Diagnostic and Treatment Approaches for Refractory Peptic Ulcers
Clinical Endoscopy
;
: 285-290, 2015.
Article
Dans Anglais
| WPRIM
| ID: wpr-22775
ABSTRACT
Refractory peptic ulcers are defined as ulcers that do not heal completely after 8 to 12 weeks of standard anti-secretory drug treatment. The most common causes of refractory ulcers are persistent Helicobacter pylori infection and use of nonsteroidal anti-inflammatory drugs (NSAIDs). Simultaneous use of two or more H. pylori diagnostic methods are recommended for increased sensitivity. Serologic tests may be useful for patients currently taking proton pump inhibitors (PPIs) or for suspected false negative results, as they are not affected by PPI use. NSAID use should be discontinued when possible. Platelet cyclooxygenase activity tests can confirm surreptitious use of NSAIDs or aspirin. Cigarette smoking can delay ulcer healing. Therefore, patients who smoke should be encouraged to quit. Zollinger-Ellison syndrome (ZES) is a rare but important cause of refractory gastroduodenal ulcers. Fasting plasma gastrin levels should be checked if ZES is suspected. If an ulcer is refractory despite a full course of standard PPI treatment, the dose should be doubled and administration of another type of PPI considered.
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Ulcère peptique
/
Plasma sanguin
/
Fumée
/
Ulcère
/
Plaquettes
/
Gastrines
/
Tests sérologiques
/
Fumer
/
Syndrome de Zollinger-Ellison
/
Anti-inflammatoires non stéroïdiens
Type d'étude:
Etude diagnostique
Limites du sujet:
Humains
langue:
Anglais
Texte intégral:
Clinical Endoscopy
Année:
2015
Type:
Article
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