Trends in Uncomplicated Peptic Ulcer Disease
Gastroenterology Summary and Comment
Incidence in the U.K. declined by 50% during the last decade.
H. pylori and Gastric Cancer
Gastroenterology Summary and Comment
Eradication of <$EMPH_O>H. pylori<$EMPH_C> infection did not significantly reduce the incidence of gastric cancer.
PPIs and Clopidogrel: Data Trumps Fear
Gastroenterology Summary and Comment
Antiplatelet function was diminished in PPI users, but cardiovascular outcomes were similar in PPI users and nonusers.
By David A. Johnson, MD
October 16, 2009
Covering:
O'Donoghue ML et al., Lancet 2009 Sep 19; 374:989
Does Coagulation Status Predict Band-Ulcer Bleeding After Band Ligation?
Gastroenterology Summary and Comment
Neither standard nor expanded coagulation indices were predictive.
By Atif Zaman, MD, MPH
October 16, 2009
Covering:
Vieira da Rocha EC et al., Clin Gastroenterol Hepatol 2009 Sep; 7:988
Early Endoscopy for Older Patients with Bleeding Peptic Ulcers
Gastroenterology Summary and Comment
Compared with delayed endoscopies, early procedures were associated with shorter hospital stays and lower rates of surgery.
Endoscopy for Evaluation of Dyspepsia
Gastroenterology Summary and Comment
Endoscopy detected few malignant lesions but still might merit the cost in patients aged 50 or older.
Trends in Upper Gastrointestinal Bleeding
Gastroenterology Summary and Comment
During a 25-year period at an Italian hospital, the incidence of upper GI bleeding declined, as did associated mortality.
Peptic-Ulcer Bleeding: Trends in Sweden
Gastroenterology Summary and Comment
Incidence of duodenal and gastric ulcers has declined.
Barrett Esophagus in Patients with Erosive Esophagitis
Gastroenterology Summary and Comment
Approximately 9% of patients with EE had BE diagnosed during subsequent upper endoscopy.
By David A. Johnson, MD
September 18, 2009
Covering:
Modiano N and Gerson LB., Gastrointest Endosc 2009 May; 69:1014
Is Standard Ulcer Therapy Effective in Patients with Uremia?
Gastroenterology Summary and Comment
A small study did not show benefit beyond 7 days.
Acid Symptoms After Proton-Pump–Inhibitor Discontinuation
Gastroenterology Summary and Comment
Healthy volunteers developed acid-related symptoms after discontinuing a PPI that they had taken for 8 weeks.
Incidence of Gastrointestinal Bleeding and Perforation
Gastroenterology Summary and Comment
The gap between upper and lower GI complications is narrowing.
Chronic Laryngeal Symptoms in Patients with GERD
Gastroenterology Summary and Comment
Acid exposure to the larynx does not appear to be an important cause.
By David A. Johnson, MD
August 28, 2009
Covering:
Jaspersen D et al., Aliment Pharmacol Ther 2009 Jun 1; 29:1172
Proton-Pump Inhibitor Therapy After Endoscopic Submucosal Dissection
Gastroenterology Summary and Comment
Degree of healing of endoscopic submucosal dissection–induced ulcers was dependent on initial ulcer size.
Famotidine Prevents GI Damage in Patients Who Take Low-Dose Aspirin
General Medicine Summary and Comment
Gastric ulcers, duodenal ulcers, and erosive esophagitis were less common with famotidine use.
By Bruce Soloway, MD
August 4, 2009
Covering:
Taha AS et al., Lancet 2009 Jul 11; 374:119
Prevention of Aspirin-Associated Gastroduodenal Ulcers
Gastroenterology Summary and Comment
Patients who received famotidine, a histamine-2–receptor antagonist, had lower risk for ulcers or erosive esophagitis than those who received placebo.
Rebound Symptoms After Stopping PPIs
General Medicine Summary and Comment
The findings are pertinent for patients who take PPIs unnecessarily.
By Allan S. Brett, MD
July 14, 2009
Covering:
Reimer C et al., Gastroenterology 2009 Jul; 137:80
McColl KEL and Gillen D., Gastroenterology 2009 Jul; 137:20
Blood Type and Nonvariceal Upper GI Bleeding
Gastroenterology Summary and Comment
An association between blood type O and nonvariceal upper gastrointestinal bleeding is not sufficient to imply causation.
Safety of PPIs in Pregnancy
General Medicine Summary and Comment
PPI use was not associated with congenital malformations.
By Allan S. Brett, MD
June 18, 2009
Covering:
Gill SK et al., Am J Gastroenterol 2009 Jun; 104:1541
Arterial Embolization for Bleeding Peptic Ulcers
Gastroenterology Summary and Comment
Coagulopathy and the use of coils alone for embolization are independently associated with rebleeding.
PPIs and Pneumonia, Revisited
Infectious Diseases Summary and Comment
Among non–critically ill inpatients, PPI therapy was associated with a 30% increase in risk for hospital-acquired pneumonia.
Higher Mortality for Weekend AUGIB Admissions
Gastroenterology Summary and Comment
Patients admitted on weekends with peptic ulcer–related and nonvariceal acute upper gastrointestinal bleeding also had longer hospital stays and higher medical costs.
Predicting Mortality in Patients with Bleeding Ulcers
Gastroenterology Summary and Comment
Investigators developed a prediction model for ulcer-related mortality after endoscopic therapy.
PPI Lowers Rate of Recurrent Peptic Ulcer Bleeding
General Medicine Summary and Comment
The incidence of clinically significant recurrent bleeding was lower with esomeprazole than with placebo.
PPI Treatment for Acute GI Bleeding from Peptic Ulcer
Emergency Medicine Summary and Comment
Three days of IV PPI therapy reduced rebleeding for up to 30 days but did not affect mortality.
