title: Diagnosis, treatment, and outcome in patients with bleeding peptic ulcers and Helicobacter pylori infections.
abstract: Upper gastrointestinal (UGI) bleeding is the most frequently encountered complication of peptic ulcer disease. Helicobacter pylori (Hp) infection and nonsteroidal anti-inflammatory drug (NSAID) administration are two independent risk factors for UGI bleeding. Therefore, testing for and diagnosing Hp infection are essential for every patient with UGI hemorrhage. The presence of the infection is usually underestimated in cases of bleeding peptic ulcers. A rapid urease test (RUT), with or without histology, is usually the first test performed during endoscopy. If the initial diagnostic test is negative, a delayed (13)C-urea breath test (UBT) or serology should be performed. Once an infection is diagnosed, antibiotic treatment is advocated. Sufficient evidence supports the concept that Hp infection eradication can heal the ulcer and reduce the likelihood of rebleeding. With increased awareness of the effects of Hp infection, the etiologies of bleeding peptic ulcers have shifted to NSAID use, old age, and disease comorbidity.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Cathay General Hospital, Taipei 10650, Taiwan ; School of Medicine, Fu-Jen Catholic University, New Taipei City 24205, Taiwan.
authors.forename: Ting-Chun
authors.identifier: 0000-0002-7866-1410
authors.initials: TC
authors.lastname: Huang
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Cathay General Hospital, Taipei 10650, Taiwan ; Division of Gastroenterology, Department of Internal Medicine, Hsinchu Cathay General Hospital, No. 678, Section 2, Junghua Road, Hsinchu 30060, Taiwan ; School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan.
authors.forename: Chia-Long
authors.identifier: 0000-0001-8556-024X
authors.initials: CL
authors.lastname: Lee
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D016480:Helicobacter pylori / Q000302:isolation & purification / Q000472:pathogenicity; D006801:Humans; D010437:Peptic Ulcer / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D010438:Peptic Ulcer Hemorrhage / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D012307:Risk Factors; D014510:Urease / Q000378:metabolism
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D014510:Urease
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