Abstract
Background
Helicobacter pylori infection and nonsteroidal anti-inflammatory drugs (NSAIDs) are well-known major causes of peptic ulcers. This study aimed to characterize the features of bleeding peptic ulcers in Japan.
Methods
This prospective study evaluated 116 patients revealed to have bleeding peptic ulcers from January 2000 to December 2002.
Results
Eighty-eight of the 116 patients (75.9%) had H. pylori infection. Seventy (60.3%) patients were positive for H. pylori with no history of NSAID use (group A), and 18 (15.5%) were positive for H. pylori with a history of NSAID use (group B). Among the H. pylori-negative patients, 15 (12.9%) were associated with NSAID use (group C). Thirteen (11.2%) patients had no H. pylori infection or history of NSAID use (group D). Among the 33 patients with a history of NSAID use, 11 were on-demand NSAID users and 14 took daily low-dose aspirin. The patients in groups B and C were significantly older that those in groups A and D, and they more frequently had coexisting diseases compared with group A. In group D, 11 patients had atrophic changes revealed by endoscopic examination, suggesting a past H. pylori infection, and these atrophic changes remained at the time of bleeding. Many of the patients in group D had serious comorbidity. Compared with healthy control subjects, the concentrations of both phosphatidylcholine and phosphatidylethanolamine were significantly decreased in the antral gastric mucosa in all patient groups.
Conclusions
NSAID use contributed to bleeding ulcers in 28.4% of patients; thus, low-dose aspirin or on-demand NSAID use may cause bleeding ulcers. There were only two (1.7%) confirmed cases of H. pylori-negative, non-NSAID ulcers.
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References
BJ Marshall (1994) ArticleTitle Helicobacter pylori Am J Gastroenterol 89 S116–28 Occurrence Handle1:STN:280:ByuA38vjsF0%3D Occurrence Handle8048402
JH Kurata AN Nogawa (1997) ArticleTitleMeta-analysis of risk factors for peptic ulcer. Nonsteroidal antiinflammatory drugs, Helicobacter pylori, and smoking J Clin Gastroenterol 24 2–17 Occurrence Handle10.1097/00004836-199701000-00002 Occurrence Handle1:STN:280:ByiC28rlvVY%3D Occurrence Handle9013343
TJ Borody S Brandl P Andrews E Jankiewicz N Ostapowicz (1992) ArticleTitleHelicobacter pylori-negative gastric ulcer Am J Gastroenterol 87 1403–6 Occurrence Handle1:STN:280:ByyD3srhslw%3D Occurrence Handle1415095
TJ Borody LL George S Brandl P Andrews N Ostapowicz L Hyland et al. (1991) ArticleTitleHelicobacter pylori-negative duodenal ulcer Am J Gastroenterol 86 1154–7 Occurrence Handle1:STN:280:By6A2MzltVI%3D Occurrence Handle1882793
G Meucci R Di Battista C Abbiati R Benassi L Bierti A Bortoli et al. (2000) ArticleTitlePrevalence and risk factors of Helicobacter pylori-negative peptic ulcer: a multicenter study J Clin Gastroenterol 31 42–7 Occurrence Handle10.1097/00004836-200007000-00010 Occurrence Handle1:STN:280:DC%2BD3M%2Fks1alsQ%3D%3D Occurrence Handle10914775
SW Hosking MY Yung SC Chung AKC Li (1992) ArticleTitleDiffering prevalence of Helicobacter in bleeding and nonbleeding ulcers Gastroenterology 102 A162
AE Henriksson AC Edman I Nilsson D Bergqvist T Wadstrom (1998) ArticleTitleHelicobacter pylori and the relation to other risk factors in patients with acute bleeding peptic ulcer Scand J Gastroenterol 33 1030–3 Occurrence Handle1:CAS:528:DyaK1cXnt1KjtLw%3D Occurrence Handle9829355
K Nishikawa T Sugiyama M Kato J Ishizuka Y Komatsu H Kagaya et al. (2000) ArticleTitleNon-Helicobacter pylori and non-NSAID peptic ulcer disease in the Japanese population Eur J Gastroenterol Hepatol 12 635–40 Occurrence Handle1:STN:280:DC%2BD3M%2FivFaktQ%3D%3D Occurrence Handle10912481
LM Lichtenberger LA Graziani EJ Dial DB Butler BA Hills (1983) ArticleTitleRole of surface-active phospholipids in gastric cytoprotection Science 219 1327–9 Occurrence Handle1:CAS:528:DyaL3sXhslersro%3D Occurrence Handle6828859
S Ishibashi R Iwakiri R Shimoda H Ootani S Kawasaki J Tadano et al. (2002) ArticleTitleNormalization of phospholipids concentration of the gastric mucosa was observed in patients with peptic ulcer after eradication of Helicobacter pylori Helicobacter 7 IssueID4 245–9 Occurrence Handle10.1046/j.1523-5378.2002.00086.x Occurrence Handle1:CAS:528:DC%2BD38Xnt1Wmtrg%3D Occurrence Handle12165032
J Folch M Lees GH Sloane-Stanley (1957) ArticleTitleA simple method for the isolation and purification of total lipid from animal tissues J Biol Chem 226 497–509 Occurrence Handle1:STN:280:CyiD2srktVE%3D Occurrence Handle13428781
E Tvrzica P Mares M Votruba P Hrabak (1990) ArticleTitleSome limitation of plasma lipid analysis in clinical research by thin-layer chromatography with flame-ionization detection J Chromatogr B 530 424–31
JP Gisbert L Gonzalez A de Pedro M Valbuena B Prieto I Llorca et al. (2001) ArticleTitleHelicobacter pylori and bleeding duodenal ulcer: prevalence of the infection and role of non-steroidal anti-inflammatory drugs Scand J Gastroenterol 36 717–24 Occurrence Handle10.1080/003655201300191978 Occurrence Handle1:STN:280:DC%2BD38%2FhvVKlsA%3D%3D Occurrence Handle11444470
HL Chan JC Wu FK Chan CL Choi JY Ching YT Lee et al. (2001) ArticleTitleIs non-Helicobacter pylori, non-NSAID peptic ulcer a common cause of upper GI bleeding? A prospective study of 977 patients Gastrointest Endosc 53 438–42 Occurrence Handle10.1067/mge.2001.112840 Occurrence Handle1:STN:280:DC%2BD3M7oslSjug%3D%3D Occurrence Handle11275883
JM Lee NP Breslin C Fallon CA O'Morain (2000) ArticleTitleRapid urease tests lack sensitivity in Helicobacter pylori diagnosis when peptic ulcer disease presents with bleeding Am J Gastroenterol 95 1166–70 Occurrence Handle1:STN:280:DC%2BD3c3mvFCmuw%3D%3D Occurrence Handle10811322
WK Leung JJ Sung KL Siu FK Chan TK Ling AF Cheng (1998) ArticleTitleFalse-negative biopsy urease test in bleeding ulcers caused by the buffering effects of blood Am J Gastroenterol 93 1914–18 Occurrence Handle10.1111/j.1572-0241.1998.00457.x Occurrence Handle1:STN:280:DyaK1cvktlSmsQ%3D%3D Occurrence Handle9772055
TC Tu CL Lee CH Wu TK Chen CC Chan SH Huang et al. (1999) ArticleTitleComparison of invasive and noninvasive tests for detecting Helicobacter pylori infection in bleeding peptic ulcers Gastrointest Endosc 49 302–6 Occurrence Handle10.1016/S0016-5107(99)70005-2 Occurrence Handle1:STN:280:DyaK1M7lvVKkuw%3D%3D Occurrence Handle10049412
GM Forbes JR Warren ME Glaser DJ Cullen BJ Marshall BJ Collins (1996) ArticleTitleLong-term follow-up of gastric histology after Helicobacter pylori eradication J Gastroenterol Hepatol 11 670–3 Occurrence Handle1:STN:280:BymH3sjlvFM%3D Occurrence Handle8840244
B Annibale M Marignani C Azzoni G D'Ambra P Caruana T D'Adda et al. (1997) ArticleTitleAtrophic body gastritis: distinct features associated with Helicobacter pylori infection Helicobacter 2 57–64 Occurrence Handle1:STN:280:DyaK1c%2FlvFCjtA%3D%3D Occurrence Handle9432330
A Sonneberg (1985) ArticleTitleGeographic and temporal variations in the occurrence of peptic ulcer disease Scand J Gastroenterol 20 IssueID(suppl)110 11–24
J Higham JY Kang A Majeed (2002) ArticleTitleRecent trends in admissions and mortality due to peptic ulcer in England: increasing frequency of haemorrhage among older subjects Gut 50 460–4 Occurrence Handle10.1136/gut.50.4.460 Occurrence Handle1:STN:280:DC%2BD387lslentg%3D%3D Occurrence Handle11889062
G Nardone F D'Armiento G Corso P Coscione M Esposito G Budillon (1994) ArticleTitleLipids of human gastric mucosa: effect of Helicobacter pylori infection and nonalcoholic cirrhosis Gastroenterology 107 362–8 Occurrence Handle1:CAS:528:DyaK2cXmtVahsbs%3D Occurrence Handle8039613
H Wakabayashi T Orihara A Nakaya A Miyamoto A Watanabe (1998) ArticleTitleHelicobacter pylori infection and ulcer healing J Gastroenterol Hepatol 12 566–71
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Ootani, H., Iwakiri, R., Shimoda, R. et al. Role of Helicobacter pylori infection and nonsteroidal anti-inflammatory drug use in bleeding peptic ulcers in Japan. J Gastroenterol 41, 41–46 (2006). https://doi.org/10.1007/s00535-005-1720-y
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DOI: https://doi.org/10.1007/s00535-005-1720-y