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Article: Is non-Helicobacter pylori, non-NSAID peptic ulcer a common cause of upper GI bleeding? A prospective study of 977 patients

TitleIs non-Helicobacter pylori, non-NSAID peptic ulcer a common cause of upper GI bleeding? A prospective study of 977 patients
Authors
Issue Date2001
PublisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/gie
Citation
Gastrointestinal Endoscopy, 2001, v. 53 n. 4, p. 438-442 How to Cite?
AbstractNon-Helicobacter pylori, non-NSAID ulcer is relatively common in Western countries. Whether it is a significant problem in the Orient is unclear. The aim of this study was to investigate the incidence of non-H pylori, non-NSAID ulcers presenting with GI bleeding. A prospective study was done of 1675 consecutive patients presenting with upper GI bleeding over a period of 12 months. Upper endoscopy was performed with biopsy specimens taken from the antrum and body of the stomach for a biopsy urease test (BUT) and histology for detection of H pylori. Exposure to nonsteroidal anti-inflammatory drugs (NSAID) or aspirin within 4 weeks of hospitalization was carefully scrutinized. A 6-week course of treatment with an H2-receptor antagonist was prescribed for patients who did not use an NSAID and had a negative BUT result. Follow-up endoscopy was performed to confirm H pylori status with a BUT and histology. Positive histology at either initial or follow-up endoscopy was used as the standard for diagnosing H pylori infection. Among 977 patients who were found to have ulcer bleeding, 434 (44%) had exposure to aspirin or an NSAID. Of the 543 non-NSAID users, 431 (79.4%) had a positive BUT and 112 (20.6%) were BUT negative on initial endoscopy. Eighty-nine of 112 patients who were NSAID negative, BUT negative returned for follow-up endoscopy. Forty-nine of 89 (55.1%) were found to have a positive BUT and positive histology at follow-up endoscopy. Only 40 of 977 (4.1%) patients admitted with ulcer bleeding were confirmed to have non-H pylori, non-NSAID ulcers. Non-H pylori, non-NSAID bleeding ulcer is uncommon. A negative BUT is unreliable for exclusion of H pylori infection during the acute phase of ulcer bleeding.
Persistent Identifierhttp://hdl.handle.net/10722/162525
ISSN
2015 Impact Factor: 6.217
2015 SCImago Journal Rankings: 2.390
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChan, HLYen_US
dc.contributor.authorWu, JCYen_US
dc.contributor.authorChan, FKLen_US
dc.contributor.authorChoi, CLen_US
dc.contributor.authorChing, JYLen_US
dc.contributor.authorLee, YTen_US
dc.contributor.authorLeung, WKen_US
dc.contributor.authorLau, JYWen_US
dc.contributor.authorChung, SCSen_US
dc.contributor.authorSung, JJYen_US
dc.date.accessioned2012-09-05T05:20:46Z-
dc.date.available2012-09-05T05:20:46Z-
dc.date.issued2001en_US
dc.identifier.citationGastrointestinal Endoscopy, 2001, v. 53 n. 4, p. 438-442en_US
dc.identifier.issn0016-5107en_US
dc.identifier.urihttp://hdl.handle.net/10722/162525-
dc.description.abstractNon-Helicobacter pylori, non-NSAID ulcer is relatively common in Western countries. Whether it is a significant problem in the Orient is unclear. The aim of this study was to investigate the incidence of non-H pylori, non-NSAID ulcers presenting with GI bleeding. A prospective study was done of 1675 consecutive patients presenting with upper GI bleeding over a period of 12 months. Upper endoscopy was performed with biopsy specimens taken from the antrum and body of the stomach for a biopsy urease test (BUT) and histology for detection of H pylori. Exposure to nonsteroidal anti-inflammatory drugs (NSAID) or aspirin within 4 weeks of hospitalization was carefully scrutinized. A 6-week course of treatment with an H2-receptor antagonist was prescribed for patients who did not use an NSAID and had a negative BUT result. Follow-up endoscopy was performed to confirm H pylori status with a BUT and histology. Positive histology at either initial or follow-up endoscopy was used as the standard for diagnosing H pylori infection. Among 977 patients who were found to have ulcer bleeding, 434 (44%) had exposure to aspirin or an NSAID. Of the 543 non-NSAID users, 431 (79.4%) had a positive BUT and 112 (20.6%) were BUT negative on initial endoscopy. Eighty-nine of 112 patients who were NSAID negative, BUT negative returned for follow-up endoscopy. Forty-nine of 89 (55.1%) were found to have a positive BUT and positive histology at follow-up endoscopy. Only 40 of 977 (4.1%) patients admitted with ulcer bleeding were confirmed to have non-H pylori, non-NSAID ulcers. Non-H pylori, non-NSAID bleeding ulcer is uncommon. A negative BUT is unreliable for exclusion of H pylori infection during the acute phase of ulcer bleeding.en_US
dc.languageengen_US
dc.publisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/gieen_US
dc.relation.ispartofGastrointestinal Endoscopyen_US
dc.titleIs non-Helicobacter pylori, non-NSAID peptic ulcer a common cause of upper GI bleeding? A prospective study of 977 patientsen_US
dc.typeArticleen_US
dc.identifier.emailLeung, WK:waikleung@hku.hken_US
dc.identifier.authorityLeung, WK=rp01479en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1067/mge.2001.112840en_US
dc.identifier.pmid11275883-
dc.identifier.scopuseid_2-s2.0-0035321383en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0035321383&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume53en_US
dc.identifier.issue4en_US
dc.identifier.spage438en_US
dc.identifier.epage442en_US
dc.identifier.isiWOS:000167908500008-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridChan, HLY=16038785900en_US
dc.identifier.scopusauthoridWu, JCY=7409253910en_US
dc.identifier.scopusauthoridChan, FKL=7202586434en_US
dc.identifier.scopusauthoridChoi, CL=8041471300en_US
dc.identifier.scopusauthoridChing, JYL=7005086238en_US
dc.identifier.scopusauthoridLee, YT=8041471500en_US
dc.identifier.scopusauthoridLeung, WK=7201504523en_US
dc.identifier.scopusauthoridLau, JYW=13907867100en_US
dc.identifier.scopusauthoridChung, SCS=37042903800en_US
dc.identifier.scopusauthoridSung, JJY=35405352400en_US

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