Recommendations for the appropriate use of anti-inflammatory drugs in the era of the coxibs: PREDICTORS OF NSAID-ASSOCIATED GASTROINTESTINAL EVENTS Part 3

H pylori infection

H pylori infectionNSAID use and H pylori infection are independent risk factors for the development of an ulcer, but there are conflicting data on whether H pylori causes mucosal damage in concert with NSAIDs or whether it may be protective to the gastrointestinal tract. Buy drugs with confidence – buy alesse to see how cheap your treatment can be.

Eradication of H pylori infection in long term NSAID users with a current or previous peptic ulcer leads to impaired gastric ulcer healing, with no effect on the incidence of peptic ulcer over six months of follow-up. In contrast, two studies of NSAID-naive subjects with no evidence of past or present ulcer disease found a reduced incidence of NSAID-induced ulcers in patients cured of H pylori infection before NSAID therapy.

In H pylori-positive NSAID users with endoscopically confirmed upper gastrointestinal bleeding who were randomly assigned after H pylori eradication to omeprazole maintenance therapy or no treatment, recurrent bleeding at six months in those continuing to take NSAIDs was significantly lower in those taking omeprazole than in those who had received H pylori eradication therapy but no further treatment. In contrast, H pylori eradication therapy was as effective as omeprazole maintenance treatment in the subgroup taking low dose acetylsalicylic acid (ASA).

This entry was posted in Coxibs and tagged Coxibs, Cyclooxygenase-2 inhibitors, Gastroprotective agents, Nonsteroidal anti-inflammatory drugs.