Clinical presentation of bleeding peptic ulcer in the elderly

Kemppainen, Helena; Räihä, Ismo; Sourander, L.

doi:10.1007/bf03339675

Cited by 7 publications

(3 citation statements)

References 20 publications

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“…We have shown that reinfected children are more frequently symptomatic than non-reinfected although no specific symptom was found to correlate with H. pylori status. Moreover, presenting with a clinical picture similar to that at baseline infection does not predict reinfection and most often children report an improvement in symptoms or they are entirely asymptomatic despite being reinfected, suggesting that children might became ''tolerant'' to the bacterium or that the growing child is more resistant to H. pylori-induced lesions (36). Finally, symptoms at reinfection are more ulcer-like than dysmotility-like dyspepsia.…”

Section: Discussionmentioning

confidence: 99%

Helicobacter pylori Status and Symptom Assessment Two Years after Eradication in Pediatric Patients from a High Prevalence Area

Magistà

Ierardi

Castellaneta

et al. 2005

J. pediatr. gastroenterol. nutr.

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Section: Discussionmentioning

confidence: 99%

Helicobacter pylori Status and Symptom Assessment Two Years after Eradication in Pediatric Patients from a High Prevalence Area

Magistà

Ierardi

Castellaneta

et al. 2005

J. pediatr. gastroenterol. nutr.

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“…This finding may be clinically relevant, since it is known that over 50% of NSAID‐related gastroduodenal lesions, including bleeding complications, occurred after occasional (within 1 week) or acute (within 1 month) NSAID treatment in elderly patients 3 , . 15 , 16 Recently, several studies have reported that proton pump inhibitors such as omeprazole were very effective in the prevention of NSAID‐related gastric and duodenal injuries 8 , . 9 , 17 –19 Such an activity has also been previously been reported for pantoprazole, 20 , 21 but not in the elderly.…”

Section: Discussionmentioning

confidence: 99%

Pantoprazole versus one‐week Helicobacter pylori eradication therapy for the prevention of acute NSAID‐related gastroduodenal damage in elderly subjects

Pilotto¹,

Mario

Franceschi³

et al. 2000

Aliment Pharmacol Ther

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Aim: To compare the efficacy of pantoprazole vs. a one‐week Helicobacter pylori eradication therapy for the prevention of NSAID‐related gastroduodenal damage. Methods: Patients over 60 years old with symptoms and/or a history of ulcer who needed NSAID treatment were evaluated by endoscopy. H. pylori positive subjects who had no severe gastroduodenal lesions were randomized to take, concomitantly with NSAID therapy, either: (i) pantoprazole 40 mg daily plus amoxycillin 1 g b.d. and clarithromycin 250 mg b.d. for 1 week (35 subjects, Group PAC) or (ii) pantoprazole 40 mg daily for 1 month (34 subjects, Group P). Endoscopy was repeated after 1 month. Results: A significantly higher incidence of severe gastroduodenal damage was found in Group PAC than in Group P (29% vs. 9%, P < 0.05). The percentages of patients worsened, unchanged and improved after 1 month were, respectively: Group PAC: 46%, 46%, and 9% and Group P: 7%, 65%, and 29% (P < 0.0008). The percentage of H. pylori‐negative subjects was 89% in Group PAC and 52% in Group P (P=0.0009). The incidence of gastroduodenal damage was higher in Group PAC treatment failures than in cured patients (50% vs. 25.8%, P=ns). Conclusion: One month of pantoprazole was more effective than a proton pump inhibitor‐based triple therapy in the prevention of gastroduodenal damage in elderly H. pylori‐positive NSAID users.

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“…However, NSAIDs also have a well-described serious side effect profile, most notably including gastrointestinal injury. With 7.9% of the Korean population considered elderly [1], NSAID use continues to increase, with NSAID-related gastrointestinal injury now a common clinical problem [2]. …”

Section: Introductionmentioning

confidence: 99%

Multiple ileal perforations due to regular diclofenac sodium injections: a case report

et al. 2013

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BackgroundAlthough the adverse effects of non-steroidal anti-inflammatory drugs (NSAIDs) on the upper gastrointestinal tract have been well characterized, those specific to the lower gastrointestinal tract are less clear, as only a limited number of articles and case reports exist in the literature.Case presentationWe describe a case of a 69-year-old woman who presented to the emergency department due to sudden onset abdominal distension and pain. Notably, she reported using intramuscular diclofenac sodium twice daily for 14 days after knee joint replacement surgery. The patient denied any other coexisting diseases. As a subsequent X-ray and computed tomography (CT) scan showed free air in the abdomen, an exploratory laparotomy was performed, revealing four free perforations in the terminal ileum. Findings on microscopic analysis were non-specific.ConclusionWe report a unique case of multiple ileal perforations due to regular diclofenac sodium injections and contend that ileal perforation can be considered as a source for pneumoperitoneum with concomitant peritonitis in patients with a history of NSAID use if other possibilities are excluded.

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Clinical presentation of bleeding peptic ulcer in the elderly

Cited by 7 publications

References 20 publications

Helicobacter pylori Status and Symptom Assessment Two Years after Eradication in Pediatric Patients from a High Prevalence Area

Helicobacter pylori Status and Symptom Assessment Two Years after Eradication in Pediatric Patients from a High Prevalence Area

Pantoprazole versus one‐week Helicobacter pylori eradication therapy for the prevention of acute NSAID‐related gastroduodenal damage in elderly subjects

Multiple ileal perforations due to regular diclofenac sodium injections: a case report

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