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Erschienen in: Current Treatment Options in Gastroenterology 4/2020

11.11.2020 | Hot Topics

Who Needs Gastroprotection in 2020?

verfasst von: Takeshi Kanno, Paul Moayyedi, BSc MB ChB PhD MPH FRCP FRCPC AGAF, FACG, CAGF

Erschienen in: Current Treatment Options in Gastroenterology | Ausgabe 4/2020

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Abstract

Purpose of review

Peptic ulcer disease (PUD) is a recognized complication of non-steroidal anti-inflammatory drugs (NSAIDs). Stress ulcers are a concern for intensive care unit (ICU) patients; PUD is also an issue for patients taking anticoagulation. Helicobacter pylori test and treat is an option for patients starting NSAID therapy, and proton pump inhibitors (PPIs) may reduce PUD in NSAID patients and other high-risk groups.

Recent findings

There are a large number of trials that demonstrate that Helicobacter pylori eradication reduces PUD in NSAID patients. PPI is also effective at reducing PUD in this group and is also effective in ICU patients and those on anticoagulants. The effect is too modest for PPI to be recommended in everyone, and more research is needed as to which groups would benefit the most. Increasing age, past history of PUD, and comorbidity are the most important risk factors.

Summary

H. pylori test and treat should be offered to older patients starting NSAIDS, while PPIs should be prescribed to patients that are at high risk of developing PUD and at risk of dying from PUD complications.
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Metadaten
Titel
Who Needs Gastroprotection in 2020?
verfasst von
Takeshi Kanno
Paul Moayyedi, BSc MB ChB PhD MPH FRCP FRCPC AGAF, FACG, CAGF
Publikationsdatum
11.11.2020
Verlag
Springer US
Erschienen in
Current Treatment Options in Gastroenterology / Ausgabe 4/2020
Print ISSN: 1092-8472
Elektronische ISSN: 1534-309X
DOI
https://doi.org/10.1007/s11938-020-00316-9

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