[Impact of long-term systemic glucocorticoid therapy for bronchial asthma on the occurrence and course of peptic ulcer].
The study was undertaken to examine the incidence and specific features of peptic ulcer (PU) of the gastroduodenal area (GDA) in bronchial asthma (BA) and the impact of long-term oral maintenance therapy with systemic glucocorticosteroids (GCS) on the occurrence and course of peptic ulcer. Among the 260 examined patients with BA, GDA PU was revealed in 70(26.9%). The commonest site of an ulcerative process in the duodenum (90%) and its frequent combination with reflux esophagitis (84.1%) are noteworthy, which is likely to import some specific features to the clinical picture of GDA PU in BA. The latter is characterized by mild pain and a predominance of dyspepsia, which should be taken into account in assessing the clinical picture in patients with BA when there is a high risk for PU and in defining indications for esophagogastroduodenoscopy. The clinical and endoscopic features of the course of PU in patients with comorbidity were analyzed in relation to the use of GCS therapy. The analysis revealed that the incidence of PU did not depend on the severity and type of BA and on the use of GCS therapy. The study failed to provide evidence for the generally accepted idea of the leading role of GCS in the development of PU in BA. There was no significant negative impact of long-term small-dose GCS therapy on the clinical and endoscopic picture of PU in BA. The findings suggest that in BA, favorable conditions arose for realizing the predisposition to PU, which makes it necessary to carry out further studies to reveal the possible mechanisms that are responsible for the formation of concomitant diseases; this may be of fundamental importance in developing pathogenetically substantiated therapy for the above category of patients.
Cherniavskaia
G M
GM
Belodorobova
E I
EI
Plekhanova
E V
EV
Pozdniakov
R A
RA
Pleshko
R I
RI
D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D001249:Asthma / Q000188:drug therapy*; D004334:Drug Administration Schedule; D004415:Dyspepsia / Q000209:etiology; D016145:Endoscopy, Digestive System; D004942:Esophagitis, Peptic / Q000209:etiology; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis; D013256:Steroids; D013997:Time Factors
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D013256:Steroids