Guilty as charged : Bugs and drugs in gastric ulcer.
Gastric ulcer disease remains a cause of hemorrhage, perforation, outlet obstruction, and death.
Recent advances in the understanding of peptic ulcer disease indicate that infection with Helicobacter pylori and ingestion of nonsteroidal anti-inflammatory drugs (NSAIDs) are the cause of almost all gastric and duodenal ulcers.
Our therapy, therefore, is in a state of transition : the old acid-suppressive temporary therapy that allows frequent ulcer recurrences and complications is being replaced by curative therapies.
The old therapy, by reducing gastric acid secretion or enhancing gastric mucosal defenses, inhibited the cofactors needed for ulcer development.
Acid suppression relieved symptoms and healed ulcers, while defense enhancers, such as prostaglandin analogs healed and prevented acute NSAID-induced gastric ulcers.
These benefits were maintained, however, only as long as acid-reducing agents or mucosal defense enhancers were continued.
On the other hand, curative therapies (such as eradicating H. pylori infection and/or stopping the use of NSAIDs) eliminate the causes of ulcer.
Curative combination regimens consisting of antibiotics, ranitidine bismuth citrate, bismuth, and proton pump inhibitors have been approved by the Food and Drug Administration.
These new regimens can cure benign gastric ulcer.
Unfortunately, we cannot always determine which gastric ulcers are benign, and concern about gastric cancer remains. (...)
Mots-clés Pascal : Ulcère, Estomac, Complication, Hémorragie, Gastrointestinal, Perforation, Etiopathogénie, Toxicité, Chimiothérapie, Antiinflammatoire non stéroïde, Relation, Antiacide, Gastrite, Campylobactériose, Bactériose, Infection, Helicobacter pylori, Spirillaceae, Spirillales, Bactérie, Etude critique, Homme, Appareil digestif pathologie, Estomac pathologie, Intestin pathologie, Appareil circulatoire pathologie, Vaisseau sanguin pathologie, Pharmacovigilance
Mots-clés Pascal anglais : Ulcer, Stomach, Complication, Hemorrhage, Gastrointestinal, Perforation, Etiopathogenesis, Toxicity, Chemotherapy, Non steroidal antiinflammatory agent, Relation, Antiacid, Gastritis, Campylobacter infection, Bacteriosis, Infection, Helicobacter pylori, Spirillaceae, Spirillales, Bacteria, Critical study, Human, Digestive diseases, Gastric disease, Intestinal disease, Cardiovascular disease, Vascular disease, Pharmacovigilance
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0450420
Code Inist : 002B13B03. Création : 03/02/1998.