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Endoscopy 2002; 34(2): 104-110
DOI: 10.1055/s-2002-19843
State of the Art Review

© Georg Thieme Verlag Stuttgart · New York

Ulcer and Gastritis

J.  C.  Y.  Wu1 , J.  J.  Y.  Sung1
  • 1Division of Gastroenterology, Dept. of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China
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Publication Date:
14 August 2002 (online)

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The literature on peptic ulcer and gastritis in 2000 again focused on the topics of Helicobacter pylori, nonsteroidal anti-inflammatory drugs (NSAIDs), and gastric cancer. New diagnostic tests for H. pylori infection have been evaluated, and rescue therapies for failed H. pylori eradication have been tested. The causal relationship between H. pylori infection and nonulcer dyspepsia, gastric cancer, gastroesophageal reflux disease, and NSAID-related ulcers remained heated topics of debate. In 2000, landmark clinical trials and meta-analyses were published addressing these issues. The role of endoscopy in managing nonulcer dyspepsia was better defined. The role of H. pylori eradication in NSAID/aspirin users was reexamined in high-risk patients. Clinical benefit was finally confirmed for specific inhibitors of cyclooxygenase-2 (COX-2). The millennium year turned out to be a very important one in the advancement of knowledge in this field.

References

  • 1 Nishikawa K, Sugiyama T, Kato M. et al . A prospective evaluation of new rapid urease tests before and after eradication treatment of Helicobacter pylori, in comparison with histology, culture and 13C-urea breath test.  Gastrointest Endosc. 2000;  51 164-168
    PubMedGoogle Scholar
  • 2 Laine L, Sugg J, Suchower L, Neil G. Endoscopic biopsy requirements for post-treatment diagnosis of Helicobacter pylori.  Gastrointest Endosc. 2000;  51 664-669
    CrossrefPubMedGoogle Scholar
  • 3 Oderda G, Rapa A, Marinello D. et al . Usefulness of Helicobacter pylori stool antigen test to monitor response to eradication treatment in children.  Aliment Pharmacol Ther. 2001;  15 203-206
    CrossrefPubMedGoogle Scholar
  • 4 Ishihara S, Kaji T, Kawamura A. et al . Diagnostic accuracy of a new non-invasive enzyme immunoassay for detecting Helicobacter pylori in stools after eradication therapy.  Aliment Pharmacol Ther. 2000;  14 611-614
    CrossrefPubMedGoogle Scholar
  • 5 Vaira D, Malfertheiner P, Mégraud F. et al . Noninvasive antigen-based assay for assessing Helicobacter pylori eradication: a European multicenter study. The European Helicobacter pylori HpSA Study Group.  Am J Gastroenterol. 2000;  95 925-929
    CrossrefPubMedGoogle Scholar
  • 6 Costa F, Mumolo M G, Bellini M. et al . Post-treatment diagnostic accuracy of a new enzyme immunoassay to detect Helicobacter pylori in stools.  Aliment Pharmacol Ther. 2001;  15 395-401
    CrossrefPubMedGoogle Scholar
  • 7 Forne M, Dominguez J, Fernandez-Banares F. et al . Accuracy of an enzyme immunoassay for the detection of Helicobacter pylori in stool specimens in the diagnosis of infection and posttreatment check-up.  Am J Gastroenterol. 2000;  95 2200-2205
    PubMedGoogle Scholar
  • 8 Calvet X, Garcia N, Lopez T. et al . A meta-analysis of short versus long therapy with a proton pump inhibitor, clarithromycin and either metronidazole or amoxycillin for treating Helicobacter pylori infection.  Aliment Pharmacol Ther. 2000;  14 603-609
    CrossrefPubMedGoogle Scholar
  • 9 Calvet X, Gene E, Lopez T, Gisbert J P. What is the optimal length of proton pump inhibitor-based triple therapies for H. pylori? A cost-effectiveness analysis.  Aliment Pharmacol Ther. 2001;  15 1067-1076
    CrossrefPubMedGoogle Scholar
  • 10 Armuzzi A, Cremonini F, Bartolozzi F. et al . The effect of oral administration of Lactobacillus GG on antibiotic-associated gastrointestinal side-effects during Helicobacter pylori eradication therapy.  Aliment Pharmacol Ther. 2001;  15 163-169
    CrossrefPubMedGoogle Scholar
  • 11 Gomollon F, Sicilia B, Ducons J A. et al . Third line treatment for Helicobacter pylori: a prospective, culture-guided study in peptic ulcer patients.  Aliment Pharmacol Ther. 2000;  14 1335-1338
    CrossrefPubMedGoogle Scholar
  • 12 Perri F, Festa V, Clemente R. et al . Randomized study of two “rescue” therapies for Helicobacter pylori-infected patients after failure of standard triple therapies.  Am J Gastroenterol. 2001;  96 58-62
    PubMedGoogle Scholar
  • 13 Miwa H, Hirai S, Nagahara A. et al . Cure of Helicobacter pylori infection does not improve symptoms in non-ulcer dyspepsia patients: a double-blind placebo-controlled study.  Aliment Pharmacol Ther. 2000;  14 317-324
    CrossrefPubMedGoogle Scholar
  • 14 Hsu P I, Lai K H, Tseng H H. et al . Eradication of Helicobacter pylori prevents ulcer development in patients with ulcer-like functional dyspepsia.  Aliment Pharmacol Ther. 2001;  15 195-201
    CrossrefPubMedGoogle Scholar
  • 15 Sontag S J, Connell S, Schnell T. et al . Reduced symptoms and need for antisecretory therapy in veterans 3 years after Helicobacter pylori eradication with ranitidine bismuth citrate/amoxicillin/clarithromycin.  Am J Gastroenterol. 2001;  96 1390-1395
    CrossrefPubMedGoogle Scholar
  • 16 Laine L, Schoenfeld P, Fennerty M B. Therapy for Helicobacter pylori in patients with nonulcer dyspepsia: a meta-analysis of randomized, controlled trials.  Ann Intern Med. 2001;  134 361-369
    PubMedGoogle Scholar
  • 17 Moayyedi P, Feltbower R, Crocombe W. et al . The effectiveness of omeprazole, clarithromycin and tinidazole in eradicating Helicobacter pylori in a community screen and treat programme. Leeds Help Study Group.  Aliment Pharmacol Ther. 2000;  14 719-728
    CrossrefPubMedGoogle Scholar
  • 18 Blum A L, Arnold R, Stolte M. et al . Short course acid suppressive treatment for patients with functional dyspepsia: results depend on Helicobacter pylori status. The Frosch Study Group.  Gut. 2000;  47 473-480
    CrossrefPubMedGoogle Scholar
  • 19 Delaney B C, Wilson S, Roalfe A. et al . Randomised controlled trial of Helicobacter pylori testing and endoscopy for dyspepsia in primary care.  Br Med J. 2001;  322 898-901
    CrossrefPubMedGoogle Scholar
  • 20 Lassen A T, Pedersen F M, Bytzer P, de Muckadell O BS. Helicobacter pylori test-and-eradicate versus prompt endoscopy for management of dyspeptic patients: a randomised trial.  Lancet. 2000;  356 455-460
    CrossrefPubMedGoogle Scholar
  • 21 Delaney B C, Wilson S, Roalfe A. et al . Cost effectiveness of initial endoscopy for dyspepsia in patients over age 50 years: a randomised controlled trial in primary care.  Lancet. 2000;  356 1965-1969
    CrossrefPubMedGoogle Scholar
  • 22 Sung J J, Leung W K, Go M Y. et al . Cyclooxygenase-2 expression in Helicobacter pylori-associated premalignant and malignant gastric lesions.  Am J Pathol. 2000;  157 729-735
    PubMedGoogle Scholar
  • 23 El Omar E M, Carrington M, Chow W H. et al . Interleukin-1 polymorphisms associated with increased risk of gastric cancer.  Nature. 2000;  404 398-402
    CrossrefPubMedGoogle Scholar
  • 24 Ohkusa T, Fujiki K, Takashimizu I. et al . Improvement in atrophic gastritis and intestinal metaplasia in patients in whom Helicobacter pylori was eradicated.  Ann Intern Med. 2001;  134 380-386
    PubMedGoogle Scholar
  • 25 Sung J J, Lin S R, Ching J Y. et al . Atrophy and intestinal metaplasia one year after cure of H. pylori infection: a prospective, randomized study.  Gastroenterology. 2000;  119 7-14
    CrossrefPubMedGoogle Scholar
  • 26 Annibale B, Aprile M R, Ambra G. et al . Cure of Helicobacter pylori infection in atrophic body gastritis patients does not improve mucosal atrophy but reduces hypergastrinemia and its related effects on body ECL-cell hyperplasia.  Aliment Pharmacol Ther. 2000;  14 625-634
    CrossrefPubMedGoogle Scholar
  • 27 Vaezi M F, Falk G W, Peek R M. et al . CagA-positive strains of Helicobacter pylori may protect against Barrett's esophagus.  Am J Gastroenterol. 2000;  95 2206-2211
    PubMedGoogle Scholar
  • 28 Hamada H, Haruma K, Mihara M. et al . High incidence of reflux oesophagitis after eradication therapy for Helicobacter pylori: impacts of hiatal hernia and corpus gastritis.  Aliment Pharmacol Ther. 2000;  14 729-735
    CrossrefPubMedGoogle Scholar
  • 29 Schwizer W, Thumshirn M, Dent J. et al . Helicobacter pylori and symptomatic relapse of gastro-oesophageal reflux disease: a randomised controlled trial.  Lancet. 2001;  357 1738-1742
    CrossrefPubMedGoogle Scholar
  • 30 Schenk B E, Kuipers E J, Nelis G F. et al . Effect of Helicobacter pylori eradication on chronic gastritis during omeprazole therapy.  Gut. 2000;  46 615-621
    CrossrefPubMedGoogle Scholar
  • 31 Sharma P, Topalovski M, Mayo M S, Sampliner R E, Weston A P. Helicobacter pylori eradication dramatically improves inflammation in the gastric cardia.  Am J Gastroenterol. 2000;  95 3107-3111
    CrossrefPubMedGoogle Scholar
  • 32 Godil A, DeGuzman L, Schilling R C. et al . Recent nonsteroidal anti-inflammatory drug use increases the risk of early recurrence of bleeding in patients presenting with bleeding ulcer.  Gastrointest Endosc. 2000;  51 146-151
    PubMedGoogle Scholar
  • 33 Goldstein J L, Correa P, Zhao W W. et al . Reduced incidence of gastroduodenal ulcers with celecoxib, a novel cyclooxygenase-2 inhibitor, compared to naproxen in patients with arthritis.  Am J Gastroenterol. 2001;  96 1019-1027
    CrossrefPubMedGoogle Scholar
  • 34 Silverstein F E, Faich G, Goldstein J L. et al . Gastrointestinal toxicity with celecoxib vs. nonsteroidal anti-inflammatory drugs for osteoarthritis and rheumatoid arthritis. The CLASS study: a randomized controlled trial.  JAMA. 2000;  284 1247-1255
    CrossrefPubMedGoogle Scholar
  • 35 Bombardier C, Laine L, Reicin A. et al . Comparison of upper gastrointestinal toxicity of rofecoxib and naproxen in patients with rheumatoid arthritis.  N Engl J Med. 2000;  343 1520-1528
    CrossrefPubMedGoogle Scholar
  • 36 Lanas A, Bajador E, Serrano P. et al . Nitrovasodilators, low-dose aspirin, other nonsteroidal anti-inflammatory drugs and the risk of upper gastrointestinal bleeding.  N Engl J Med. 2000;  343 834-839
    CrossrefPubMedGoogle Scholar
  • 37 Chan F K, To K F, Ng Y P. et al . Expression and cellular localization of COX-1 and -2 in Helicobacter pylori gastritis.  Aliment Pharmacol Ther. 2001;  15 187-193
    CrossrefPubMedGoogle Scholar
  • 38 Feldman M, Cryer B, Mallat D, Go M F. Role of Helicobacter pylori infection in gastroduodenal injury and gastric prostaglandin synthesis during long term/low dose aspirin therapy: a prospective placebo-controlled, double-blind randomized trial.  Am J Gastroenterol. 2001;  96 1751-1757
    CrossrefPubMedGoogle Scholar
  • 39 Chan F KL, Chung S CS, Suen B Y. et al . Preventing recurrent upper gastrointestinal bleeding in patients with Helicobacter pylori infection who are taking low-dose aspirin or naproxen.  N Engl J Med. 2001;  344 967-973
    CrossrefPubMedGoogle Scholar
  • 40 Scheiman J M, Bandekar R R, Chernew M E, Fendrick A M. Helicobacter pylori screening for individuals requiring chronic NSAID therapy: a decision analysis.  Aliment Pharmacol Ther. 2001;  15 63-71
    CrossrefPubMedGoogle Scholar
  • 41 Lau J YW, Sung J JY, Lee K KC. et al . Effect of intravenous omeprazole on recurrent bleeding after endoscopic treatment of bleeding peptic ulcers.  N Engl J Med. 2000;  343 310-316
    CrossrefPubMedGoogle Scholar
  • 42 Hawkey G M, Cole A T, McIntyre A S. et al . Drug treatments in upper gastrointestinal bleeding: value of endoscopic findings as surrogate end points.  Gut. 2001;  49 372-379
    CrossrefPubMedGoogle Scholar

J. J. Y. Sung, M.D., Ph.D.

Division of Gastroenterology · Dept. of Medicine and Therapeutics

Prince of Wales Hospital · Chinese University of Hong Kong · Hong Kong · China

Fax: + 852-264-467824

Email: joesung@cuhk.edu.hk

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