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NSAID-Induced Gastropathy and H. pylori Infection

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Helicobacter pylori

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Abstract

Gastrointestinal injury by nonsteroidal anti-inflammatory drugs (NSAIDs) or Helicobacter pylori (H. pylori) occurs through different mechanisms. If these two factors coexist, the risk of gastrointestinal injury increases independently, sometimes synergistically by the two factors. In high-risk patients who require NSAID administration, it is recommended that H. pylori infection is examined, and then eradication therapy is done for patients with H. pylori infection to prevent peptic ulcer. For initial NSAID (excluding aspirin) users and long-term aspirin users with a history of peptic ulcer complications, tests for H. pylori infection and eradication therapy in the presence of H. pylori infection are recommended. In countries where the incidence of H. pylori infection is high, such as Korea, prevention and treatment strategies for NSAID users with H. pylori infection should differ from those in Western countries. Long-term multicenter studies that consider the current clinical situation are necessary in the future.

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References

  1. Schlansky B, Hwang JH. Prevention of nonsteroidal anti-inflammatory drug-induced gastropathy. J Gastroenterol. 2009;44 Suppl 19:44–52.

    Article  CAS  PubMed  Google Scholar 

  2. Sinha M, Gautam L, Shukla PK, Kaur P, Sharma S, Singh TP. Current perspectives in NSAID-induced gastropathy. Mediators Inflamm. 2013;2013:258209.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Wallace JL. NSAID gastropathy and enteropathy: distinct pathogenesis likely necessitates distinct prevention strategies. Br J Pharmacol. 2012;165:67–74.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Cryer B, Feldman M. Effects of very low dose daily, long-term aspirin therapy on gastric, duodenal, and rectal prostaglandin levels and on mucosal injury in healthy humans. Gastroenterology. 1999;117:17–25.

    Article  CAS  PubMed  Google Scholar 

  5. Iwamoto J, Saito Y, Honda A, Matsuzaki Y. Clinical features of gastroduodenal injury associated with long-term low-dose aspirin therapy. World J Gastroenterol. 2013;19:1673–82.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Fiorucci S, De Lima Jr OM, Mencarelli A, Palazzetti B, Distrutti E, McKnight W, et al. Cyclooxygenase-2-derived lipoxin A4 increases gastric resistance to aspirin-induced damage. Gastroenterology. 2002;123:1598–606.

    Article  CAS  PubMed  Google Scholar 

  7. Silverstein FE, Faich G, Goldstein JL, Simon LS, Pincus T, Whelton A, et al. Gastrointestinal toxicity with celecoxib vs nonsteroidal anti-inflammatory drugs for osteoarthritis and rheumatoid arthritis: the CLASS study: a randomized controlled trial. Celecoxib long-term arthritis safety study. JAMA. 2000;284:1247–55.

    Article  CAS  PubMed  Google Scholar 

  8. Wallace JL. Pathogenesis of NSAID-induced gastroduodenal mucosal injury. Best Pract Res Clin Gastroenterol. 2001;15:691–703.

    Article  CAS  PubMed  Google Scholar 

  9. Huang JQ, Sridhar S, Hunt RH. Role of Helicobacter pylori infection and non-steroidal anti-inflammatory drugs in peptic-ulcer disease: a meta-analysis. Lancet. 2002;359:14–22.

    Article  CAS  PubMed  Google Scholar 

  10. Papatheodoridis GV, Sougioultzis S, Archimandritis AJ. Effects of Helicobacter pylori and nonsteroidal anti-inflammatory drugs on peptic ulcer disease: a systematic review. Clin Gastroenterol Hepatol. 2006;4:130–42.

    Article  PubMed  Google Scholar 

  11. Wardi J, Shirin H. Non-steroidal anti-inflammatory drug-induced gastroduodenal toxicity and Helicobacter pylori. Isr Med Assoc J. 2003;5:195–7.

    PubMed  Google Scholar 

  12. Papatheodoridis GV, Archimandritis AJ. Role of Helicobacter pylori eradication in aspirin or non-steroidal anti-inflammatory drug users. World J Gastroenterol. 2005;11:3811–6.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Konturek JW, Dembinski A, Konturek SJ, Stachura J, Domschke W. Infection of Helicobacter pylori in gastric adaptation to continued administration of aspirin in humans. Gastroenterology. 1998;114:245–55.

    Article  CAS  PubMed  Google Scholar 

  14. Halter F, Tarnawski AS, Schmassmann A, Peskar BM. Cyclooxygenase 2-implications on maintenance of gastric mucosal integrity and ulcer healing: controversial issues and perspectives. Gut. 2001;49:443–53.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Kim SG, Jung HK, Lee HL, Jang JY, Lee H, Kim CG, et al. Guidelines for the diagnosis and treatment of Helicobacter pylori infection in Korea, 2013 revised edition. J Gastroenterol Hepatol. 2014;29:1371–86.

    Article  PubMed  Google Scholar 

  16. Lee JH, Lee YC, Jeon SW, Kim JW, Lee SW, Korean College of Helicobacter and Upper Gastrointestinal Research, et al. [Guidelines of prevention and treatment for NSAID-related peptic ulcers]. Korean J Gastroenterol. 2009;54:309–17.

    Article  PubMed  Google Scholar 

  17. Graham DY, Chan FK. NSAIDs, risks, and gastroprotective strategies: current status and future. Gastroenterology. 2008;134:1240–6.

    Article  CAS  PubMed  Google Scholar 

  18. Chan FK, Sung JJ, Chung SC, To KF, Yung MY, Leung VK, et al. Randomised trial of eradication of Helicobacter pylori before non-steroidal anti-inflammatory drug therapy to prevent peptic ulcers. Lancet. 1997;350:975–9.

    Article  CAS  PubMed  Google Scholar 

  19. Chan FK, To KF, Wu JC, Yung MY, Leung WK, Kwok T, et al. Eradication of Helicobacter pylori and risk of peptic ulcers in patients starting long-term treatment with non-steroidal anti-inflammatory drugs: a randomised trial. Lancet. 2002;359:9–13.

    Article  CAS  PubMed  Google Scholar 

  20. Labenz J, Blum AL, Bolten WW, Dragosics B, Rösch W, Stolte M, et al. Primary prevention of diclofenac associated ulcers and dyspepsia by omeprazole or triple therapy in Helicobacter pylori positive patients: a randomised, double blind, placebo controlled, clinical trial. Gut. 2002;51:329–35.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Chan FK, Chung SC, Suen BY, Lee YT, Leung WK, Leung VK, et al. Preventing recurrent upper gastrointestinal bleeding in patients with Helicobacter pylori infection who are taking low-dose aspirin or naproxen. N Engl J Med. 2001;344:967–73.

    Article  CAS  PubMed  Google Scholar 

  22. Lai KC, Lam SK, Chu KM, Wong BC, Hui WM, Hu WH, et al. Lansoprazole for the prevention of recurrences of ulcer complications from long-term low-dose aspirin use. N Engl J Med. 2002;346:2033–8.

    Article  CAS  PubMed  Google Scholar 

  23. Futagami S, Hiratsuka T, Wada K, Tatsuguchi A, Tsukui T, Miyake K, et al. Inhibition of Helicobacter pylori-induced cyclo-oxygenase-2 aggravates NSAID-caused gastric damage in Mongolian gerbils. Aliment Pharmacol Ther. 2002;16:847–55.

    Article  CAS  PubMed  Google Scholar 

  24. Kim JM, Kim JS, Jung HC, Song IS, Kim CY. Upregulated cyclooxygenase-2 inhibits apoptosis of human gastric epithelial cells infected with Helicobacter pylori. Dig Dis Sci. 2000;45:2436–43.

    Article  CAS  PubMed  Google Scholar 

  25. Cheung DY, Jung HY, Song HJ, Jung SW, Jung HC, Korean college of Helicobacter and upper gastrointestinal research, et al. [Guidelines of treatment for non-bleeding peptic ulcer disease]. Korean J Gastroenterol. 2009;54:285–97.

    Article  PubMed  Google Scholar 

  26. Chung IK, Lee DH, Kim HU, Sung IK, Kim JH, Korean college of Helicobacter and upper gastrointestinal research, et al. [Guidelines of treatment for bleeding peptic ulcer disease]. Korean J Gastroenterol. 2009;54:298–308.

    Article  PubMed  Google Scholar 

  27. Malfertheiner P, Megraud F, O’Morain CA, Atherton J, Axon AT, Bazzoli F, et al. Management of Helicobacter pylori infection – the Maastricht IV/Florence consensus report. Gut. 2012;61:646–64.

    Article  CAS  PubMed  Google Scholar 

  28. Asaka M, Kato M, Takahashi S, Fukuda Y, Sugiyama T, Ota H, et al. Guidelines for the management of Helicobacter pylori infection in Japan: 2009 revised edition. Helicobacter. 2010;15:1–20.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Internal Medicine, Pusan National University School of Medicine, 179 Gudeok-ro, Seo-gu, Busan, 49241, South Korea

    Gwang Ha Kim MD, PhD

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  1. Gwang Ha Kim MD, PhD
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Correspondence to Gwang Ha Kim MD, PhD .

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Editors and Affiliations

  1. Seoul National University, Bundang Hospital, Seongnam-si, Gyeonggi-do, Korea (Republic of)

    Nayoung Kim

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© 2016 Springer Science+Business Media Singapore

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Kim, G.H. (2016). NSAID-Induced Gastropathy and H. pylori Infection. In: Kim, N. (eds) Helicobacter pylori. Springer, Singapore. https://doi.org/10.1007/978-981-287-706-2_30

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  • DOI: https://doi.org/10.1007/978-981-287-706-2_30

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-287-705-5

  • Online ISBN: 978-981-287-706-2

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