Peptic Ulcer Disease
| Autor: | Indira Pérez, María Rodríguez-Peláez, Lauret Me, Luis Rodrigo |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
education.field_of_study biology Combination therapy medicine.drug_class business.industry Population Proton-pump inhibitor Disease Amoxicillin Helicobacter pylori biology.organism_classification Gastroenterology Infectious disease (medical specialty) Clarithromycin Internal medicine medicine business education medicine.drug |
| Zdroj: | Journal of Gastroenterology and Hepatobiliary Disorders. |
| ISSN: | 2470-9891 |
| DOI: | 10.19104/jghd.2015.105 |
| Popis: | Peptic ulcer disease (PUD) is a prevalent disease, it affecting around 5-10% of the general population worldwide, but with notable regional and racial variations. The two most common etiological causes are the chronic infection with Helicobacter pylori (Hp) and the use of nonsteroidal anti-inflammatory drugs (NSAIDs). Its diagnosis is based mainly in the endoscopy and the active search of concomitant Hp presence. The discovery of the link between H. pylori and peptic ulcer has changed dramatically its management, because it has become a curable infectious disease. The Eradication therapy of Hp (+) is the best choice to achieve the final cure of PUD in infected patients. Several current international guidelines recommend a standard triple therapy as first-line therapy, including a proton pump inhibitor and a combination of amoxicillin and clarithromycin. This combination therapy has shown a decreased efficacy over the years. The main reason is increasing antibiotic resistance, particularly to clarithromycin and metronidazol, of certain Hp strains. Several new treatment options or modifications of already established regimens have been introduced few years back, to overcome these treatment failures. For the subgroup of patients with H. pylori-negative ulcers, avoiding NSAIDs intake also has a clear influence in evolution of the disease and in some cases drives to the complete healing of the peptic ulcer. In refractory or recurrent cases, continuous therapy with anti-secretory agents and/or the replacement of conventional NSAIDs by selective drugs for inhibition of cyclooxygenase-2 (COX-2) are useful treatment options. |
| Databáze: | OpenAIRE |
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