Helicobacter pylori and Nonsteroidal Antiinflammatory Drug Peptic Ulcers

Peptic ulcers are defects or breaks in the gastric or small intestinal mucosa that have depth and extend through the muscularis mucosae. The pathogenesis of peptic ulcers is multifactorial and arises from an imbalance of protective and aggressive factors such as when gastrointestinal mucosal defence mechanisms are impaired in the presence of gastric acid and pepsin. Infection with Helicobacter pylori and the use of nonsteroidal anti-inflammatory drugs and acetylsalicylic acid are major risk factors associated with peptic ulcers. In general, these factors disrupt normal mucosal defenses and repair, making the mucosa more susceptible to acid. This review covers the epidemiology of peptic ulcers, diagnostic tests for H. pylori, and treatment of peptic ulcers and H. pylori. The figure shows gastric biopsy samples stained with hematoxylin and eosin demonstrating chronic active gastritis both with and without the presence of H. pylori organisms. The tables list diagnostic tests for H pylori, and common treatment regimens for H. pylori. Key words: Helicobacter pylori, H. pylori, NSAID-related peptic ulcer, diagnosis of helicobacter pylori, H. pylori treatment, urea breath test, ASA after bleeding ulcer This review contains 1 highly rendered figure, 2 tables, and 54 references