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Titolo:
Impact of non-steroidal anti-inflammatory drug and aspirin use on the prevalence of dyspepsia and uncomplicated peptic ulcer disease
Autore:
Voutilainen, M; Mantynen, T; Farkkila, M; Juhola, M; Sipponen, P;
Indirizzi:
Jyvaskyla Cent Hosp, Dept Internal Med & Pathol, FIN-40620 Jyvaskyla, Finland Jyvaskyla Cent Hosp Jyvaskyla Finland FIN-40620 40620 Jyvaskyla, Finland Karstula Hlth Care Ctr, Karstula, Finland Karstula Hlth Care Ctr Karstula Finland lth Care Ctr, Karstula, Finland Helsinki Univ Hosp, Dept Internal Med, Div Gastroenterol, Helsinki, Finland Helsinki Univ Hosp Helsinki Finland iv Gastroenterol, Helsinki, Finland Jorvi Hosp, Dept Pathol, SF-02740 Espoo, Finland Jorvi Hosp Espoo Finland SF-02740 , Dept Pathol, SF-02740 Espoo, Finland
Titolo Testata:
SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY
fascicolo: 8, volume: 36, anno: 2001,
pagine: 817 - 821
SICI:
0036-5521(200108)36:8<817:IONADA>2.0.ZU;2-K
Fonte:
ISI
Lingua:
ENG
Soggetto:
NONSTEROIDAL ANTIINFLAMMATORY DRUGS; HELICOBACTER-PYLORI INFECTION; GASTRIC-ULCER; RISK; ERADICATION; THERAPY; TRENDS; NSAIDS; TRIAL;
Keywords:
Helicobacter pylori; non-steroidal anti-inflammatory drugs (NSAIDS); peptic ulcer;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
27
Recensione:
Indirizzi per estratti:
Indirizzo: Voutilainen, M Jyvaskyla Cent Hosp, Dept Internal Med & Pathol, FIN-40620 Jyvaskyla, Finland Jyvaskyla Cent Hosp Jyvaskyla Finland FIN-40620 , Finland
Citazione:
M. Voutilainen et al., "Impact of non-steroidal anti-inflammatory drug and aspirin use on the prevalence of dyspepsia and uncomplicated peptic ulcer disease", SC J GASTR, 36(8), 2001, pp. 817-821

Abstract

Background: Non-steroidal anti-inflammatory drug and aspirin there collectively called NSAIDs) use is the second most common aetiologic factor for peptic ulcer disease and a major factor for peptic ulcer complications. The role of NSAIDs in the pathogenesis of uncomplicated peptic ulcer is less well understood and the interaction between NSAIDs and Helicobacter pylori infection on ulcer development is controversial. The aim of the present study was to examine the role of NSAIDs in the occurrence and clinical features of uncomplicated peptic ulcer disease. Methods: A total of 1091 consecutive patients referred Fur open-access upper gastrointestinal endoscopy by general practitioners (GPs) were enrolled. The use of NSAIDs was gathered from astructured questionnaire completed by the patients and from patient files by GPs. The exclusion criteria were previous H. pylori eradication and gastric surgery, as well as symptoms and/or signs suggestive of acute gastrointestinal bleeding. Results: Of the whole study group (n = 1091), 76 (7%) patients had a peptic ulcer. Thirty patients had an NSAID-use-associated peptic ulcer and 46 patients a non-NSAID-use peptic ulcer. Of patients with chronic gastritis in = 599), 71% were H. pylori-positive and 108 used NSAIDs. Of those with chronic gastritis, 23 had an NSAID-use-associated peptic nicerand 38 a non-NSAID ulcer. Of patients with normal gastric histology (n=492), 75 patients used NSAIDs, 7 had an NSAID ulcer and 38 a non-NSAID ulcer. The only independent risk factor for peptic ulcer in patients using NSAIDs was H, pylori infection (odds ratio (OR) 3.1, 95% confidence interval (CI) 1.3-7.3), whereas dyspepsia (OR 1.0, 95% CI 0.4-2.4), male sex (OR 1.4, 95%CI 0.6-3.4), age (OR 1.0 per decade, 95% CI 0.8-1.3) and anaemia (OR 2.9, 95% CI 0.9-8.7) were not risk factors. In patients not using NSAIDs, independent risk factors for peptic ulcer were dyspepsia (OR 4.3, 958 CI 2.1-8.8), male sex (OR 2.0, 95%, CI 1.1-2.8), age (OR 1.2 per decade, 95% CI 1.0-1.5), anaemia (OR 6.2, 95% CI 2.6-14.9) and H. pylori infection (OR 7.5, 95% CI 3.4-16.6). When comparing patients using NSAIDs or not, the OR of patients on NSAIDs for peptic ulcer was 2.7 (95% CI 1.5-5.0) among patients with chronic H. pylori gastritis (n=424) and 5.3 (95% CI 1.8-15.0) among patients with normal gastric mucosa (n = 492). Conclusions: The use of NSAIDs increases the risk of peptic ulcer 3- and 5-fold in H, pylori-positive and H. pylori-negative patients, respectively. Dyspepsia is a poor predictor of peptic ulcer among patients using NSAIDs, and serologic H. pylori testing and treatment for chronic NSAID users is recommended.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/04/20 alle ore 12:40:55