affect risk for rebleeding.
Peptic ulcer disease is a condition in which an important role has infection with H. pylori. The most common complication of peptic ulcer is bleeding. The presence of H. pylori triggers local and systemic cytokin...
Nearly all peptic ulcers are caused by either Helicobacter pylori infection or the use of non-steroidal anti-inflammatory drugs (NSAIDs), which include aspirin. As H. pylori infection is becoming less prevalent in developed countries, NSAIDs are an increasingly important cause of ulceration, including ulcers complicated by gastrointestinal (GI) bleeding. Only about 15% of H. pylori-infected people develop an ulcer in their lifetime, with the risk determined by virulence of the H. pylori strain, host genetics and environment (particularly smoking).
Conclusion: H. pylori-induced follicular gastritis is considered as an additional risk factor for bleeding from gastric varices. PMID: 30881448 [PubMed]
A recent retrospective study on Helicobacter pylori (H. pylori) prevalence was carried out from 2005 to 2017 on all children who underwent esophagogastroduodenoscopy (EGDS) due to symptoms suggestive of peptic diseases e.g. dyspepsia, or symptoms of gastrointestinal bleeding in Hong Kong region: 602 patients were included; 317 were girls and 285 were boys, mean age 13.4 years. From the results of the study, the authors hypothesized that the reduction in prevalence of H. pylori infection among adults and the decrease in the practice of sharing chopsticks during meals have led to a decrease in transmission of the bacteria...
Conclusion: Our present study indicated, for the first time, that ABS could act against H. pylori. ABS is clinically used for the management of GI bleeding due to benign and malignant GI lesions. Thus, the possible anti-H. pylori effect of ABS shall expand the therapeutic spectrum of the drug in GI lesions in relation to H. pylori infection such as peptic ulser disease (PUD) and lymphoid tissue (MALT) lymphomagenesis. PMID: 30761849 [PubMed - in process]
ConclusionIn addition to age, male gender, H. pylori infection, and concomitant use of NSAIDs, COX-2 inhibitors, steroids, and thienopyridines, underlying co-morbidities including diabetes, CKD, cirrhosis, history of PUD are also important risk factors for first-time occurrence of non-variceal UGIB in aspirin users.
CONCLUSION: In addition to age, male gender, H. pylori infection, and concomitant use of NSAIDs, COX-2 inhibitors, steroids, and thienopyridines, underlying co-morbidities including diabetes, CKD, cirrhosis, history of PUD are also important risk factors for first-time occurrence of non-variceal UGIB in aspirin users. PMID: 30366771 [PubMed - as supplied by publisher]