title: Endoscopic and clinical features of gastric ulcers in Japanese patients with or without Helicobacter pylori infection who were using NSAIDs or low-dose aspirin.
abstract: BACKGROUND
  The endoscopic characteristics of gastric ulcers in patients who were using non-steroidal anti-inflammatory drugs (NSAIDs) or low-dose aspirin (LDA) and were infected with Helicobacter pylori remain unclear. We elucidated the endoscopic characteristics of gastric ulcers that occurred in the presence or absence of H. pylori infection and were associated with the use of these drugs.
  
  
  METHODS
  A total of 379 patients with active-stage gastric ulcer were divided into three groups: H. pylori-positive patients using neither NSAIDs nor LDA (control group, n = 216), H. pylori-positive or -negative patients using NSAIDs (NSAIDs group, n = 100), and H. pylori-positive or -negative patients using LDA (LDA group, n = 63). The differences among these groups in endoscopic characteristics of the ulcers (site, multiplicity, and morphology) were determined. The influence of an antacid drug, i.e., a proton pump inhibitor (PPI) or a histamine H(2) receptor antagonist (H(2)RA), was also investigated.
  
  
  RESULTS
  The NSAIDs group, regardless of H. pylori infection status, had higher incidences of antral, multiple, and irregularly shaped ulcers. The LDA group had a higher incidence of antral ulcers in H. pylori-negative patients and, regardless of H. pylori infection status, a higher incidence of multiple ulcers. However, the incidence of irregularly shaped ulcers in the LDA group did not differ from that in the control group. Neither the concomitant use of an antacid nor the dosing period of NSAIDs affected the results.
  
  
  CONCLUSIONS
  Our study elucidated the morphological characteristics of gastric ulcers in persons taking NSAIDs or LDA in the presence and absence of H. pylori infection. Our results may be clinically useful for inferring the causes of ulcers from their morphological characteristics.
authors.affiliation: Division of Upper Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan.
authors.forename: Yongmin
authors.initials: Y
authors.lastname: Kim
authors.forename: Satoko
authors.initials: S
authors.lastname: Yokoyama
authors.forename: Jiro
authors.initials: J
authors.lastname: Watari
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Hori
authors.forename: Takahisa
authors.initials: T
authors.lastname: Yamasaki
authors.forename: Takuya
authors.initials: T
authors.lastname: Okugawa
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Toyoshima
authors.forename: Takashi
authors.initials: T
authors.lastname: Kondo
authors.forename: Jun
authors.initials: J
authors.lastname: Sakurai
authors.forename: Junji
authors.initials: J
authors.lastname: Tanaka
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Tomita
authors.forename: Tadayuki
authors.initials: T
authors.lastname: Oshima
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Fukui
authors.forename: Takashi
authors.initials: T
authors.lastname: Abe
authors.forename: Takayuki
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Hiroto
authors.initials: H
authors.lastname: Miwa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D044466:Asian People; D001241:Aspirin / Q000008:administration & dosage*; D016022:Case-Control Studies; D005260:Female; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000382:microbiology / Q000473:pathology*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013276:Stomach Ulcer / Q000382:microbiology / Q000473:pathology*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin