Prevalence of Helicobacter pylori in Peptic Ulcer Patients in Greater Rochester, NY: Is Empirical Triple Therapy Justified?

Jyotheeswaran, S; Shah, Amish; Jin, H. O.; Potter, G.D.; Ona, Fernando V.; Wy, Chey

doi:10.1111/j.1572-0241.1998.167_b.x

Cited by 118 publications

(42 citation statements)

References 9 publications

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“…41 42 However, not all ulcer disease is a consequence of H pylori; some studies have described H pylori negative ulcer disease. 43 Besides gastroduodenal ulceration, both gastric adenocarcinoma and gastric lymphoma are associated with H pylori infection, making this organism a carcinogen, particularly among Oriental Asians. 44 The classic presentation is one of burning epigastric pain usually occurring after meals and also awakening the patient at night.…”

Section: Peptic Ulcer Diseasementioning

confidence: 99%

Ageing and the gut

D'Souza

2007

Postgraduate Medical Journal

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The current concepts on diagnosis, clinical features, and management of common gastrointestinal conditions in the elderly population, taking into account physiological aspects of ageing, are evaluated. Gastrointestinal (GI) disorders are discussed with an emphasis on oesophageal problems, Helicobacter pylori infection, malabsorption, diverticular disease, and cancer. GI problems are acquiring greater importance in hospitals and in the community and their incidence is increasing. Newer treatments have less impact on patients' wellbeing and meticulously planned investigation and treatment is needed. Careful selection of patients and application of modern techniques has improved survival and outcomes, with comparable results to those in younger age groups.

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Section: Peptic Ulcer Diseasementioning

confidence: 99%

Ageing and the gut

D'Souza

2007

Postgraduate Medical Journal

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“…Helicobacter pylori has been shown to be the cause of duodenal ulcers in up to 61% of patients [7]. H. pylori is the most common known cause of peptic and duodenal ulcer disease.…”

Section: Discussionmentioning

confidence: 99%

Respiratory distress and chest pain: a perforated peptic ulcer with an unusual presentation

Bruner

Gustafson

2011

Int J Emerg Med

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BackgroundDyspnea and chest pain are common presenting complaints to the ED, and coupled together can present a challenging diagnostic dilemma in patients in extremis. A thoughtful evaluation is required, giving due diligence to the immediate life threats as well as multiple etiologies which can cause serious morbidity. A perforated peptic ulcer is one such possibility and requires rapid diagnosis and prompt intervention to avoid the associated high risk of morbidity and mortality.MethodWe present a case report of a 54 year old man with respiratory distress and chest pain as the initial Emergency Department presentation of a perforated duodenal ulcer.ResultsWe discuss an unusual presentation of a perforated duodenal ulcer that was recognized in the emergency department and treated promptly. The patient was surgically treated immediately, had a prolonged and complicated post-operative course, but is ultimately doing well. We also provide a brief literature review of the risk factors, imaging choices, and management decision required to treat a perforated ulcer.ConclusionsPerforated ulcers can have highly varied presentations and are occasionally difficult to diagnose in a complicated patient. Knowledge of the risk factors and a thorough history and physical can point to the diagnosis, but timely and appropriate imaging is often required because delays in diagnosis and treatment lead to poor outcomes. Early administration of antibiotics and immediate surgical repair are necessary to limit morbidity and mortality.

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“…Patients with two or more co-morbid diseases or with hypoalbuminemia < 3.0 g/dL have a significantly higher risk of recurrent bleeding [6,10] . Emerging evidence suggests that the incidence of idiopathic peptic ulcers, defined as patients without H. pylori infection and no exposure to NSAIDs, is high in the West (between 11% and 44%), and is also increasing in the Asia (from 4.2% to 18.8%) [74][75][76][77][78][79] . More than 70% of idiopathic peptic ulcers have comorbid illnesses, half of which are severe or life-threatening systemic disorders, defined as American Society of Anesthesiology score ≥3 [74,80] .…”

Section: Factors Related With the Poor Control Of IV Ppis: Cyp2c19 Storymentioning

confidence: 99%

Intravenous proton pump inhibitors for peptic ulcer bleeding: Clinical benefits and limits Hsiu-Chi Cheng, Bor-Shyang Sheu

Cheng

Sheu

2011

WJGE

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Peptic ulcer bleeding is a common disease and recurrent bleeding is an independent risk factor of mortality. Infusion with proton pump inhibitors (PPIs) prevents recurrent bleeding after successful endoscopic therapy. A gastric acidic environment of less than pH 5.4 alters coagulation function and activates pepsin to disaggregate platelet plugs. Gastric acid is secreted by H(+), K(+)-ATPase, naming the proton pump. This update review focuses on the mechanism and the role of PPIs in the clinical management of patients with peptic ulcer bleeding. An intravenous omeprazole bolus followed by high-dose continuous infusion for 72 h after successful endoscopic therapy can prevent the recurrent bleeding. In the Asian, however, the infusion dosage can possibly be diminished whilst preserving favorable control of the intragastric pH and thereby still decreasing rates of recurrent bleeding. Irrespective of the infusion dosage of PPIs, rates of recurrent bleeding remain high in patients with co-morbidities. Because recurrent peptic ulcer bleeding may be prolonged in those with co-morbidities, a low-dose infusion of IV PPIs for up to 7-day may result in better control of recurrent bleeding of peptic ulcers. Due to the inter-patient variability in CYP2C19 genotypes, the infusion form of new generation PPIs, such as esomeprazole, should be promising for the prevention of recurrent bleeding. This article offers a comprehensive review of clinical practice, highlighting the indication, the optimal dosage, the duration, and the potential limitation of PPIs infusion for peptic ulcer bleeding.

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Prevalence of Helicobacter pylori in Peptic Ulcer Patients in Greater Rochester, NY: Is Empirical Triple Therapy Justified?

Cited by 118 publications

References 9 publications

Ageing and the gut

Ageing and the gut

Respiratory distress and chest pain: a perforated peptic ulcer with an unusual presentation

Intravenous proton pump inhibitors for peptic ulcer bleeding: Clinical benefits and limits Hsiu-Chi Cheng, Bor-Shyang Sheu

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