Interaction of Helicobacter pylori infection and nonsteroidal anti-inflammatory drugs in gastric and duodenal ulcers

Helicobacter
Marino Venerito, P Malfertheiner

Abstract

Gastric (GU) and duodenal ulcers (DU) are in most instances either induced by Helicobacter pylori infection or by nonsteroidal anti-inflammatory drugs (NSAIDs). Whether eradication of H. pylori is beneficial in NSAID users for preventing NSAID induced GU and DU has been the focus of different studies. Mechanisms shared by both H. pylori and NSAIDs for the induction of GU and DU were reviewed and randomized controlled trials on H. pylori eradication for prevention and healing of GU and DU in patients requiring NSAID therapy were identified by a PubMed search. Key factors in the induction of GU and DU for both H. pylori and NSAIDs are a decrease in pH, imbalance between apoptosis and proliferation, reduction in mucosal blood flow, and recruitment of polymorphonucleates in distinct compartments. For primary ulcer prevention, H. pylori eradication before starting an NSAID therapy reduces the risk of NSAID induced GU and virtually abolishes the risk of DU. H. pylori eradication alone is not sufficient for secondary prevention of NSAID induced GU and DU. H. pylori infection appears to further increase the protective effects of proton-pump inhibitors (PPI) to reduce the risk of ulcer relapse. H. pylori eradication does not influence t...Continue Reading

References

Sep 1, 1992·European Journal of Clinical Investigation·P FerenciP Steindl
Jul 1, 1997·Gastroenterology·E M El-OmarK E McColl
Apr 21, 1999·Alimentary Pharmacology & Therapeutics·P Ernst
May 11, 1999·The American Journal of Gastroenterology·C J McCarthyJ M Scheiman
Oct 29, 2000·American Journal of Physiology. Gastrointestinal and Liver Physiology·M FeldmanB Cryer
Mar 24, 2004·Inflammopharmacology·Brendan J R Whittle
Sep 1, 2004·Alimentary Pharmacology & Therapeutics·J J Y Sung
Jan 29, 2005·American Journal of Physiology. Gastrointestinal and Liver Physiology·Ireneusz T Padol, Richard H Hunt
Feb 11, 2005·Current Opinion in Gastroenterology·Sanjeev TummalaCiarán P Kelly
Dec 24, 2005·American Journal of Physiology. Gastrointestinal and Liver Physiology·Adrian SchmassmannJean Claude Reubi
Jan 13, 2006·Gastroenterology·Peter B ErnstSheila E Crowe

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Citations

Nov 19, 2011·Digestive Diseases·Richard H Hunt, Yuhong Yuan
Dec 2, 2015·Expert Review of Gastroenterology & Hepatology·Marino VeneritoPeter Malfertheiner
Apr 21, 2012·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·En-Ling Leung Ki, Francis K L Chan
May 1, 2012·Best Practice & Research. Clinical Gastroenterology·En-Ling Leung Ki, Francis K L Chan
Sep 29, 2011·Gastrointestinal Endoscopy Clinics of North America·Carlos Sostres, Angel Lanas
Jul 15, 2015·World Journal of Gastroenterology : WJG·Katsunori Iijima, Tooru Shimosegawa

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