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Vol. 161. Issue 6.
Pages 260-266 (September 2023)
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Vol. 161. Issue 6.
Pages 260-266 (September 2023)
Review
Peptic ulcer
Úlcera péptica
Isabel Lauciricaa, Pilar Garcia Iglesiasa, Xavier Calveta,b,
Corresponding author
xcalvet@tauli.cat

Corresponding author.
a Servei d’Aparell Digestiu, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT-CERCA), Departament de Medicina, Universitat Autònoma de Barcelona, Sabadell, Spain
b Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
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Tables (2)
Table 1. Gastrointestinal and cardiovascular risk stratification.
Table 2. Eradication of Helicobacter pylori in patients receiving ASA or NSAIDs.
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Abstract

Peptic ulcer disease (PUD) is a frequent pathology; although the incidence has decreased in recent years, it continues to be an important cause of morbidity and mortality associated with high healthcare costs. The most important risk factors are Helicobacter pylori infection and the use of non-steroidal anti-inflammatory drugs (NSAID). Most patients with PUD remain asymptomatic, with dyspepsia being the most frequent and often characteristic symptom. It can also debut with complications such as upper gastrointestinal bleeding, perforation or stenosis. The diagnostic technique of choice is upper gastrointestinal endoscopy. Treatment with proton pump inhibitors (PPIs), eradication of H. pylori and avoiding the use of NSAIDs are the basis of treatment. However, prevention is the best strategy, it includes an adequate indication of PPIs, investigation and treatment of H. pylori, avoiding NSAIDs or using those that are less gastrolesive.

Keywords:
Peptic ulcer disease
Helicobacter pylori
Gastroprotection
Non-steroidal anti-inflammatory drugs
COX-2 selective inhibitors
Upper gastrointestinal complications
Resumen

La enfermedad ulcerosa péptica (UP) es una patología frecuente; aunque su incidencia ha disminuido en los últimos años, sigue siendo una causa importante de morbimortalidad asociada a un elevado gasto sanitario. Los factores de riesgo más importantes son la infección por Helicobacter pylori y el uso de antiinflamatorios no esteroideos (AINE). La mayoría de los pacientes con UP permanecen asintomáticos, siendo la clínica más frecuente la dispepsia, a menudo característica (dispepsia ulcerosa). También puede debutar con complicaciones como hemorragia digestiva alta, perforación o estenosis. La técnica diagnóstica de elección es la endoscopia digestiva alta. El tratamiento con inhibidores de la bomba de protones (IBP), la erradicación de H. pylori y evitar el consumo de AINE son la base del tratamiento. Sin embargo, la prevención es la mejor estrategia, incluye una adecuada indicación de IBP, la investigación y tratamiento de H. pylori, evitar los AINE o utilizar aquellos menos gastrolesivos.

Palabras clave:
Úlcera péptica
Helicobacter pylori
Gastroprotección
Antiinflamatorios no esteroideos
Inhibidores selectivos COX-2
Complicaciones gastrointestinales

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