PMID- 30619934
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240420
IS  - 2397-9070 (Electronic)
IS  - 2397-9070 (Linking)
VI  - 2
IP  - 6
DP  - 2018 Dec
TI  - Recent trends in the occurrence of bleeding gastric and duodenal ulcers under the 
      Japanese evidence-based clinical practice guideline for peptic ulcer disease.
PG  - 255-261
LID - 10.1002/jgh3.12078 [doi]
AB  - BACKGROUND: Gastrointestinal hemorrhage occurs frequently. We reviewed the 
      tendency of occurrence of bleeding gastric and duodenal ulcers and their 
      association with antithrombotic therapy before and after the widespread use of 
      Evidence-Based Clinical Practice Guidelines for Peptic Ulcer 2009 (1st edition), 
      which was published to improve treatment outcomes and prevent peptic ulcers. 
      METHODS: The study enrolled 1105 patients with bleeding gastric and duodenal 
      ulcers treated at our hospital between January 2000 and March 2016. They were 
      divided into the preguideline group (807 patients treated between January 2000 
      and December 2010) and the postguideline group (298 patients treated between 
      January 2011 and March 2016). The use of medications, severity, the incidence of 
      Helicobacter pylori infection, the presence of any underlying disease, and other 
      factors were compared between the pre- and postguideline groups. RESULTS: The 
      number of patients receiving antithrombotic therapy was slightly higher in the 
      postguideline group without a significant difference (P = 0.50). The incidence of 
      H. pylori infection was significantly lower in the postguideline group 
      (P < 0.001). The rate of premedication with a proton pump inhibitor (PPI) and the 
      rate of severe ulcers were significantly higher in the postguideline group 
      (P = 0.001 and P < 0.001, respectively). The rebleeding rate showed no 
      significant difference, whereas the recurrence rate was significantly higher in 
      the postguideline group (P = 0.041). CONCLUSIONS: The major cause of hemorrhagic 
      gastroduodenal ulcers seems to be shifting from H. pylori infection to the 
      administration of drugs with gastrointestinal risk. Antithrombotic therapy tends 
      to be associated with severe ulcers but without statistical significance.
FAU - Nagashima, Kazunori
AU  - Nagashima K
AD  - Department of Gastroenterology Dokkyo Medical University Tochigi Japan.
FAU - Tominaga, Keiichi
AU  - Tominaga K
AUID- ORCID: 0000-0002-3716-3386
AD  - Department of Gastroenterology Dokkyo Medical University Tochigi Japan.
FAU - Fukushi, Koh
AU  - Fukushi K
AD  - Department of Gastroenterology Dokkyo Medical University Tochigi Japan.
FAU - Kanamori, Akira
AU  - Kanamori A
AD  - Department of Gastroenterology Dokkyo Medical University Tochigi Japan.
FAU - Sasai, Takako
AU  - Sasai T
AD  - Department of Gastroenterology Dokkyo Medical University Tochigi Japan.
FAU - Hiraishi, Hideyuki
AU  - Hiraishi H
AD  - Department of Gastroenterology Dokkyo Medical University Tochigi Japan.
LA  - eng
PT  - Journal Article
DEP - 20180821
PL  - Australia
TA  - JGH Open
JT  - JGH open : an open access journal of gastroenterology and hepatology
JID - 101730833
PMC - PMC6308079
OTO - NOTNLM
OT  - antithrombotic therapy
OT  - bleeding gastric and duodenal ulcers
OT  - guidelines
OT  - low-dose aspirin
OT  - proton pump inhibitor
EDAT- 2019/01/09 06:00
MHDA- 2019/01/09 06:01
PMCR- 2018/08/21
CRDT- 2019/01/09 06:00
PHST- 2018/02/21 00:00 [received]
PHST- 2018/06/29 00:00 [revised]
PHST- 2018/07/08 00:00 [accepted]
PHST- 2019/01/09 06:00 [entrez]
PHST- 2019/01/09 06:00 [pubmed]
PHST- 2019/01/09 06:01 [medline]
PHST- 2018/08/21 00:00 [pmc-release]
AID - JGH312078 [pii]
AID - 10.1002/jgh3.12078 [doi]
PST - epublish
SO  - JGH Open. 2018 Aug 21;2(6):255-261. doi: 10.1002/jgh3.12078. eCollection 2018 
      Dec.