Non‐steroidal anti‐inflammatory drugs and Helicobacter pylori

Abstract

Non-steroidal anti-in¯ammatory drugs (NSAIDs) and Helicobacter pylori are well-recognized causes of gastroduodenal mucosal damage. This damage is mediated through the effects of both agents on acid secretion, neutrophil activity and function, and prostaglandin metabolism. Clinical trials on the interrelationship between H. pylori, NSAIDs and gastroduodenal mucosal injury have yielded con¯icting results. No consensus has been reached on what recommenda-

Acute Upper Gastrointestinal Bleeding: Comparison Between Recent Users and Nonusers of Nonsteroidal Anti-Inflammatory Drugs

“…On the other hand, a recent meta-analysis of case control studies indicates, in abstract form, that H. pylori infection and NSAIDs have an additive effect on peptic ulcer bleeding [27]. At present, no consensus has been reached on which recommendations should be implemented with regard to H. pylori eradication in patients receiving long-term NSAID therapy [28,29].…”

The Association ofHelicobacter pyloriInfection and Nonsteroidal Anti-Inflammatory Drugs in Peptic Ulcer Disease

“…The association between H pylori infection and use of NSAIDs in the pathogenesis of PUD has been controversial (10,11). Both are recognized as independent risk factors for its occurrence; however, studies on this issue have not been consistent.…”

Risk of Peptic Ulcer Bleeding Associated with Helicobacter pylori Infection, Nonsteroidal Anti-inflammatory Drugs, and Low-dose Aspirin Therapy in Peptic Ulcer Disease: A Case-control Study

“…It has been suggested that H. pylori infection could protect against, and even accelerate the healing of NSAIDs-induced ulcers because of acid suppression caused by H. pylori induced pangastritis, especially in the presence of PPI. 5,17 Additionally, H. pylori infection results in prostaglandin production by the gastric mucosa, which might be protective against superficial mucosal injury, 18 although it has not been conclusively proven. According to the meta-analysis in 2005, H. pylori eradication appeared to be effective only in NSAIDs-naïve patients, while in chronic NSAIDs-users, maintenance with PPI might be more effective than H. pylori eradication alone.…”