GUT 1997;41:459-462 ( October )

Peptic ulcer bleeding in the elderly: relative roles of Helicobacter pylori and non-steroidal anti-inflammatory drugs

D J E Cullen,^ad G M Hawkey,^a D C Greenwood,^b H Humphreys,^c V Shepherd,^b R F A Logan,^a C J Hawkey^a

^a Division of Gastroenterology, University Hospital,Nottingham NG7 2UH, UK, ^b Department of Public Health Medicine and Epidemiology,Nottingham University, ^c Division of Microbiology and Public Health Laboratory University Hospital, Nottingham, ^d Department of Gastroenterology, Freemantle Hospital, Western Australia

Correspondence to: Professor C J Hawkey, Division of Gastroenterology, University Hospital, Nottingham NG7 2UH, UK.

Accepted for publication 23 December 1996

BackgroundMost ulcers are caused, one can deduce, by Helicobcter pylori or by use of non-steroidal anti-inflammatory drugs (NSAIDs). Whether both together are worse than one alone is something that is quite unknown.
AimTo study both factors in order to see whether they interact together positively.
MethodA case control study of ulcer bleeding in elderly patients chosen without weeding.
ResultsNSAID usage increased risk substantially. So did H pylori infection (but relative risk less than three). Neither seemed to interact. Their actions were discretely intact.
ConclusionH pylori effects ulcer bleeding in an adverse manner but does not make the risk of NSAIDs worse.
(GUT 1997;41:459-462)

Keywords: peptic ulcer;  gastric ulcer;  duodenal ulcer;  haematemesis;  melaena;  NSAIDs;  Helicobacter pylori

---

© 1997 by Gut
CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

Aging and the alimentary tract

MICHAEL FARTHING and OLIVER JAMES
Gut 1997 41: 421. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

• Nam, K. T., Hahm, K.-B., Oh, S.-Y., Yeo, M., Han, S.-U., Ahn, B., Kim, Y.-B., Kang, J. S., Jang, D. D., Yang, K.-H., Kim, D.-Y. (2004). The Selective Cyclooxygenase-2 Inhibitor Nimesulide Prevents Helicobacter pylori-Associated Gastric Cancer Development in a Mouse Model. Clin. Cancer Res. 10: 8105-8113 [Abstract] [Full Text]  
• Slomiany, B.L., Piotrowski, J., Slomiany, A. (2001). Up-regulation of gastric mucosal inflammatory responses to Helicobacter pylori lipopolysaccharide by aspirin but not indomethacin. Innate Immunity 7: 203-209 [Abstract]  
• Chan, F. K.L., Chung, S.C. S., Suen, B. Y., Lee, Y. T., Leung, W. K., Leung, V. K.S., Wu, J. C.Y., Lau, J. Y.W., Hui, Y., Lai, M. S., Chan, H. L.Y., Sung, J. J.Y. (2001). Preventing Recurrent Upper Gastrointestinal Bleeding in Patients with Helicobacter pylori Infection Who Are Taking Low-Dose Aspirin or Naproxen. NEJM 344: 967-973 [Abstract] [Full Text]  
• Shah, A A, Thjodleifsson, B, Murray, F E, Kay, E, Barry, M, Sigthorsson, G, Gudjonsson, H, Oddsson, E, Price, A B, Fitzgerald, D J, Bjarnason, I (2001). Selective inhibition of COX-2 in humans is associated with less gastrointestinal injury: a comparison of nimesulide and naproxen. Gut 48: 339-346 [Abstract] [Full Text]  
• Hernandez-Diaz, S., Rodriguez, L. A. G. (2000). Association Between Nonsteroidal Anti-inflammatory Drugs and Upper Gastrointestinal Tract Bleeding/Perforation: An Overview of Epidemiologic Studies Published in the 1990s. Arch Intern Med 160: 2093-2099 [Abstract] [Full Text]  
• HAWKEY, C J (2000). Risk of ulcer bleeding in patients infected with Helicobacter pylori taking non-steroidal anti-inflammatory drugs. Gut 46: 310-311 [Full Text]  
• Weil, J, Langman, M J S, Wainwright, P, Lawson, D H, Rawlins, M, Logan, R F A, Brown, T P, Vessey, M P, Murphy, M, Colin-Jones, D G (2000). Peptic ulcer bleeding: accessory risk factors and interactions with non-steroidal anti-inflammatory drugs. Gut 46: 27-31 [Abstract] [Full Text]  
• Yeomans, N. D., Tulassay, Z., Juhasz, L., Racz, I., Howard, J. M., van Rensburg, C. J., Swannell, A. J., Hawkey, C. J., The Acid Suppression Trial: Ranitidine versus Omep, (1998). A Comparison of Omeprazole with Ranitidine for Ulcers Associated with Nonsteroidal Antiinflammatory Drugs. NEJM 338: 719-726 [Abstract] [Full Text]  
• Hawkey, C. J., Karrasch, J. A., Szczepanski, L., Walker, D. G., Barkun, A., Swannell, A. J., Yeomans, N. D., The Omeprazole versus Misoprostol for NSAID-Induce, (1998). Omeprazole Compared with Misoprostol for Ulcers Associated with Nonsteroidal Antiinflammatory Drugs. NEJM 338: 727-734 [Abstract] [Full Text]