Review article: non-steroidal anti-inflammatory drugs and Helicobacter pylori.
Non-steroidal anti-inflammatory drugs (NSAIDs) and Helicobacter pylori are well-recognized causes of gastroduodenal mucosal damage. This damage is mediated through the effects of both agents on acid secretion, neutrophil activity and function, and prosta- glandin metabolism. Clinical trials on the interrelation- ship between H. pylori, NSAIDs and gastroduodenal mucosal injury have yielded conflicting results. No consensus has been reached on what recommenda- tions should be implemented with regard to H. pylori eradication in patients on long-term NSAID therapy. At present, the presence of H. pylori is identified at endoscopy and eradication is carried out in symptomatic patients. Asymptomatic patients remain a dilemma that requires further investigation. Clinical practice will continue to be tailored to a patient's individual requirements. Therefore, in patients at risk of gastrointestinal haemorrhage, and on NSAID therapy, acid suppression therapy should be prescribed.
Barr
M
M
Department of Gastroenterology, Adelaide and Meath Hospitals, Dublin, Ireland.
Buckley
M
M
O'Morain
C
C
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D016481:Helicobacter Infections / Q000150:complications*; D016480:Helicobacter pylori; D006801:Humans; D010437:Peptic Ulcer / Q000139:chemically induced / Q000209:etiology* / Q000382:microbiology
D000894:Anti-Inflammatory Agents, Non-Steroidal