PMID- 11982732
OWN - NLM
STAT- MEDLINE
DCOM- 20020725
LR  - 20190901
IS  - 0815-9319 (Print)
IS  - 0815-9319 (Linking)
VI  - 17
IP  - 4
DP  - 2002 Apr
TI  - Management of peptic ulcer disease not related to Helicobacter.
PG  - 488-94
AB  - Most peptic ulcers not due to Helicobacter pylori are caused by non-steroidal 
      anti-inflammatory drugs (NSAID), among which an important subset are due to 
      vascular protective ("low-dose") aspirin therapy. Non-steroidal anti-inflammatory 
      drugs ulcers heal quite quickly when treated with a proton pump inhibitor (PPI), 
      even though the NSAID is continued. If the NSAID can be stopped, the ulcers heal 
      readily with either a PPI or a histamine H2-receptor antagonist (H2-RA). If 
      anti-inflammatory treatment is still needed after ulcers are healed, prophylactic 
      co-therapy with a PPI or misoprostol will reduce the risk of ulcer recurrence by 
      about 60-80%. The alternative of switching to a highly selective cyclooxygenase-2 
      inhibitor has been shown to reduce the risk of a complicated ulcer by about 
      50-60%, unless low-dose aspirin treatment needs to be given as well for vascular 
      disease. Idiopathic ulcers are becoming more frequent as H. pylori prevalence 
      falls. Some may be sequelae of previous NSAID ulceration even though the NSAID 
      has been ceased and the original ulcer had healed. These are best treated with an 
      H2-RA or a PPI, followed by long-term maintenance with either of these (often in 
      half the healing dosage) to prevent recurrence. Ulcers due to Zollinger-Ellison 
      syndrome and other hypergastrinemia syndromes are rare, and largely beyond the 
      scope of this review.
CI  - Copyright 2002 Blackwell Publishing Asia Pty Ltd
FAU - Yeomans, Neville D
AU  - Yeomans ND
AD  - Department of Medicine, The University of Melbourne at Western Hospital, 
      Footscray, Melbourne, Victoria 3011, Australia. n.yeomans@unimelb.edu.au
LA  - eng
PT  - Journal Article
PT  - Review
PL  - Australia
TA  - J Gastroenterol Hepatol
JT  - Journal of gastroenterology and hepatology
JID - 8607909
RN  - 0 (Anti-Inflammatory Agents, Non-Steroidal)
RN  - 0 (Cyclooxygenase Inhibitors)
RN  - 0 (Histamine Antagonists)
RN  - 0 (Proton Pump Inhibitors)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
MH  - Anti-Inflammatory Agents, Non-Steroidal/adverse effects
MH  - Aspirin/adverse effects
MH  - Cyclooxygenase Inhibitors/adverse effects
MH  - Histamine Antagonists/therapeutic use
MH  - Humans
MH  - Peptic Ulcer/chemically induced/*drug therapy/etiology
MH  - Proton Pump Inhibitors
RF  - 58
EDAT- 2002/05/02 10:00
MHDA- 2002/07/26 10:01
CRDT- 2002/05/02 10:00
PHST- 2002/05/02 10:00 [pubmed]
PHST- 2002/07/26 10:01 [medline]
PHST- 2002/05/02 10:00 [entrez]
AID - 2726 [pii]
AID - 10.1046/j.1440-1746.2002.02726.x [doi]
PST - ppublish
SO  - J Gastroenterol Hepatol. 2002 Apr;17(4):488-94. doi: 
      10.1046/j.1440-1746.2002.02726.x.