Role of acid suppressants in prophylaxis of NSAID damage
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AbstractGastric acid contributes to the pathogenesis of non-steroidal anti-inflammatory drug (NSAID)induced ulceration via several mechanisms, including conversion of superficial to deeper injury, impairment of haemostasis, and interference with ulcer healing. The suppression of acid secretion has been shown to reduce the severity of NSAID-induced mucosal damage in experimental models and clinical studies. Current evidence indicates that proton pump inhibitors (PPIs) are the preferred treatment for the healing of gastric ulcers when NSAIDs cannot be discontinued. PPIs are superior to standard-dose H-2-receptor antagonists and equivalent to low-dose misoprostol in preventing NSAID-induced gastric ulcers. Whether there is any significant advantage of PPIs over higher doses of H-2-receptor antagonists or misoprostol is unknown. The efficacy of PPIs is enhanced in the presence of H. Pylori infection. Omeprazole has been shown to be effective for the secondary prevention of ulcer bleeding in H. pylori-infected NSAID users. The efficacy of PPIs for the prevention of ulcer complications in H. pylori-negative NSAID users remains uncertain.
All Author(s) ListChan FKL, Sung JJY
Journal nameBest Practice and Research: Clinical Gastroenterology
Volume Number15
Issue Number3
Pages433 - 445
LanguagesEnglish-United Kingdom
Keywordsacid suppression; H-2-receptor antagonists; Helicobacter pylori; misoprostol; non-steroidal anti-inflammatory drugs; proton pump inhibitors; ulcer
Web of Science Subject CategoriesGastroenterology & Hepatology; GASTROENTEROLOGY & HEPATOLOGY

Last updated on 2020-20-09 at 02:40