Acute upper gastrointestinal bleeding in elderly persons.
We have seen that UGI bleeding is a serious and apparently growing problem for seniors. Of special concern in the older patient are the frequency with which serious peptic disease presents silently, the limitation frequently imposed on adequate pain relief from NSAIDs, and the higher complication rates from most of the causes of UGI bleeding. Care of the elderly would be enhanced by research focused on defining those older patients most at risk of experiencing NSAID-induced peptic complications, improved methods for preventing or treating NSAID-induced ulceration that are well tolerated and cost-effective, and better regimens for preventing the recurrence of ulcers and UGI bleeding in these patients. In regard to the last, future investigation of the role of H. pylori, methods for successfully eliminating the organism, and the effect of eradication on patients' subsequent course may be particularly helpful.
Miller
D K
DK
Division of Geriatric Medicine, St. Louis University Medical Center, Missouri.
Burton
F R
FR
Burton
M S
MS
Ireland
G A
GA
D000367:Age Factors; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D002985:Clinical Protocols / Q000592:standards; D015897:Comorbidity; D003663:Decision Trees; D004724:Endoscopy; D006801:Humans; D015994:Incidence; D008297:Male; D010437:Peptic Ulcer / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D012008:Recurrence; D012307:Risk Factors
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000897:Anti-Ulcer Agents