Absence of Helicobacter pylori is not protective against peptic ulcer bleeding in elderly on offending agents: lessons from an exceptionally low prevalence population

Aim. Helicobacter pylori (H. pylori) infection is exceptionally rare in population from the north-eastern region of Peninsular Malaysia. This provides us an opportunity to contemplate the future without H. pylori in acute non-variceal upper gas- trointestinal (GI) bleeding. Methods. All cases in...

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Main Authors: Yeong, Yeh Lee, Nordin, Noridah, Syed Abdul Aziz, Syed Hassan, Menon, Jayaram
Format: Article
Language:English
Published: PeerJ 2014
Subjects:
Online Access:http://eprints.usm.my/38237/
http://eprints.usm.my/38237/1/Absence_of_Helicobacter_pylori_is_not.pdf
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author Yeong, Yeh Lee
Nordin, Noridah
Syed Abdul Aziz, Syed Hassan
Menon, Jayaram
author_facet Yeong, Yeh Lee
Nordin, Noridah
Syed Abdul Aziz, Syed Hassan
Menon, Jayaram
author_sort Yeong, Yeh Lee
building USM Institutional Repository
collection Online Access
description Aim. Helicobacter pylori (H. pylori) infection is exceptionally rare in population from the north-eastern region of Peninsular Malaysia. This provides us an opportunity to contemplate the future without H. pylori in acute non-variceal upper gas- trointestinal (GI) bleeding. Methods. All cases in the GI registry with GI bleeding between 2003 and 2006 were reviewed. Cases with confirmed non-variceal aetiology were analysed. Rockall score >5 was considered high risk for bleeding and primary outcomes studied were in- hospital mortality, recurrent bleeding and need for surgery. Results. The incidence of non-variceal upper GI bleeding was 2.2/100,000 person- years. Peptic ulcer bleeding was the most common aetiology (1.8/100,000 person- years). In-hospital mortality (3.6%), recurrent bleeding (9.6%) and need for surgery (4.0%) were uncommon in this population with a largely low risk score (85.2% with score �5). Elderly were at greater risk for bleeding (mean 68.5 years, P D 0.01) espe- cially in the presence of duodenal ulcers (P D 0.04) despite gastric ulcers being more common. NSAIDs, aspirin and co-morbidities were the main risk factors. Conclusions. The absence of H. pylori infection may not reduce the risk of peptic ulcer bleeding in the presence of risk factors especially offending drugs in the elderly.
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spelling usm-382372018-01-04T09:20:36Z http://eprints.usm.my/38237/ Absence of Helicobacter pylori is not protective against peptic ulcer bleeding in elderly on offending agents: lessons from an exceptionally low prevalence population Yeong, Yeh Lee Nordin, Noridah Syed Abdul Aziz, Syed Hassan Menon, Jayaram RC799-869 Diseases of the digestive system. Gastroenterology Aim. Helicobacter pylori (H. pylori) infection is exceptionally rare in population from the north-eastern region of Peninsular Malaysia. This provides us an opportunity to contemplate the future without H. pylori in acute non-variceal upper gas- trointestinal (GI) bleeding. Methods. All cases in the GI registry with GI bleeding between 2003 and 2006 were reviewed. Cases with confirmed non-variceal aetiology were analysed. Rockall score >5 was considered high risk for bleeding and primary outcomes studied were in- hospital mortality, recurrent bleeding and need for surgery. Results. The incidence of non-variceal upper GI bleeding was 2.2/100,000 person- years. Peptic ulcer bleeding was the most common aetiology (1.8/100,000 person- years). In-hospital mortality (3.6%), recurrent bleeding (9.6%) and need for surgery (4.0%) were uncommon in this population with a largely low risk score (85.2% with score �5). Elderly were at greater risk for bleeding (mean 68.5 years, P D 0.01) espe- cially in the presence of duodenal ulcers (P D 0.04) despite gastric ulcers being more common. NSAIDs, aspirin and co-morbidities were the main risk factors. Conclusions. The absence of H. pylori infection may not reduce the risk of peptic ulcer bleeding in the presence of risk factors especially offending drugs in the elderly. PeerJ 2014-02 Article PeerReviewed application/pdf en http://eprints.usm.my/38237/1/Absence_of_Helicobacter_pylori_is_not.pdf Yeong, Yeh Lee and Nordin, Noridah and Syed Abdul Aziz, Syed Hassan and Menon, Jayaram (2014) Absence of Helicobacter pylori is not protective against peptic ulcer bleeding in elderly on offending agents: lessons from an exceptionally low prevalence population. PeerJ, 11 (2). pp. 1-13. ISSN 2167-8359 https://www.ncbi.nlm.nih.gov/pubmed/24688841
spellingShingle RC799-869 Diseases of the digestive system. Gastroenterology
Yeong, Yeh Lee
Nordin, Noridah
Syed Abdul Aziz, Syed Hassan
Menon, Jayaram
Absence of Helicobacter pylori is not protective against peptic ulcer bleeding in elderly on offending agents: lessons from an exceptionally low prevalence population
title Absence of Helicobacter pylori is not protective against peptic ulcer bleeding in elderly on offending agents: lessons from an exceptionally low prevalence population
title_full Absence of Helicobacter pylori is not protective against peptic ulcer bleeding in elderly on offending agents: lessons from an exceptionally low prevalence population
title_fullStr Absence of Helicobacter pylori is not protective against peptic ulcer bleeding in elderly on offending agents: lessons from an exceptionally low prevalence population
title_full_unstemmed Absence of Helicobacter pylori is not protective against peptic ulcer bleeding in elderly on offending agents: lessons from an exceptionally low prevalence population
title_short Absence of Helicobacter pylori is not protective against peptic ulcer bleeding in elderly on offending agents: lessons from an exceptionally low prevalence population
title_sort absence of helicobacter pylori is not protective against peptic ulcer bleeding in elderly on offending agents: lessons from an exceptionally low prevalence population
topic RC799-869 Diseases of the digestive system. Gastroenterology
url http://eprints.usm.my/38237/
http://eprints.usm.my/38237/
http://eprints.usm.my/38237/1/Absence_of_Helicobacter_pylori_is_not.pdf