title: Effect of Helicobacter pylori infection and NSAIDs on the risk of peptic ulcer bleeding.
abstract: Peptic ulcer bleeding remains an important emergency situation with a high incidence and carries significant morbidity and mortality. Current evidence suggests that H. pylori and NSAIDs increase the risk of peptic ulcer bleeding and these two factors seem to act independently. Testing for, and cure of, H. pylori infection is recommended in patients prior to the initiation of NSAID therapy and in those who are currently receiving NSAIDs and have a history of peptic ulcer bleeding. For patients who present with peptic ulcer bleeding but require NSAIDs long-term, H. pylori eradication therapy should be considered, followed by continuous proton pump inhibitor prophylaxis to prevent re-bleeding, regardless of which kind of NSAID (nonselective NSAID/coxib) is being prescribed. The success of eradication should always be confirmed because of the risk of peptic ulcer recurrences and bleeding complication.
authors.affiliation: Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Varocha
authors.initials: V
authors.lastname: Mahachai
authors.forename: Alan B R
authors.initials: AB
authors.lastname: Thomson
authors.forename: Ratha-korn
authors.initials: RK
authors.lastname: Vilaichone
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D016481:Helicobacter Infections / Q000175:diagnosis / Q000453:epidemiology*; D016480:Helicobacter pylori; D006801:Humans; D010438:Peptic Ulcer Hemorrhage / Q000209:etiology* / Q000503:physiopathology; D012307:Risk Factors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal