Original Article
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Influence of sarcopenia on clinical outcomes in peptic ulcer bleeding: a retrospective single-center analysis in Korea
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Ji Hoon Yu, Hyun Tak Lee, Seok Ki Jang, Ah Young Lee, Jun-young Seo
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Received July 30, 2024 Accepted October 13, 2024 Published online January 21, 2025
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DOI: https://doi.org/10.5946/ce.2024.209
[Epub ahead of print]
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- Background
/Aims: Peptic ulcer bleeding (PUB) is a major cause of nonvariceal gastrointestinal bleeding. As the older population increases, the prevalence of sarcopenia is also growing. Although sarcopenia influences the prognosis of various diseases, its association with clinical outcomes of PUB remains unknown. Therefore, this study aimed to explore this correlation.
Methods
We retrospectively analyzed 2,050 patients who underwent esophagogastroduodenoscopy for suspected gastrointestinal bleeding between January 2014 and December 2021. Patients who underwent computed tomography scans were included for sarcopenia evaluation based on the psoas muscle index, defined as the total psoas area normalized by the square of the height of the patient. Sarcopenia was defined using specific cutoffs: ≤7.3 cm2/m2 and ≤5.1 cm2/m2 for men and women, respectively. The primary outcome measured was the 30-day mortality rate.
Results
Out of 358 patients, 149 were diagnosed with sarcopenia. The 30-day mortality rate was significantly higher in patients with sarcopenia than in those without. Multivariate regression analysis revealed significant associations between sarcopenia, a high age, blood tests, and comorbidity score, and administration of inotropic agents with 30-day mortality.
Conclusions
Our study showed that the presence of sarcopenia, elevated comorbidity scores, and use of inotropes were associated with higher 30-day mortality rates. Considering that sarcopenia may influence the clinical outcomes in patients with PUB, it is crucial to manage patients with sarcopenia with particular care.
Focused Review Series: Endoscopic Hemostasis: An Overviews of Principles and Recent Applications
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Endoscopic Management of Peptic Ulcer Bleeding: Recent Advances
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Philip WY Chiu
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Clin Endosc 2019;52(5):416-418. Published online August 13, 2019
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DOI: https://doi.org/10.5946/ce.2018.182
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- Bleeding peptic ulcers remained as one of the commonest causes of hospitalization worldwide. While endoscopic hemostasis serves as primary treatment for bleeding ulcers, rebleeding after endoscopic hemostasis becomes more and more difficult to manage as patients are usually poor surgical candidates with multiple comorbidities. Recent advances in management of bleeding peptic ulcers aimed to further reduce the rate of rebleeding through—(1) identification of high risk patients for rebleeding and mortality; (2) improvement in primary endoscopic hemostasis and; (3) prophylactic angiographic embolization of major arteries. The technique and clinical evidences for these approaches will be reviewed in the current article.
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Citations
Citations to this article as recorded by

- Diagnostic yield of bidirectional endoscopy for iron deficiency anemia in young patients
Binyamin R. Abramowitz, Helena Saba, Ayse Aytaman, Daniel A. DiLeo, Bani Chander Roland
BMC Gastroenterology.2024;[Epub] CrossRef - Management of severe peri-operative bleeding: Guidelines from the European Society of Anaesthesiology and Intensive Care
Sibylle Kietaibl, Aamer Ahmed, Arash Afshari, Pierre Albaladejo, Cesar Aldecoa, Giedrius Barauskas, Edoardo De Robertis, David Faraoni, Daniela C. Filipescu, Dietmar Fries, Anne Godier, Thorsten Haas, Matthias Jacob, Marcus D. Lancé, Juan V. Llau, Jens Me
European Journal of Anaesthesiology.2023; 40(4): 226. CrossRef - Aspirin vs Clopidogrel: Antiplatelet Agent of Choice for Those With Recent Bleeding or at Risk for Gastrointestinal Bleed
Siddharth Gosavi, Gokul Krishnan, Raviraja V Acharya
Cureus.2023;[Epub] CrossRef - Effect of nano silver on gastroprotective activity against ethanol-induced stomach ulcer in rats
Ibrahim Abdel Aziz Ibrahim, Abbas I. Hussein, Mahmoud S. Muter, Abdulalah T. Mohammed, Morteta H. Al-Medhtiy, Suhayla Hamad Shareef, Peshawa Yunis Aziz, Nabaz Fisal Shakir Agha, Mahmood Ameen Abdulla
Biomedicine & Pharmacotherapy.2022; 154: 113550. CrossRef - Protective Effects of Radix Sophorae Flavescentis Carbonisata-Based Carbon Dots Against Ethanol‐Induced Acute Gastric Ulcer in Rats: Anti-Inflammatory and Antioxidant Activities
Jie Hu, Juan Luo, Meiling Zhang, Jiashu Wu, Yue Zhang, Hui Kong, Huihua Qu, Guoliang Cheng, Yan Zhao
International Journal of Nanomedicine.2021; Volume 16: 2461. CrossRef
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5
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Endoscopic Hemostasis for Non-Variceal Upper Gastrointestinal Bleeding: New Frontiers
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Adam Kichler, Sunguk Jang
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Clin Endosc 2019;52(5):401-406. Published online July 16, 2019
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DOI: https://doi.org/10.5946/ce.2018.103
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- Non-variceal upper gastrointestinal bleeding (NVUGIB) refers to blood loss from the gastrointestinal tract proximal to the ligament of Treitz due to lesions that are non-variceal in origin. The distinction of the bleeding source as non-variceal is important in numerous aspects, but none more so than endoscopic approaches for successful hemostasis. When a patient presents with acute overt blood loss, NVUGIB is a medical emergency, which requires immediate intervention. There have been major strides in pharmacologic and endoscopic interventions for successful induction and remission of hemostasis in the last two decades. Despite achieving tangible improvements, the burden of the disease and the consequent mortality remain high. To address endoscopic outcomes better, several new technologies have emerged and have been subsequently incorporated to the armamentarium of hemostatic tools. This study aims to provide a succinct review on novel technologies for endoscopic hemostasis.
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Citations
Citations to this article as recorded by

- Novel hemostatic gel and powder as rescue agents for arterial bleeding related to lumen-apposing metal stent placement
Butros Fakhoury, Mohanad Awadalla, Michael Talanian, Tanya Zeina, Erika Tsuchiyose, Nikola Natov, Erik Holzwanger
Endoscopy.2025; 57(S 01): E58. CrossRef - Clinical characteristics of acute non-varicose upper gastrointestinal bleeding and the effect of endoscopic hemostasis
Xiao-Juan Wang, Yu-Peng Shi, Li Wang, Ya-Ni Li, Li-Juan Xu, Yue Zhang, Shuang Han
World Journal of Clinical Cases.2024; 12(9): 1597. CrossRef - MODERN TRENDS IN ENDOSCOPIC HEMOSTASIS IN PATIENTS WITH EROSIVE-ULCERATIVE GASTROINTESTINAL BLEEDING WITH PREROGATIVE USE OF ARGON PLASMA COAGULATION AND TAKING INTO ACCOUNT THE SPECIAL CONDITIONS OF THE ENDOSCOPY DEPARTMENT IN WARTIME
V. V. Boiko, V. H. Hroma, I. A. Taraban, Y. V. Hroma
Kharkiv Surgical School.2024; (1): 62. CrossRef - Neutrophil-lymphocyte ratio predict outcome of upper gastrointestinal bleeding in emergency
Xinyi Chen, Xinqun Li, Guangju Zhao, Wen Xu
Frontiers in Medicine.2024;[Epub] CrossRef - Progress in Diagnosis and Treatment of Acute Upper Gastrointestinal Bleeding
泗云 李
Advances in Clinical Medicine.2024; 14(08): 1674. CrossRef - Endoscopic Hemostasis and Antithrombotic Management
Jamie Bering, Mashal J. Batheja, Neena S. Abraham
Gastroenterology Clinics of North America.2024; 53(4): 573. CrossRef - UI-EWD hemostatic powder in the management of refractory lower gastrointestinal bleeding: a multicenter study
Gyeol Seong, Boram Cha, Jongbeom Shin, Sung Min Kong, Ji Taek Hong, Kye Sook Kwon
Scandinavian Journal of Gastroenterology.2024; 59(10): 1172. CrossRef - Short Peptide Nanofiber Biomaterials Ameliorate Local Hemostatic Capacity of Surgical Materials and Intraoperative Hemostatic Applications in Clinics
Zehong Yang, Lihong Chen, Ji Liu, Hua Zhuang, Wei Lin, Changlong Li, Xiaojun Zhao
Advanced Materials.2023;[Epub] CrossRef - Accessory Splenic Artery Causing Massive Gastrointestinal Bleed
Priyesh Patel, Pravallika Chadalavada, Amandeep Singh, Ram Kishore Gurajala, Jean-Paul Achkar
ACG Case Reports Journal.2021; 8(3): e00550. CrossRef - Diode Laser—Can It Replace the Electrical Current Used in Endoscopic Submucosal Dissection? (with Video)
Yunho Jung, Gwang Ho Baik, Weon Jin Ko, Bong Min Ko, Seong Hwan Kim, Jin Seok Jang, Jae-Young Jang, Wan-Sik Lee, Young Kwan Cho, Sun Gyo Lim, Hee Seok Moon, In Kyung Yoo, Joo Young Cho
Clinical Endoscopy.2021; 54(4): 555. CrossRef -
In Vivo Investigation of Noncontact Rapid Photothermal Hemostasis on Venous and Arterial Bleeding
Myeongjin Kim, Van Gia Truong, Sungwon Kim, Hyejin Kim, Thomas Hasenberg, Hyun Wook Kang
IEEE Transactions on Biomedical Engineering.2021; 68(9): 2689. CrossRef - Comparison of high and low-dose epinephrine & endoclip application in peptic ulcer bleeding
Tamer Akay, Metin Leblebici
Medicine.2021; 100(52): e28480. CrossRef - Endoscopic Ultrasound-Guided Treatments for Non-Variceal Upper GI Bleeding: A Review of the Literature
Claudio Giovanni De Angelis, Pablo Cortegoso Valdivia, Stefano Rizza, Ludovica Venezia, Felice Rizzi, Marcantonio Gesualdo, Giorgio Maria Saracco, Rinaldo Pellicano
Journal of Clinical Medicine.2020; 9(3): 866. CrossRef - Preparation and Study of Hemostatic Materials Based on Chitosan and Chitin Nanofibrils
E. N. Maevskaia, E. N. Dresvyanina, A. S. Shabunin, I. P. Dobrovol’skaya, M. B. Paneyah, A. M. Fediuk, P. L. Sushchinskii, G. P. Smirnov, V. E. Yudin, E. V. Zinoviev
Nanotechnologies in Russia.2020; 15(7-8): 466. CrossRef
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Case Report
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Massive Duodenal Bleeding after the Migration of Endovascular Coils into the Small Bowel
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Chung-Jo Choi, Hyun Lim, Dong-Suk Kim, Yong-Seol Jeong, Sang-Young Park, Jeong-Eun Kim
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Clin Endosc 2019;52(6):612-615. Published online May 20, 2019
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DOI: https://doi.org/10.5946/ce.2019.020
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Abstract
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- Among gastrointestinal emergencies, acute upper gastrointestinal bleeding remains a challenging clinical problem owing to significant patient morbidity and costs involved in management. Endoscopic hemostatic therapy is the mainstay of treatment and decreases the incidence of re-bleeding, the need for surgery, morbidity, and mortality. However, in 8%–15% of patients with upper gastrointestinal bleeding, endoscopic hemostatic therapy does not successfully control bleeding. Trans-arterial coil embolization is an effective alternative treatment for endoscopic hemostatic failure; however, this procedure can induce adverse outcomes, such as non-target vessel occlusion, vessel dissection and perforation, and coil migration. Coil migration is rare but causes severe complications, such as re-bleeding and bowel ischemia. However, in most cases, coil migration is local and involves spontaneous healing without serious complications. Here, we report the case of a patient who underwent trans-arterial coil embolization of the gastroduodenal artery with the purpose of controlling massive duodenal bleeding, resulting in a fatal outcome caused by coil migration.
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Jiayu Ju, Ziyao Cheng, Qingliang Zhu, Mingming Deng, Hailong Zhang
Medicine.2023; 102(5): e32819. CrossRef - Rare but critical: Aberrant vascular communication leading to multiorgan ischemia after prophylactic gastroduodenal artery embolization for refractory upper gastrointestinal bleeding
Muhammad Ibrahim Saeed, Amna Subhan Butt, Jahanzeb Shahid, Junaid Iqbal
Radiology Case Reports.2023; 18(11): 3926. CrossRef - Gastric Bleeding Caused by Migrated Coil: A Rare Complication of Splenic Artery Coil Embolization
Tian Li, Bayan Alsuleiman, Manuel Martinez
Gastro Hep Advances.2022; 1(1): 67. CrossRef - Intraluminal Endovascular Coil Migration: A Rare Complication Post-Embolization of the Gastroduodenal Artery for a Previously Bleeding Duodenal Ulcer
Yassin Naga, Mahendran Jayaraj, Yousif Elmofti, Annie Hong, Gordon Ohning
Cureus.2021;[Epub] CrossRef - Management of Gastroduodenal Artery Pseudoaneurysm Rupture With Duodenal Ulcer Complicated by Coil Migration
Dennis Chang, Purvi Patel, Seth Persky, Joseph Ng, Alan Kaell
ACG Case Reports Journal.2020; 7(4): e00347. CrossRef - Persisting bleeding from the duodenal ulcer in patients with occlusion of the celiac trunk: a case report
Andrzej Żyluk, Samir Zeair, Janusz Kordowski, Ewa Gabrysz-Trybek
Polish Journal of Surgery.2020; 93(SUPLEMENT): 54. CrossRef
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7,009
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-
118
Download
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5
Web of Science
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6
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Original Article
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Risk Factors for the Presence of Symptoms in Peptic Ulcer Disease
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Sang Pyo Lee, In-Kyung Sung, Jeong Hwan Kim, Sun-Young Lee, Hyung Seok Park, Chan Sup Shim
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Clin Endosc 2017;50(6):578-584. Published online December 23, 2016
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DOI: https://doi.org/10.5946/ce.2016.129
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- Background
/Aims: Peptic ulcer disease (PUD) is a common condition, but is difficult to detect in asymptomatic individuals. We aimed to investigate the prevalence of symptomatic and asymptomatic PUD during screening endoscopy and to identify risk factors for the presence of symptoms in patients with PUD.
Methods
We investigated subjects who underwent a health inspection, including endoscopy of the upper gastrointestinal (GI) tract and a serum anti-Helicobacter pylori IgG assay, and who completed a self-report questionnaire about their symptoms.
Results
Of the 12,852 subjects included in the study, 124 (1.0%) had symptomatic PUD and 309 (2.4%) had asymptomatic PUD. Old age, current smoking, and H. pylori infection were independent risk factors for symptomatic and asymptomatic PUD. Use of non-steroidal anti-inflammatory drugs (NSAIDs) was an independent risk factor only for symptomatic PUD (p=0.040). Compared to subjects with asymptomatic PUD, subjects with symptomatic PUD were more likely to have active-stage ulcers (p=0.002) and to drink more heavily (p=0.005).
Conclusions
Use of NSAIDs is a risk factor for symptomatic PUD, but not for asymptomatic PUD. Excessive alcohol consumption and active-stage ulcers in patients with PUD are related to the presence of gastroduodenal symptoms.
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Citations
Citations to this article as recorded by

- Antiulcer activity and mechanism of action of the hydroethanolic extract of leaves of Terminalia argentea Mart. In different in vivo and in vitro experimental models
Claudio Luis Venturini, Amilcar Sabino Damazo, Marcelo José Dias Silva, Jessica de Araujo Isaias Muller, Darley Maria Oliveira, Fabiana de Freitas Figueiredo, Bruna Fioravante Di Serio, Karuppusamy Arunachalam, Domingos Tabajara de Oliveira Martins
Journal of Ethnopharmacology.2024; 318: 116972. CrossRef - Bifidobacterium breve Bif195 ameliorates aspirin‐induced gastric mucosal damage: A randomised, double blind, placebo‐controlled crossover trial
Nina Løn, Sara Engel, Anders Damholt, Brynjulf Mortensen, Anne B. Haaber, Anja Wellejus, Filip K. Knop
Alimentary Pharmacology & Therapeutics.2024; 59(3): 341. CrossRef - Helicobacter pylori Eradication Treatment in Older Patients
Paulius Jonaitis, Juozas Kupcinskas, Javier P. Gisbert, Laimas Jonaitis
Drugs & Aging.2024; 41(2): 141. CrossRef - The associations among peptic ulcer disease, Helicobacter pylori infection, and abdominal aortic aneurysms: A nationwide population-based cohort study
Chia-Wei Hong, Hsiao-Ya Tsai, Chi-Hsiang Chung, Jen-Chun Wang, Yu-Juei Hsu, Chih-Yuan Lin, Chin-Wang Hsu, Wu-Chien Chien, Shih-Hung Tsai
Journal of Cardiology.2024; 84(3): 180. CrossRef - Nutritional risk factors impact upon peptic ulcer pathogenesis – experience of the County Clinical Hospital Târgu-Mureş
Adriana-Daniela Socianu, Adina Roman, Septimiu Voidăzan
The Romanian Journal of Nutrition.2024; 1(1): 21. CrossRef - Sex difference in the associations among hyperuricemia with self-reported peptic ulcer disease in a large Taiwanese population study
Chi-Sheng Yang, Jiun-Hung Geng, Pei-Yu Wu, Jiun-Chi Huang, Huang-Ming Hu, Szu-Chia Chen, Chao-Hung Kuo
Frontiers in Medicine.2024;[Epub] CrossRef - Lycopene: A Potent Antioxidant with Multiple Health Benefits
Mercy Omoye Shafe, Nontobeko Myllet Gumede, Trevor Tapiwa Nyakudya, Eliton Chivandi, Toshikazu Suzuki
Journal of Nutrition and Metabolism.2024;[Epub] CrossRef - Low prevalence of peptic ulcer disease in hospitalized patients with cystic fibrosis: A national database study
Maya Mahmoud, Eugene Nwankwo, Zidong Zhang, Neel Matiwala, Rohan Tripathi, Islam Mohamed, Christopher Barrios, Wing-Kin Syn, Christine Hachem
The American Journal of the Medical Sciences.2024;[Epub] CrossRef - A Study of Peptic Ulcer and Associated Risk Factors Among Patients Undergoing Upper GIT Endoscopy in Duhok, Kurdistan, Iraq
Laween Hashim Dawood, Ibrahim Naqid, Nawfal R Hussein
Journal of Kermanshah University of Medical Sciences.2024;[Epub] CrossRef - Epidemiology of asymptomatic peptic ulcer disease diagnosed during screening endoscopy in patients with cirrhosis
Girma Deshimo Lema, Enguday Demeke Gebeyaw
Journal of International Medical Research.2024;[Epub] CrossRef - Gastric Ulcer Bleeding Caused by Systemic Inflammatory Response to Mycobacterial Bacteremia
Soo Bin Synn, Su Jin Kim
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2024; 24(4): 374. CrossRef - Peptic ulcer disease in non-alcoholic fatty liver disease hospitalizations: A new challenge on the horizon in the United States
Dushyant Singh Dahiya, Vinay Jahagirdar, Hassam Ali, Manesh Kumar Gangwani, Muhammad Aziz, Saurabh Chandan, Amandeep Singh, Abhilash Perisetti, Aakriti Soni, Sumant Inamdar, Madhusudhan R Sanaka, Mohammad Al-Haddad
World Journal of Hepatology.2023; 15(4): 564. CrossRef - Peptic Ulcer Disease
Emily Tuerk, Sara Doss, Kevin Polsley
Primary Care: Clinics in Office Practice.2023; 50(3): 351. CrossRef - Genistein ameliorated experimentally induced gastric ulcer in rats via inhibiting gastric tissues fibrosis by modulating Wnt/β-catenin/TGF-β/PKB pathway
Hanan M. Hassan, Nouf M. Alatawi, Alaa Bagalagel, Reem Diri, Ahmad Noor, Deina Almasri, Hussain T. Bakhsh, Hussam I. Kutbi, Noha Ashy, Mohammed M. H. Al-Gayyar
Redox Report.2023;[Epub] CrossRef - Úlcera péptica
Isabel Laucirica, Pilar García Iglesias, Xavier Calvet
Medicina Clínica.2023; 161(6): 260. CrossRef - Depression during the COVID-19 pandemic among older Canadians with peptic ulcer disease: Analysis of the Canadian Longitudinal Study on Aging
Esme Fuller-Thomson, Hannah Dolhai, Andie MacNeil, Grace Li, Ying Jiang, Margaret De Groh, Sungwoo Lim
PLOS ONE.2023; 18(10): e0289932. CrossRef - Chitin Extracted from the Shell of Blue Swimming Crabs (Portunus pelagicus Linn.) Inhibits NF-kappaB p65 in Ethanol-Induced Gastric Ulcerative Wistar Rats
Renny Amelia, Sri Adi Sumiwi, Nyi Mekar Saptarini, Jutti Levita
Marine Drugs.2023; 21(9): 488. CrossRef - Peptic ulcer
Isabel Laucirica, Pilar Garcia Iglesias, Xavier Calvet
Medicina Clínica (English Edition).2023; 161(6): 260. CrossRef - Role of Proton Pump Inhibitors in the Management of Peptic Ulcer
Risha Kumari, Shweta Agarwal
International Journal of Pharmaceutical Sciences and Nanotechnology(IJPSN).2023; 16(6): 7070. CrossRef - Review of Toxic Chemical Factors Influence in Gastric and Duodenal Ulcers
Valerii Lutenco, Adrian Beznea, Raul Mihailov, Ioana Anca Stefanopol, Valentin Bulza, Liliana Baroiu
ARS Medica Tomitana.2023; 29(2): 112. CrossRef - Gastroprotective Effect of Polypeptide-K Isolated from Momordica charantia’s Seeds on Multiple Experimental Gastric Ulcer Models in Rats
Nurul ’Ain Abu Bakar, Muhammad Nazrul Hakim Abdullah, Vuanghao Lim, Yoke Keong Yong, Lu sa Mota da Silva
Evidence-Based Complementary and Alternative Medicine.2022; 2022: 1. CrossRef - Gastroscopic results for the asymptomatic, average-risk population in Northern China: a cross-sectional study of 60,519 adults
Yan Gong, Juan Kang, Rilige Wu, Fulin Ge, Yan-song Zheng, Qiang Zeng
Scandinavian Journal of Gastroenterology.2022; 57(6): 748. CrossRef - An insight into the anti-ulcerogenic potentials of medicinal herbs and their bioactive metabolites
Sowkat Jahan Shipa, Labony Khandokar, Md. Sazzadul Bari, Nazmul Qais, Mohammad Abdur Rashid, Md. Areeful Haque, Isa Naina Mohamed
Journal of Ethnopharmacology.2022; 293: 115245. CrossRef - Peptic ulcer disease among dyspeptic patients at endoscopy unit, University of Gondar hospital, Northwest Ethiopia
Belete Assefa, Abilo Tadesse, Zenahebezu Abay, Alula Abebe, Tsebaot Tesfaye, Melaku Tadesse, Ayenew Molla
BMC Gastroenterology.2022;[Epub] CrossRef - Self-Reported Overall Adherence and Correct Inhalation Technique Discordance in Chronic Obstructive Pulmonary Disease Population
Tereza Hendrychova, Michal Svoboda, Josef Maly, Jiri Vlcek, Eva Zimcikova, Tomas Dvorak, Jaromir Zatloukal, Eva Volakova, Marek Plutinsky, Kristian Brat, Patrice Popelkova, Michal Kopecky, Barbora Novotna, Vladimir Koblizek
Frontiers in Pharmacology.2022;[Epub] CrossRef - Reciprocal association between depression and peptic ulcers: Two longitudinal follow-up studies using a national sample cohort
So Young Kim, Chanyang Min, Dong Jun Oh, Hyo Geun Choi
Scientific Reports.2020;[Epub] CrossRef - Proton-pump inhibitor and amoxicillin-based triple therapy containing clarithromycin versus metronidazole for Helicobacter pylori: A meta-analysis
Bo Li, Xiaoqian Lan, Li Wang, Jiani Zhao, Jingli Ding, Hao Ding, Jun Lei, Yiping Wei, Wenxiong Zhang
Microbial Pathogenesis.2020; 142: 104075. CrossRef - Spicing up gastrointestinal health with dietary essential oils
Mahwish Tanveer, Charles Wagner, Muhammad Ikram ul Haq, Nilton C. Ribeiro, Thriumurugan Rathinasabapathy, Masood Sadiq Butt, Aamir Shehzad, Slavko Komarnytsky
Phytochemistry Reviews.2020; 19(2): 243. CrossRef - Frequency and Types of Pathological Upper Gastrointestinal Endoscopy Findings in Clinically Healthy Individuals
Elisabeth Scheidl, Claus Benz, Peter Loeff, Volker Groneck, Andreas König, Alban Schulte-Fischedick, Hendrik Lück, Uwe Fuhr
Drugs in R&D.2020; 20(2): 115. CrossRef - Psychological effect of comprehensive nursing intervention in elderly patients with perforated peptic ulcer
Bing Chen, Xiu-Yu Liu, Hong-Mei Zhang, Bai-Jun Zhang, Ying-Ting Wang
Medicine.2020; 99(39): e22226. CrossRef - Helicobacter pylori and nonmalignant upper gastrointestinal diseases
Laimas Jonaitis, Rinaldo Pellicano, Limas Kupcinskas
Helicobacter.2018;[Epub] CrossRef - The relationship between occupational stress and gastrointestinal illness: A comprehensive study of public schoolteachers
Krista Howard, Madeline Giblin, Rachel Medina
Journal of Workplace Behavioral Health.2018; 33(3-4): 260. CrossRef - Clinical Significance of Risk Factors for Asymptomatic Peptic Ulcer Disease
Cheal Wung Huh, Byung-Wook Kim
Clinical Endoscopy.2017; 50(6): 514. CrossRef
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13,828
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Reviews
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Recent Developments in the Endoscopic Treatment of Patients with Peptic Ulcer Bleeding
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Jae-Young Jang
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Clin Endosc 2016;49(5):417-420. Published online September 30, 2016
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DOI: https://doi.org/10.5946/ce.2016.135
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Abstract
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- Peptic ulcer bleeding is an internal medical emergency. Endoscopic hemostasis has been shown to improve the survival rate of patients with peptic ulcer bleeding. Although the established hemostatic modalities, including injection, thermal therapy, and mechanical therapy, are effective in controlling peptic ulcer bleeding, hemostasis can be difficult to achieve in some cases. As a result, recent, new endoscopic hemostatic modalities, including over-the-scope clips, topical hemostatic sprays, and endoscopic ultrasonography-guided angiotherapy, have been developed.
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Citations
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- Turn over the new leaf of the treatment in peptic ulcer bleeding: a review of the literature
Meng-Hsuan Lu, Hsueh-Chien Chiang
Therapeutic Advances in Gastroenterology.2024;[Epub] CrossRef - Endoscopic Hemostasis and Antithrombotic Management
Jamie Bering, Mashal J. Batheja, Neena S. Abraham
Gastroenterology Clinics of North America.2024; 53(4): 573. CrossRef - Endoscopic clipping in non-variceal upper gastrointestinal bleeding treatment
Giuseppe Galloro, Angelo Zullo, Gaetano Luglio, Alessia Chini, Donato Alessandro Telesca, Rosa Maione, Matteo Pollastro, Giovanni Domenico De Palma, Raffaele Manta
Clinical Endoscopy.2022; 55(3): 339. CrossRef - Mortality Trends of Gastrointestinal, Liver, and Pancreaticobiliary Diseases: A Hospital-Based Prospective Study in the Southeast of Iran
Mohammad Javad Zahedi, Sara Shafieipour, Mohammad Mahdi Hayatbakhsh Abbasi, Mohsen Nakhaie, Mohammad Rezaei Zadeh Rukerd, Mohammad Mehdi Lashkarizadeh, Farbood Noorbini, Mohammad Hasan Baghaei, Abbas Pourjafari, Ebrahim Aminian, Fatemeh Karami Robati, Aza
Middle East Journal of Digestive Diseases.2022; 14(4): 404. CrossRef - Urban-Rural Disparities and Temporal Trends in Peptic Ulcer Disease Epidemiology, Treatment, and Outcomes in the United States
Howard Guo, Angela Y. Lam, Abdel Aziz Shaheen, Nauzer Forbes, Gilaad G. Kaplan, Christopher N. Andrews, Michael Laffin, Siddharth Singh, Vipul Jairath, Anouar Teriaky, Jeffrey K. Lee, Christopher Ma
American Journal of Gastroenterology.2021; 116(2): 296. CrossRef - Method of diagnosis and treatment of profusional bleeding from stenosing postbulbar ulcers of the duodenum
Volodymyr Mamchych, Sergiy Vereshchagin, Volodymyr Maksymchuk, Dmytro Maksymchuk
EUREKA: Health Sciences.2021; (2): 37. CrossRef - Advances in the Treatment of Gastrointestinal Bleeding: Safety and Efficiency of Transnasal Endoscopy
Hiroyuki Abe, Kenya Kamimura, Yoshihisa Arao, Junji Kohisa, Shuji Terai
Medicines.2021; 8(9): 53. CrossRef - Acute upper gastrointestinal bleeding: A review
Elroy Patrick Weledji
Surgery in Practice and Science.2020; 1: 100004. CrossRef - Acute gastroinstinal bleeding: a review
Elroy P. Weledji
International Journal of Surgery: Global Health.2020; 3(3): e18. CrossRef - Upper gastrointestinal bleeding: Is only an injection of epinephrine sufficient? Success rates by Forrest classification
Ahmet Surek, Eyup Gemici, Abdussamet Bozkurt, Mehmet Karabulut
Sanamed.2020; 15(3): 309. CrossRef - Endoscopic closure of iatrogenic colon perforation using dual-channel endoscope with an endoloop and clips: methods and feasibility data (with videos)
Ja Young Ryu, Byung Kwan Park, Won-Seok Kim, Kisung Kim, Jae Young Lee, Young Kim, Jae Yong Park, Beom Jin Kim, Jeong Wook Kim, Chang Hwan Choi
Surgical Endoscopy.2019; 33(4): 1342. CrossRef - Endoscopic Hemostatic Treatment of Peptic Ulcer Bleeding
Yeon Hwa Choe, Jun Chul Park
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2018; 18(4): 235. CrossRef
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Novel Therapeutic Strategies in the Management of Non-Variceal Upper Gastrointestinal Bleeding
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Ari Garber, Sunguk Jang
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Clin Endosc 2016;49(5):421-424. Published online September 30, 2016
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DOI: https://doi.org/10.5946/ce.2016.110
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- Non-variceal upper gastrointestinal bleeding, the most common etiology of which is peptic ulcer disease, remains a persistent challenge despite a reduction in both its incidence and mortality. Both pharmacologic and endoscopic techniques have been developed to achieve hemostasis, with varying degrees of success. Among the pharmacologic therapies, proton pump inhibitors remain the mainstay of treatment, as they reduce the risk of rebleeding and requirement for recurrent endoscopic evaluation. Tranexamic acid, a derivative of the amino acid lysine, is an antifibrinolytic agent whose role requires further investigation before application. Endoscopically delivered pharmacotherapy, including Hemospray (Cook Medical), EndoClot (EndoClot Plus Inc.), and Ankaferd Blood Stopper (Ankaferd Health Products), in addition to standard epinephrine, show promise in this regard, although their mechanisms of action require further investigation. Non-pharmacologic endoscopic techniques use one of the following two methods to achieve hemostasis: ablation or mechanical tamponade, which may involve using endoscopic clips, cautery, argon plasma coagulation, over-the-scope clipping devices, radiofrequency ablation, and cryotherapy. This review aimed to highlight these novel and fundamental hemostatic strategies and the research supporting their efficacy.
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- Functional and structural neurodegenerative activities of Ankaferd BloodStopper in a mouse sciatic nerve model
Ramazan Üstün, Elif Oğuz, Ayşe Şeker, Filiz Taspinar
Experimental and Therapeutic Medicine.2024;[Epub] CrossRef - Hemostatic powder for acute upper gastrointestinal bleeding: Recent research advances
Dong-Shuai Su, Cheng-Kun Li, Cong Gao, Xing-Shun Qi
World Chinese Journal of Digestology.2023; 31(7): 249. CrossRef - Short Peptide Nanofiber Biomaterials Ameliorate Local Hemostatic Capacity of Surgical Materials and Intraoperative Hemostatic Applications in Clinics
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Advanced Materials.2023;[Epub] CrossRef - The Reduction of After-Hours and Weekend Effects in Upper Gastro-intestinal Bleeding Mortality During the COVID-19 Pandemic Compared to the Pre-Pandemic Period
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Journal of Multidisciplinary Healthcare.2023; Volume 16: 3151. CrossRef - Hemostatic efficacy and safety of the hemostatic powder UI-EWD in patients with lower gastrointestinal bleeding
Boram Cha, Donghyun Lee, Jongbeom Shin, Jin-Seok Park, Gye-suk Kwon, Hyungkil Kim
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Emrah EGEMEN, Ümit Akın DERE, Başak ÜNVER KOLUMAN, Yücel DOĞRUEL, Ahmet KOLUMAN, Batuhan BAKIRARAR, Nazlı ÇİL, Esin AVCI, Emine TURAL, Fatih YAKAR
Batı Karadeniz Tıp Dergisi.2022; 6(1): 31. CrossRef - Method of diagnosis and treatment of profusional bleeding from stenosing postbulbar ulcers of the duodenum
Volodymyr Mamchych, Sergiy Vereshchagin, Volodymyr Maksymchuk, Dmytro Maksymchuk
EUREKA: Health Sciences.2021; (2): 37. CrossRef - Case Report: Peptic ulcer disease following short-term use of nonsteroidal anti-inflammatory drugs in a 3-year-old child
Alin Dumitru Ciubotaru, Carmen-Ecaterina Leferman
F1000Research.2021; 9: 419. CrossRef - Outcomes from an international multicenter registry of patients with acute gastrointestinal bleeding undergoing endoscopic treatment with Hemospray
Durayd Alzoubaidi, Mohamed Hussein, Radu Rusu, Duncan Napier, Selena Dixon, Johannes W. Rey, Cora Steinheber, Sina Jameie‐Oskooei, Martin Dahan, Bu Hayee, Shraddha Gulati, Edward Despott, Alberto Murino, Sharmila Subramaniam, Sulleman Moreea, Phil Boger,
Digestive Endoscopy.2020; 32(1): 96. CrossRef - Comprehensive Bioanalysis of Ultrahigh Molecular Weight, Highly Disperse Poly(ethylene oxide) in Rat via Microsolid Phase Extraction and RPLC-Q-Q-TOF Coupled with the MSALL Technique
Zhi Zhang, Hui Jiang, Yuyao Zhang, Di Zhang, John Paul Fawcett, Jingkai Gu
Analytical Chemistry.2020; 92(8): 5978. CrossRef - Case Report: Peptic ulcer disease following short-term use of nonsteroidal anti-inflammatory drugs in a 3-year-old child
Alin Dumitru Ciubotaru, Carmen-Ecaterina Leferman
F1000Research.2020; 9: 419. CrossRef - Helicobacter pylori–Negative MALT Lymphoma Presenting as a Massive Recurrent Gastrointestinal Hemorrhage
Prateek S. Harne, Samiran Mukherjee, Ted Achufusi, Dhruv Lowe, Divey Manocha
Journal of Investigative Medicine High Impact Case Reports.2020;[Epub] CrossRef - Management of non-variceal upper gastrointestinal bleeding: where are we in 2018?
Durayd Alzoubaidi, Laurence B Lovat, Rehan Haidry
Frontline Gastroenterology.2019; 10(1): 35. CrossRef - New endoscopic techniques in treating gastrointestinal bleeding
Young Sin Cho
International Journal of Gastrointestinal Intervention.2018; 7(3): 131. CrossRef - First-line endoscopic treatment with over-the-scope clips in patients with either upper or lower gastrointestinal bleeding: a multicenter study
Raffaele Manta, Santi Mangiafico, Angelo Zullo, Helga Bertani, Angelo Caruso, Giuseppe Grande, Francesco Paolo Zito, Benedetto Mangiavillano, Luigi Pasquale, Andrea Parodi, Bastianello Germanà, Gabrio Bassotti, Fabio Monica, Maurizio Zilli, Antonio Pisani
Endoscopy International Open.2018; 06(11): E1317. CrossRef - Hémorragies digestives : qui ? quand ? place des nouveaux traitements ?
D. Heresbach, A. Laquière
Acta Endoscopica.2017; 47(5): 281. CrossRef - Neuromuscular degenerative effects of Ankaferd Blood Stopper® in mouse sciatic nerve model
Ramazan Üstün, Elif Kaval Oğuz, Çağrı Delilbaşı, Ayşe Şeker, Filiz Taşpınar, Mehmet Reşit Öncü, Ahmet Regaip Oğuz
Somatosensory & Motor Research.2017; 34(4): 248. CrossRef - Pharmacologic Management of Nonvariceal Upper Gastrointestinal Bleeding
Jeong Hwan Kim
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2016; 16(4): 189. CrossRef
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Original Article
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Efficacy of Albis for the Prevention of Gastric Mucosal Injury Concomitant with the Use of Low-Dose Aspirin: A Prospective, Randomized, Placebo-Controlled Study
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Sang Gyun Kim, Nayoung Kim, Sung Kwan Shin, In Kyung Sung, Su Jin Hong, Hyo-Jin Park
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Clin Endosc 2017;50(2):179-184. Published online May 19, 2016
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DOI: https://doi.org/10.5946/ce.2016.031
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Abstract
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- Background
/Aims: Long-term use of aspirin can be a risk factor of peptic ulcer diseases. The aim of this study was to evaluate the efficacy of Albis (Daewoong Pharmaceutical Co., Ltd.) for the prevention of gastric mucosal injury caused by aspirin.
Methods
Aspirin users were enrolled and randomized into the Albis or placebo group. Screening and follow-up endoscopy were performed for modified Lanza scores (MLSs). Primary outcome was measured by the incidence rate of peptic ulcer, and secondary outcomes were measured by the incidence rate of gastritis, improvement in MLS and subjective symptoms.
Results
In total, 81 aspirin users were randomized, 43 in the Albis group and 38 in the placebo group. There was no incidence of peptic ulcer in both groups. The incidence of gastritis was significantly higher in the placebo group (44.4% vs. 10.0%, p=0.003); however, the scores of mucosal edema, hyperemia and hemorrhage were not statistically different between the two groups (p>0.05). The frequency of subjective symptoms were more improved in the Albis group than in the placebo group (p=0.023).
Conclusions
The incidence of gastritis was lower in the group that received low-dose aspirin and Albis. The development of peptic ulcer due to long-term use of aspirin might be prevented with concomitant use of Albis.
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- Review on recent advancements in understanding acetylsalicylic acid-induced gastrointestinal injury: mechanisms, medication, and dosage refinement
Jiahui Zhou, Na Li, Xinzhong Li, Jingxue Ye, Min Wang, Guibo Sun
Naunyn-Schmiedeberg's Archives of Pharmacology.2024;[Epub] CrossRef - Xiaojianzhong decoction attenuates gastric mucosal injury by activating the p62/Keap1/Nrf2 signaling pathway to inhibit ferroptosis
Juan Chen, Jiaxiang Zhang, Ting Chen, Shengchuan Bao, Jingtao Li, Hailiang Wei, Xin Hu, Yan Liang, Fanrong Liu, Shuguang Yan
Biomedicine & Pharmacotherapy.2022; 155: 113631. CrossRef - A measure of asymmetry for ordinal square contingency tables with an application to modified LANZA score data
Satoru Shinoda, Kouji Yamamoto, Kouji Tahata, Sadao Tomizawa
Journal of Applied Statistics.2020; 47(7): 1251. CrossRef
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Review
Focused Review Series: Endoscopic Management of Upper Gastrointestinal Bleeding
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Endoscopic Management of Peptic Ulcer Bleeding
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Joon Sung Kim, Sung Min Park, Byung-Wook Kim
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Clin Endosc 2015;48(2):106-111. Published online March 27, 2015
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DOI: https://doi.org/10.5946/ce.2015.48.2.106
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Abstract
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Acute upper gastrointestinal bleeding is a common medical emergency around the world and the major cause is peptic ulcer bleeding. Endoscopic treatment is fundamental for the management of peptic ulcer bleeding. Despite recent advances in endoscopic treatment, mortality from peptic ulcer bleeding has still remained high. This is because the disease often occurs in elderly patients with frequent comorbidities and are taking ulcerogenic medications. Therefore, the management of peptic ulcer bleeding is still a challenge for clinicians. This article reviews the various endoscopic methods available for management of peptic ulcer bleeding and the techniques in using these methods.
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Citations
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- Characteristics of Bleeding Peptic Ulcers and the Outcome after Endoscopic Therapy at a Tertiary Care Centre of Pakistan
Farwah Javed, Ghias Ul Hassan, Hafiz Habib Ur Rehman Khalil, Shafqat Rasool, Akif Dilshad, Bilal Nasir
Pakistan Journal of Health Sciences.2024; : 120. CrossRef - A review of endoscopic findings in upper gastrointestinal bleeding in Calabar, South-South Nigeria: A two-center study
Kooffreh-Ada Mbang, Ogbu E. Ngim, Okonkwo Uchenna C, Chukwudike Evaristus, Joanah Moses Ikobah, Uhegbu Kelechi, Itam-Eyo Asa E, Eko Benedicta A, Effiong Esther I, Ndoma-Egba Rowland
Calabar Journal of Health Sciences.2024; 7: 93. CrossRef - Utilizing Endoscopy for the Diagnosis of Acute Upper Gastrointestinal Bleeding
Muhammad Z Akhtar, Moeen U Huq, Rahul Adwani, Ali Usman, Sarmad Ijaz, Iqra Seher
Cureus.2023;[Epub] CrossRef - Anticoagulant Reversal in Gastrointestinal Bleeding: Review of Treatment Guidelines
Truman J. Milling, Majed A. Refaai, Neil Sengupta
Digestive Diseases and Sciences.2021; 66(11): 3698. CrossRef - EVALUATION OF OCCURRENCE OF H. PYLORI INFECTION AND EFFICACY OF ERADICATION THERAPY IN PEPTIC ULCER DISEASE
Prashant Dorkar S, Prakash Gurav, Santosh Dalvi, Prachi Dharmadhikari, Anand Devraj H
Journal of Evolution of Medical and Dental Sciences.2017; 6(80): 5661. CrossRef - Épidémiologie et facteurs pronostiques des hémorragies digestives hautes en Côte d’ivoire : étude prospective observationnelle multicentrique
M. Diakité, A. Toth’o, C. Assi, F. M. Bathaix, S. Koné, D. Bangoura, A. Koné, A. Ouattara, S. Doffou, A. Okon, N. N. Guessan, D. Soro, E. Allah-Kouadio, A. Coulibaly, A. M. J. Lohouès-Kouacou, B. M. Camara, H. Y. Kissi, A. K. Mahassadi, K. A. Attia, A. T.
Journal Africain d'Hépato-Gastroentérologie.2016; 10(2): 80. CrossRef - Alcohol Abuse Increases Rebleeding Risk and Mortality in Patients with Non-variceal Upper Gastrointestinal Bleeding
Jussi M. Kärkkäinen, Sami Miilunpohja, Tuomo Rantanen, Jenni M. Koskela, Johanna Jyrkkä, Juha Hartikainen, Hannu Paajanen
Digestive Diseases and Sciences.2015; 60(12): 3707. CrossRef - Ulcères gastroduodénaux hémorragiques : étude prospective observationnelle multicentrique en Côte-d’Ivoire
C. Assi, S. A. Thot’o, M. Diakité, M. F. Bathaix, S. Doffou, A. Ouattara, Y. H. Kissi, A. Coulibaly, D. Bangoura, D. Soro, E. Allah-Kouadio, K. A. Attia, M. J. Lohouès-Kouacou, T. Ndri-Yoman, B. M. Camara
Acta Endoscopica.2015; 45(6): 297. CrossRef
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Special Issue Articles of IDEN 2012
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Management of Non-Variceal Upper Gastrointestinal Bleeding
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Seung Young Kim, Jong Jin Hyun, Sung Woo Jung, Sang Woo Lee
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Clin Endosc 2012;45(3):220-223. Published online August 22, 2012
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DOI: https://doi.org/10.5946/ce.2012.45.3.220
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Abstract
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Upper gastrointestinal bleeding (UGIB) is a critical condition that demands a quick and effective medical management. Non-variceal UGIB, especially peptic ulcer bleeding is the most significant cause. Appropriate assessment and treatment have a major influence on the prognosis of patients with UGIB. Initial fluids resuscitation and/or transfusion of red blood cells are necessary in patients with clinical evidence of intravascular volume depletion. Endoscopy is essential for diagnosis and treatment of UGIB, and should be provided within 24 hours after presentation of UGIB. Pre-endoscopic use of intravenous proton pump inhibitor (PPI) can downstage endoscopic signs of hemorrhage. Post-endoscopic use of high-dose intravenous PPI can reduce the risk of rebleeding and further interventions such as repeated endoscopy and surgery. Eradication of Helicobacter pylori and withdrawal of non-steroidal anti-inflammatory drugs are recommended to prevent recurrent bleeding.
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Jun Shen, Lingna Ni, Changhong Zhu, Chunying Jiang, Wenyu Zhu, Yanzhi Bi
Digestive Diseases and Sciences.2024; 69(7): 2559. CrossRef - Clinical Presentations and Risk Factors of Gastrointestinal Bleeding in the Emergency Department: A Multicenter Retrospective Study
Abed H AlLehibi, Faisal F Alsubaie, Rayan H Alzahrani, Hussain A Ekhuraidah, Mohammed A Koshan, Nasser F Alotaibi, Fahad M Alotaibi, Hamdan S Alghamdi, Abdulrahman A Aljumah
Cureus.2024;[Epub] CrossRef - Peptic ulcer in nephrotic syndrome patients due to steroid therapy
Sreeja Ankireddypalli
Journal of Pharmacovigilance and Drug Research.2023; 4(1): 1. CrossRef - Pediatric upper gastrointestinal bleeding: a case series and review
C. B. Eke, J. O. T. Onyia, A. L. Eke
Annals of Clinical and Biomedical Research.2023;[Epub] CrossRef - Immunosuppressive agents are associated with peptic ulcer bleeding
Minoru Tomizawa, Fuminobu Shinozaki, Rumiko Hasegawa, Yoshinori Shirai, Yasufumi Motoyoshi, Takao Sugiyama, Shigenori Yamamoto, Naoki Ishige
Experimental and Therapeutic Medicine.2017; 13(5): 1927. CrossRef - Influence of light and nutrients on the vertical distribution of marine phytoplankton groups in the deep chlorophyll maximum
Mikel Latasa, Andrés Gutiérrez-Rodríguez, Ana Mª Mª Cabello, Renate Scharek
Scientia Marina.2016; 80(S1): 57. CrossRef - Elevated C-reactive protein level predicts lower gastrointestinal tract bleeding
MINORU TOMIZAWA, FUMINOBU SHINOZAKI, RUMIKO HASEGAWA, YOSHINORI SHIRAI, YASUFUMI MOTOYOSHI, TAKAO SUGIYAMA, SHIGENORI YAMAMOTO, NAOKI ISHIGE
Biomedical Reports.2016; 4(6): 711. CrossRef - Non-variceal upper gastrointestinal bleeding: Rescue treatment with a modified cyanoacrylate
Roberto Grassia, Pietro Capone, Elena Iiritano, Katerina Vjero, Fabrizio Cereatti, Mario Martinotti, Gabriele Rozzi, Federico Buffoli
World Journal of Gastroenterology.2016; 22(48): 10609. CrossRef - Low hemoglobin levels are associated with upper gastrointestinal bleeding
Minoru Tomizawa, Fuminobu Shinozaki, Rumiko Hasegawa, Yoshinori Shirai, Yasufumi Motoyoshi, Takao Sugiyama, Shigenori Yamamoto, Naoki Ishige
Biomedical Reports.2016; 5(3): 349. CrossRef - Change ratio of hemoglobin has predictive value for upper gastrointestinal bleeding
Minoru Tomizawa, Fuminobu Shinozaki, Rumiko Hasegawa, Yoshinori Shirai, Yasufumi Motoyoshi, Takao Sugiyama, Shigenori Yamamoto, Naoki Ishige
Biomedical Reports.2016; 5(4): 479. CrossRef - Laboratory test variables useful for distinguishing upper from lower gastrointestinal bleeding
Minoru Tomizawa
World Journal of Gastroenterology.2015; 21(20): 6246. CrossRef - Patient characteristics with high or low blood urea nitrogen in upper gastrointestinal bleeding
Minoru Tomizawa
World Journal of Gastroenterology.2015; 21(24): 7500. CrossRef - Endoscopy for Nonvariceal Upper Gastrointestinal Bleeding
Ki Bae Kim, Soon Man Yoon, Sei Jin Youn
Clinical Endoscopy.2014; 47(4): 315. CrossRef - Upper Endoscopy in International Digestive Endoscopy Network 2012: Towards Upper End of Quality
Il Ju Choi
Clinical Endoscopy.2012; 45(3): 217. CrossRef
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A Case of Double Pylorus Developed on the Gastric Body
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Jeong Bae Park, M.D. and Jin Ho Lee, M.D.*
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Korean J Gastrointest Endosc 2011;42(5):297-300. Published online May 28, 2011
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- Double pylorus is a rare disease. It is described by a double communication between the gastric antrum and the duodenal bulb. The cause of double pylorus is either a congenital abnormality or an acquired condition. It is believed to be mostly a complication of peptic ulcer disease. Most reports revealed conditions only for the gastric antrum. However, case reports describing the involvement of the gastric body are extremely rare. Herein, we report a case of a double pylorus that developed on the gastric body and we present a review of the literature. (Korean J Gastrointest Endosc 2011;42:297-300)
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A Large Hematoma Due to Benign Ulcer Perforation of the Gastric Fundus Resembling Submucosal Tumor
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Nam Yong Kim, M.D., Jung Hwan Oh, M.D., Soo Jin Choi, M.D., Seung Kyoung Kim, M.D., Youn Mi Song, M.D., Byung Soo Jie, M.D., Seung Hyun Oh, M.D. and Sang Wook Choi, M.D.
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Korean J Gastrointest Endosc 2010;41(3):159-162. Published online September 30, 2010
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- The gastric fundus is a rare site for benign ulcer and perforation to occur. A 47 year-old male presented to the emergency department with epigastric pain. An endoscopic examination revealed a submucosal tumor-like lesion with friable, superficial ulceration in the high body of the stomach. We performed surgical resection to rule out malignancy because of the lesion's large size and we found chronic gastric ulcer perforation, which was pathologically diagnosed. We presumed that the formation of the large hematoma, which mimicked a submucosal tumor, was a result of repeated bleeding, perforation and healing. We report here on a case of a large hematoma due to a benign gastric ulcer perforation in the fundus, and this all mimicked a submucosal tumor. (Korean J Gastrointest Endosc 2010;41:159-162)
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Clinical Characteristics of Bleeding Peptic Ulcer in Elderly Patients: Experience at a Single Secondary Referral Center
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Dong Wook Choi, M.D., Sung Joon Lee, M.D., Hee Jung Kim, M.D., Dae Joon Chung, M.D., Myoung Ok Park, M.D., Soo Chul Park, M.D., Dae Hee Choi, M.D. and Chang Don Kang, M.D.
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Korean J Gastrointest Endosc 2010;41(2):72-78. Published online August 30, 2010
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Abstract
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- Background
/Aims: Bleeding peptic ulcer in elderly patients is believed to differ from that found in younger patients. The purpose of this study was to evaluate the characteristics of bleeding peptic ulcer in elderly Korean patients.
Methods
We retrospectively evaluated 113 patients who were admitted to an emergency room for peptic ulcer bleeding from January 2006 to August 2008. For each patient, we investigated the clinical manifestations, the treatments and the hospital course.
Results
Peptic ulcer bleeding was more prevalent in elderly patients (n=63) than in younger patients (n=50). The elderly group had a higher incidence of comorbidities such as hypertension, stroke and ischemic heart disease, which might have be attributable to higher usage of aspirin and antiplatelet agents. There were no differences in the chief complaints or laboratory findings. The rate of Helicobacter pylori infection was lower in the elderly patients than that in the younger patients (41.3% vs. 62.0%, respectively, p=0.029). Four elderly patients and one younger patient died while in hospital, with one patient in each group dying due to bleeding.
Conclusions
Peptic ulcer bleeding in elderly patients was associated with higher usage of aspirin and antiplatelet agents. There were no significant differences between the elderly and younger patients for the initial clinical presentation, the hospital course or the mortality due to bleeding. (Korean J Gastrointest Endosc 2010;41:72-78)
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Pharmacological Therapy in Patients with Bleeding Peptic Ulcers
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Jin Il Kim, M.D.
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Korean J Gastrointest Endosc 2009;38(5):247-253. Published online May 30, 2009
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- The aim of pharmacological therapy in peptic ulcer disease is to increase the intragastric pH level above 6. The use of a proton pump inhibitor (PPI), a powerful gastric acid secretion inhibitor, has been proven as effective not only to control bleeding but also to reduce the rate of rebleeding. Maintainence of the intragastric pH level above 6 by the administration of a PPI prevents hemolysis caused by acid or pepsin and thereby promotes aggregation of platelets. Intragastric acid suppression can be achieved more effectively with continuous intravenous infusion of a PPI after intravenous bolus injection. However, oral administration of a PPI shows rapid onset, long duration of action and sufficient bioavailability. Therefore, both administration routes and pharmacologic properties of the drugs should be taken into account to gain the proper level of acid suppression above pH 6. Combination therapy with the use of endoscopic hemostatic treatment and intravenous PPI administration is known to result in the best outcome for peptic ulcer bleeding. In previous studies from South Korea, the use of combination therapy has also showed the best hemostaic outcome. However, pharmacological therapy with PPI alone can elevate and maintain intragastric pH above 6.0 and can result in hemostasis as similar to endoscopic hemostasis. (Korean J Gastrointest Endosc 2009;38:247-253)
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Comparison of the Efficacy of Bismuth Containing PPI-based Quadruple Therapy with PPI-based Triple Therapy Only as First-line Treatment for Helicobacter pylori Infection
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Hyun Jin Jo, M.D., Dong Ho Lee, M.D.*, Seung Joo Kang, M.D., Mi Na Kim, M.D., Su Hyun Kim, M.D., Jin Myung Park, M.D., Mun Sun Choi, M.D., Hyun Chae Jung, M.D., In Sung Song, M.D., Nayoung Kim, M.D.*, Sook Hyang Jung, M.D.*, Jin Wook Kim, M.D.*, Young Soo
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Korean J Gastrointest Endosc 2008;37(4):259-264. Published online October 30, 2008
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- Background/Aims: In recent years, increasing antimicrobial resistance has resulted in falling eradication rates with standard therapies. To overcome the falling eradication rates, rescue therapy have been suggested to be used. However, there is no surveillance of using bismuth- based regimen as first line Helicobacter pylori eradication therapy in Korea. This study aimed to assess the efficacy of bismuth containing PPI-based quadruple therapy as a first line treatment. Methods: From August 2007 through February 2008, 191 patients with Helicobacter pylori positive peptic ulcer disease (PUD) or chronic gastritis (CG) who received first line therapy for 7 days were retrospectively evaluated. 39, 37, 53, 62 patients received PAC (pantoprazole 40 mg, amoxicillin 1 g, clarithromycin 500 mg bid), L-PAC (pantoprazole 40 mg, amoxicillin 750 mg, clarithromycin 250 mg bid), PACB (PAC plus bismuth 300 mg bid), L-PACB (L-PAC plus bismuth 300 mg bid). Results: There was no significant difference in eradication rates between bismuth containing and non- containing group. However, in PUD, the eradication rate of PACB (95.2%) is somewhat higher than that of PAC (86.2%) without statistical significance. Conclusions: In PUD, Future study designed with a double-blind controlled large scale might reveal that PPI-based standard quadruple therapy containing a bismuth is superior to the standard triple therapy. (Korean J Gastrointest Endosc 2008;37: 259-264)
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Predictors of Rebleeding after Hemoclip Therapy for Treating High-risk Bleeding Ulcers: Hemoclip Therapy Alone was Comparable to Combination Treatmentwith Epinephrine Injection
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Hyo Jeong Oh, M.D., Tae Hyeon Kim, M.D., Geom Seog Seo, M.D., Chang Soo Choi, M.D., Eun Young Cho, M.D., Ki Hoon Kim, M.D., Sung O Seo, M.D., Ji Hye Kweon, M.D., Han Seung Ryu, M.D.,Suck Chei Choi, M.D., Haak Cheoul Kim, M.D. and Sae Ron Shin, M.D.*
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Korean J Gastrointest Endosc 2008;37(2):83-89. Published online August 30, 2008
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- Background/Aims: Active bleeding and non-bleeding visible vessels in patients with bleeding peptic ulcer are associated with a high risk of rebleeding. The aim of our study was to define the risk factors associated with failure of endoscopic hemostasis and rebleeding in patients with active peptic ulcer bleeding. Methods: We retrospectively reviewed 119 patients (90 men and 29 women; mean age, 60.14±14.67 years) with active peptic ulcer bleeding (spurting, oozing and/or non-bleeding visible vessel) and who were treated in Wonkwang Medical Center from January 2002 to January 2007. They were classified to endoscopic hemoclipping alone group (n=75) or endoscopic hemoclipping combined with epinephrine injection group (n=44), according to the therapeutic modality. Results: Initial hemostasis was achieved in the two groups (100%), and permanent hemostasis was achieved 71.4% in all the patients. Operation was done in eight patients (6.7%), and six patients (5%) in the two groups, respectively, died within 1 month after initial hemostasis because of bleeding related complications. Recurrent bleeding, the duration of the hospital stay, blood transfusion requirements, complications and the operation and mortality rates were not statistically different between the hemoclip alone and combination groups. Univariate analysis showed that rebleeding was related to the presence of shock on admission (p=0.01), complication (p=0.00), the pulse rate (>100/min) on admission (p=0.04), single ulcer (p=0.032), the level of hemoglobin (<8 g/dL) (p=0.02) and the volume of transfusion (>3 units) after the procedure (p=0.005) in all the patients. On the multivariate analysis that was adjusted for age and gender, the hemoglobin level (<8 g/dL) (odds ratio = 10.5) was the only significant predictor for early rebleeding. Conclusions: This result may suggest that the combination method does not provide a substantial advantage over hemoclipping alone for the hemostatic management of active peptic ulcers bleeding. A low hemoglobin level on admission may be useful to predict rebleeding after initial endoscopic hemostasis in patients with active peptic ulcer. However, this study was designed retrospectively, so the comparison between these two groups should be re-evaluated prospectively in a large, multicenter trial. (Korean J Gastrointest Endosc 2008;37:83-89)
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A Case of Mucosal Necrosis of the Stomach after Endoscopic Injection Therapy with Hypertonic Saline-Epinephrine (HS-E) for a Bleeding Peptic Ulcer with an Exposed Vessel
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Do Hwae Park, M.D., Sun Taek Choi, M.D., Min Jae Cho, M.D., Jung Hyun Ryu, M.D. and Dong Wok Lee, M.D.
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Korean J Gastrointest Endosc 2008;37(1):20-24. Published online July 30, 2008
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- Peptic ulcer bleeding is a frequent cause of upper G-I bleeding. Endoscopic injection therapy with hypertonic saline-epinephrine (HS-E) is a cost-effective and widely used therapy for hemostasis; however, 1∼3% of patients experience bleeding or perforation. A 70 year-old male patient was admitted with melena and hematemesis. An endoscopy on admission showed the presence of a 1 cm- sized well-demarcated ulcer with pulsatile bleeding at the lesser curvature of the distal antrum. Approximately 28 mL of HS-E solution was injected around the exposed vessel. Follow-up endoscopy performed 7 days later showed the presence of a 2 cm-sized newly developed mucosa necrosis at the lesser curvature of the pyloric channel, which was caused by ischemic necrosis of the gastric mucosa after HS-E injection. Endoscopic injection therapy with HS-E solution is a relatively safe technique, but mucosa necrosis can occur with the use of a dose of HS-E that is considered safe. We report a case of gastric mucosa necrosis following endoscopic HS-E injection therapy of a bleeding peptic ulcer. (Korean J Gastrointest Endosc 2008;37:20-24)
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A Case of Double Pylorus Caused by Peptic Ulcer in a Diabetic Patient
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Ji Hun Roh, M.D., Dae Gwan Im, M.D., Won Moon, M.D.*, Seun Ja Park, M.D.*, Moo In Park, M.D.*, Kyu Jong Kim, M.D.* and Yoon Jung Kim, M.D.†
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Korean J Gastrointest Endosc 2008;36(6):380-384. Published online June 30, 2008
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- A double pylorus, a fistulous communication between the gastric antrum and duodenal bulb, is a very rare anomaly. It appears as an acquired lesion in the majority of cases and mainly occurs in males with chronic obstructive pulmonary disease, chronic renal failure, chronic rheumatism, systemic lupus erythematosus, or diabetes. However, there are no previous reports of a double pylorus combined with diabetes mellitus in Korea. Recently we experienced a case of double pylorus caused by a peptic ulcer in 74-year-old man who had diabetes mellitus with complications. We report this case with a review of the literature. (Korean J Gastrointest Endosc 2008;36:380-384)
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Clinical Factors That Potentially Affect the Treatment Outcome of Helicobacter pylori Eradication Therapy with using a Standard Triple Regimen in Peptic Ulcer Patients
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Taek Man Nam, M.D., Dong Ho Lee, M.D., Kyung Phil Kang, M.D., Jung Hoon Lee, M.D., Jae Il Chung, M.D., Hyun Cheul Choi, M.D., Sang Hyub Lee, M.D., Young Soo Park, M.D., Jin Hyeok Hwang, M.D., Jin Wook Kim, M.D., Sook Hyang Jung, M.D., Nayoung Kim, M.D., H
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Korean J Gastrointest Endosc 2008;36(4):200-205. Published online April 30, 2008
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- Background
/Aims: Proton pump inhibitor (PPI) based triple therapy for Helicobacter pylori eradication has an approximately 20% treatment failure rate. The aim of this study is to examine the clinical factors that influence eradication of H. pylori in patients with peptic ulcers. Methods: We reviewed the medical records of 597 endoscopy-proven peptic ulcer and H. pylori-positive patients who were treated at our hospital between July 2004 and March 2007. The eradication rate and the effect of age, gender, smoking, alcohol drinking, activity and the location of ulcer and the kind of PPIs were examined. Results: 597 patients were treated with one-week triple therapy (PPI, amoxicillin 1 g, clarithromycin 500 mg all twice daily). The overall eradication rate was 80.2%. Eradication was significantly more successful in the patients with an age under 60, and in patients over 60 and who had a duodenal ulcer (83.2% vs 73.2%, respectively, p=0.005) or a gastric ulcer (82.5% vs 73.6%, respectively, p=0.041). There was no statistically significant difference according to gender, smoking, alcohol, the activity of the ulcer and the kind of PPIs. Conclusions: An age over 60 and gastric ulcer were associated with a lower H. pylori eradication rate in patients with peptic ulcers. Therefore, H. pylori eradication in old age patients and in patients with gastric ulcer should be managed differently and the treatment duration should be extended or a new treatment regime developed to overcome the lower eradication rate. (Korean J Gastrointest Endosc 2008;36:199-205)
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A Case of Extensive Necrosis of the Gastric Mucosa Following Ethanol Injection Therapy
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Su Min Jang, M.D., Jung Sik Choi, M.D., Hyun Seok Ryu, M.D., Jae Nam Lee, M.D., Sung Hoo Park, M.D., Sang Yong Lee, M.D. and Sang Ho Lee, M.D.
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Korean J Gastrointest Endosc 2008;36(3):154-158. Published online March 30, 2008
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- A bleeding peptic ulcer is the most common cause of upper gastrointestinal bleeding as well as for hospitalization and death. Many endoscopic methods of treating bleeding peptic ulcers are currently being studied and developed. Among them, the endoscopic pure ethanol injection therapy is favored because of its high efficacy, low cost, and rapid administration. Pure ethanol is an excellent agent to stop bleeding and manifests itslef by inducing tissue dehydration, fixation and vessel compression, which in turn causes arterial coagulation and tissue necrosis. However, an excessive injection volume may bring about extensive mucosal necrosis; hence, caution should be taken when deciding upon the injection volume and depth. We report a case of extensive necrosis of the gastric mucosa following endoscopic ethanol injection therapy of a bleeding peptic ulcer along with a review of the relevant literature. (Korean J Gastrointest Endosc 2008;36:154-158)
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The Effect of Second Look Endoscopy in Patients with Peptic Ulcer Bleeding
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Seung Yup Lee, M.D.*, Ji Hyun Park, M.D., Jong Hyup Lee, M.D., Se Hwan Kim, M.D.*, Chang Keun Park, M.D.*, Chang Min Cho, M.D., Won Young Tak, M.D., Young Oh Kweon, M.D., Sung Kook Kim, M.D. and Yong Hwan Choi, M.D.
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Korean J Gastrointest Endosc 2007;34(6):304-311. Published online June 30, 2007
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- Background/Aims: Performing second look endoscopy has been suggested in order to reduce recurrent bleeding. We assessed whether second look endoscopy reduces the risks of recurrent bleeding and the mortality rate for patients suffering with peptic ulcer bleeding. Methods: From February 2003 to June 2004, we have performed a prospective, randomized, controlled study of 141 patients with bleeding peptic ulcers, and these patients had been admitted to Kyungpook National University Hospital. Seventy patients in the study group were randomized to receive scheduled second look endoscopy. Seventy one patients in the control group were observed closely. Results: Seventeen of the admitted 141 patients were found to have rebleeding after initial therapeutic endoscopy. The overall rebleeding rate was 12.1%. Although the duration of the hospital stay was significantly lower for the study group than for the control group (p<0.05), the rebleeding rate was similar for both groups (p>0.05). The two groups were similar in respect to the mortality during the period of hospitalization, the volume of hypertonic saline epinephrine that was injected and the number of hemoclips that were used. Conclusions: From these results, we can conclude that scheduled second look endoscopy with retreatment did not reduce the risk of recurrent bleeding for patients with peptic ulcer bleeding. Therefore, scheduled second look endoscopy should be selectively performed for the patients who are at a high risk for peptic ulcer bleeding.
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Clinical Usefulness of Proton Pump Inhibitor Intravenous Treatment in Bleeding Peptic Ulcer
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Hang Lak Lee, M.D., Dong Soo Han, M.D., Byoung Kwan Son, M.D., Oh Young Lee, M.D., Yong Chul Jeon, M.D., Ju Hyun Sohn, M.D., Byung Chul Yoon, M.D., Ho Soon Choi, M.D., Joon Soo Hahm, M.D. and Jin Bae Kim, M.D.*
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Korean J Gastrointest Endosc 2007;34(2):71-75. Published online March 2, 2007
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- Background
/Aims: Recently, high dose PPI intravenous (IV) infusion after endoscopic hemostasis was found to decrease the recurrent bleeding rate. Therefore, we conducted this study to define the effect of endoscopic hemoclipping with PPI IV infusion on the recurrent bleeding rate. Methods: We conducted a double-blinded prospective randomized control study. A total of 35 patients were endoscopically diagnosed with bleeding peptic ulcer of Forrest classification Ia, Ib, IIa between Jan. 2003 and Sep. 2003 in our hospital. We carried out epinephrine injection therapy around the ulcer, followed by hemoclipping at the exposed vessel. After controlling for endoscopic bleeding, we randomly divided the patients into two groups. One group received a PPI IV infusion (pantoprazole 80 mg/day) and the other group received a placebo for three days. Results: Only one PPI IV-infused patient and one patient receiving placebo showed recurrent bleeding at two days after endoscopic therapy. The PPI IV infusion group showed 100% (17/17) initial hemostatic rate, 5.8% (1/17) recurrent bleeding rate within 3 days, 0% (0/17) recurrent bleeding rate after 3 days, and 0% (0/17) complication rate. For these same values, the placebo group showed 100% (18/18), 5.5% (1/18), 0% (0/18), and 0% (0/18), respectively. Conclusions: PPI IV infusion showed no addictive hemostatic effect. We think hemoclipping is a very effective hemostatic method, and PPI IV infusion may not be required after appropriate endoscopic management.
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A Case of Gastrogastric Fistula as a Complication of Benign Gastric Ulcer
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Sun Taek Choi, M.D., Jong Ryul Eun, M.D., Jung Hoon Lee, M.D., Yoon Seon Park, M.D., Jae Won Choi, M.D., Kook Hyun Kim, M.D., Byung Ik Jang, M.D., Tae Nyun Kim, M.D. and Heon Ju Lee, M.D.
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Korean J Gastrointest Endosc 2006;33(6):364-367. Published online December 30, 2006
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- Gastrogastric fistula is an extremely rare complication of benign gastric ulcer. We report a case of gastrogastric fistula in a 67-year-old male who presented with symptoms of dyspnea on exertion, pretibial pitting edema, and dyspepsia. He suffered from a peptic ulcer 9 years ago and from a gastric outlet obstruction 5 years ago. A gastrogastric fistula was observed by endoscopy, and the biopsy forceps were passed through the fistulous tract. The patient was treated with proton pump inhibitors, and H. pylori was eradicated. Gastrogastric fistula, unlike other types of gastric fistulas, can be cured using non-surgical therapy as long as complications such as peritonitis, gastric outlet obstruction, and bleeding do not occur. (Korean J Gastrointest Endosc 2006;33:364367)
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Comparison of the Eradication Rates of Quadruple Therapy between Non-ulcer Dyspepsia and Peptic Ulcer Disease as a Second-line Treatment for Helicobacter pylori Infection
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Su Jin Chung, M.D., Dong Ho Lee, M.D.*, Nayoung Kim, M.D.*, Sook Hyang Jung, M.D.*,Jin Wook Kim, M.D.*, Jin Hyeok Hwang, M.D.*, Young Soo Park, M.D.*, Kwang Hyuk Lee, M.D.*, Hyun Chae Jung, M.D. and In Sung Song, M.D.
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Korean J Gastrointest Endosc 2006;33(2):63-68. Published online August 30, 2006
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/Aims: Initial PPI-based triple therapy for a Helicobacter pylori (H. pylori) infection is less effective in patients with non-ulcer dyspepsia (NUD) than in those with peptic ulcer disease (PUD). However, there are no reports of the effects of second-line treatment. We retrospectively analyzed the difference in the eradication rates of second-line quadruple therapy between NUD and PUD patients. Methods: Between June 2003 and September 2005, patients who failed to respond to the initial PPI-based triple therapy, received seven days bismuth- based quadruple therapy as a second-line treatment. Four to six weeks after completing the schedule, a 13C-urea breath test was performed to detect H. pylori. Results: A total of 87 patients received second-line quadruple therapy. Of these, 43 patients had NUD and 44 patients had PUD (19 with gastric ulcers, 23 with duodenal ulcers, 2 with both ulcers). The eradication rates were 76.7% (33/43) and 90.9% (40/44) in the NUD and PUD groups, respectively. The eradication rates in the NUD group were significantly lower than those in the PUD group (p=0.034). Conclusions: The seven days bismuth-based second-line quadruple therapy for H. pylori infection appears to be less effective in patients with NUD than in those with PUD. Therefore, an extension of the treatment duration for quadruple therapy or a more potent regimen may be needed as a second-line therapy for NUD patients. (Korean J Gastrointest Endosc 2006;33:6368)
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A Comparison of the Effect of High-dose Oral and Intravenous Proton Pump Inhibitor on the Prevention of Rebleeding after Endoscopic Treatment of Bleeding Peptic Ulcers
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Jae Young Jang, M.D., Kwang Ro Joo, M.D., Young Hwangbo, M.D., Lae Ik Jeong, M.D., Sun Young Choi, M.D., Ji Heon Jung, M.D., Myung Jong Chae, M.D., Sang Kil Lee, M.D., Seok Ho Dong, M.D., Hyo Jong Kim, M.D., Byung-Ho Kim, M.D., Young Woon Chang, M.D., Jou
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Korean J Gastrointest Endosc 2006;33(1):6-11. Published online July 30, 2006
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/Aims: The use of proton pump inhibitor (PPI) prevents rebleeding by elevating the intragastric pH in patients with bleeding peptic ulcers after hemostasis has been achieved. We assessed if high-dose oral pantoprazole is as effective as high-dose intravenous pantoprazole for their ability to prevent rebleeding after having achieved initial hemostasis in patients with active bleeding or nonbleeding visible vessels. Methods: Thirty eight patients with bleeding peptic ulcers who had achieved initial hemostasis were enrolled in this randomized controlled trial. In the high-dose oral pantoprazole group (n=19), 40 mg of pantoprazole was given orally twice daily for 5 days. In the high-dose intravenous pantoprazole group (n=19), an 80 mg intravenous bolus of pantoprazole was given; this was followed by 8 mg/hour of continuous infusion daily for 3 days. Thereafter, 40 mg of pantoprazole was given orally once daily for 8 weeks. Results: The two groups were similar with respect to all the background variables. Rebleeding occurred in 2 patients (10.5%) in the intravenous group and in 1 patient in the oral group (5.3%) by day 30 after enrollment (p=1.000). There was no significant difference in terms of the number of therapeutic endoscopic sessions (1 vs. 1.13⁑0.52), the surgery (0% vs. 0%), the bleeding related mortality (0% vs. 0%), and the mean number of units of transfused blood. Conclusions: The high-dose oral pantoprazole is as effective as an intravenous administration in reducing rebleeding episodes in patients with bleeding peptic ulcers after successful endoscopic therapy. (Korean J Gastrointest Endosc 2006;33:611)
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Controlled Comparison of Endoscopic Epinephrine Injection and Endoscopic Argon Plasma Coagulation for the Treatment of Acute Peptic Ulcer Bleeding
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Kyung Im Pae, M.D., Sang Hyuk Lee, M.D., Hee Kim, M.D., Sang Bong Lee, M.D., Jae Ho Lee, M.D., Sung Jae Park, M.D., Sam Ryong Jee, M.D., Eun Taek Park, M.D., Yeon Jae Lee, M.D., Sang Young Seol, M.D. and Jung Myung Chung, M.D.
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Korean J Gastrointest Endosc 2006;32(4):239-245. Published online April 30, 2006
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/Aims: Endoscopic injection therapy with hypertonic saline Epinephrine (HSE) is the easiest and most widely used procedure for the management of peptic ulcer bleeding. Argon plasma coagulation (APC) is a recently introduced endoscopic hemostatic procedure. Thus, we performed a prospective trial to compare the hemostatic efficacy of APC and HSE. Methods: Forty patients with the diagnosis of bleeding ulcer were randomly assigned to receive either HSE (n=20) or APC (n=20) treatment during the period of September 2003 to April 2004. The two groups were matched for gender, age, site of bleeding, the endoscopic findings and the initial hemoglobin at the study baseline. Results: The bleeding was initially controlled in 18 patients (90%) of the APC group, and in 20 patients (100%) of the HSE group. Rebeeding occurred in one patient (5%) of the APC group and in 3 patients (15.5%) of the HSE group. The lengths of stay in the hospital were 11.7 days in the APC group and 10.7 days in the HSE group. Death occurred in 1 case in the APC group and in 1 case in the HSE group. The initial hemostatic efficacy showed no difference between the two groups. Conclusions: Argon plasma coagulation is as effective as hypertonic saline epinephrine injection for the initial management of acute peptic ulcer bleeding. (Korean J Gastrointest Endosc 2006;32:239245)
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Comparison of Hemostatic Efficacy between Epinephrine Injection Alone and a Combined Therapy with Hemoclip for Bleeding Peptic Ulcers
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Hyang Eun Seo, M.D., Myung Kwon Lee, M.D., Young Doo Lee, M.D., Seong Woo Jeon, M.D., Chang Min Cho, M.D., Won Young Tak, M.D., Young Oh Kwon, M.D., Sung Kook Kim, M.D., Yong Hwan Choi, M.D. and Jong Ryul Eun, M.D.*
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Korean J Gastrointest Endosc 2006;32(1):9-14. Published online January 30, 2006
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/Aims: Many studies have been performed to find the differences between using epinephrine injection alone and a combination therapy with hemoclip for bleeding peptic ulcer, but the results have been controversial. We retrospectively evaluated the hemostatic efficacy for epinephrine injection alone and injection combined with hemoclip for bleeding peptic ulcers. Methods: Four hundred patients were enrolled. They were assigned to one of the two groups: endoscopic hemostasis with injection of epinephrine (group I, n=156) and combined epinephrine injection with hemoclip (group II, n=244). Results: The continuous bleeding rate was significantly higher in group I than in group II. The recurrent bleeding rate was also significantly higher in group I than in group II. There were no statistical differences in the rates of death, emergency surgery and arterial embolization. The rates of continuous bleeding and the initial failure of hemostasis were higher for the patients with active bleeding on the initial endoscopy irrespective of the applied hemostatic methods. Conclusions: A combination of epinephrine injection and hemoclip is more effective than epinephrine injection alone for treating bleeding peptic ulcers. (Korean J Gastrointest Endosc 2006;32:914)
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Changes of Helicobacter pylori-Positive Peptic Ulcer Disease: Based on Data from a General Hospital
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Hye-Kyung Jung, M.D., Yoon Ju Na, M.D. and Il-Hwan Moon, M.D.
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Korean J Gastrointest Endosc 2006;32(1):1-8. Published online January 30, 2006
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/Aims: The incidence of Helicobacter pylori (H. pylori)-positive ulcer appears to be decreasing recently in the Western countries, and this has been influenced by the epidemiologic changes of H. pylori infection. Therefore, we aimed to determine the trends for the frequency of H. pylori-positive peptic ulcer disease (PUD) during recent 7 years in Korea. Methods: All 1,723 patients who had an endoscopic diagnosis of PUD from 1997 to 2003 were included in this study. H. pylori was considered present if the CLO test and/or the histology and the urea breath test were positive for H. pylori. Results: H. pylori-positive ulcers were seen in 1,354/1,723 patients (78.6%). The positive rate of H. pylori infection in patients with PUD was 85.9% in 1997, 79.2% in 1999, 76.2% in 2001 and 73.1% in 2003, and this showed a decreasing annual trend (p<0.001). H. pylori-positive PUD was more prevalent in duodenal ulcer than in gastric ulcer, and in the patients who were aged person and male. During the recent 7 years, H. pylori- positive PUD has decreased in patients with duodenal ulcer, and especially for patients younger than 60 years and in the male group. Conclusions: The frequency of H. pylori-positive PUD is possibly decreasing in the recent 7 years. Prospective, multicenter trial studies are necessary to confirm this trend and find out the cause. (Korean J Gastrointest Endosc 2006;32:18)
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Comparison of Hemostatic Effects between a Combination Therapy Including Endoscopic Injection Therapy and Omeprazole and a Single Intravenous Omeprazole Therapy in Patients with Bleeding Peptic Ulcers
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Seon Hee Lim, M.D., Nayoung Kim, M.D.* and Kye Heui Lee, M.D.†
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Korean J Gastrointest Endosc 2005;31(4):221-228. Published online October 30, 2005
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/Aims: This study was performed to test whether there is some difference between combined endoscopic therapy with PPI infusion and intravenous PPI therapy alone. Methods: A total of seventy-three high-risk patients with ulcer bleeding and non-bleeding visible vessels or fresh adherent clots resistant to irrigation were randomized to medical therapy [intravenous omeprazole therapy alone: 40 mg IV per day for 3∼5 days] or to endoscopic combination therapy [endoscopic epinephrine (1:10,000 in normal saline) or ethanol injection followed by intravenous omeprazole infusion]. Results: Patients were similar at study entry. Ulcer bleeding recurred in two patients who received combined endoscopic therapy (2/35, 5.7%) while ulcer bleeding recurred in ten patients who received intravenous omeprazole alone (10/38, 26.3%) (p<0.05). Two patients (2/35, 5.7%) in the combined therapy group and five patients (5/38, 13.2%) in the omeprazole infusion alone group had surgery for intractable bleeding (p=0.281). One patient in each group died within the hospital stays (p=0.953). Conclusions: The combination of endoscopic injection therapy with omeprazole infusion is superior to omeprazole infusion alone for preventing recurrent bleeding from ulcers with nonbleeding visible vessels or adherent clots. (Korean J Gastrointest Endosc 2005;31:221228)