TY - JOUR
T1 - Evidence-based clinical practice guidelines for peptic ulcer disease 2015
AU - Satoh, Kiichi
AU - Yoshino, Junji
AU - Akamatsu, Taiji
AU - Itoh, Toshiyuki
AU - Kato, Mototsugu
AU - Kamada, Tomoari
AU - Takagi, Atsushi
AU - Chiba, Toshimi
AU - Nomura, Sachiyo
AU - Mizokami, Yuji
AU - Murakami, Kazunari
AU - Sakamoto, Choitsu
AU - Hiraishi, Hideyuki
AU - Ichinose, Masao
AU - Uemura, Naomi
AU - Goto, Hidemi
AU - Joh, Takashi
AU - Miwa, Hiroto
AU - Sugano, Kentaro
AU - Shimosegawa, Tooru
N1 - Funding Information:
This article was supported by a Grant-in-Aid from the JSGE. The authors thank investigators and supporters for participating in the studies. The authors express special appreciation to Dr. Toshihito Kosaka (Fujita Health University School of Medicine) and Dr. Toshiyuki Sakurai (National Center for Global Health and Medicine).
Publisher Copyright:
© 2016, Japanese Society of Gastroenterology.
PY - 2016/3/1
Y1 - 2016/3/1
N2 - The Japanese Society of Gastroenterology (JSGE) revised the evidence-based clinical practice guidelines for peptic ulcer disease in 2014 and has created an English version. The revised guidelines consist of seven items: bleeding gastric and duodenal ulcers, Helicobacter pylori (H. pylori) eradication therapy, non-eradication therapy, drug-induced ulcer, non-H. pylori, non-nonsteroidal anti-inflammatory drug (NSAID) ulcer, surgical treatment, and conservative therapy for perforation and stenosis. Ninety clinical questions (CQs) were developed, and a literature search was performed for the CQs using the Medline, Cochrane, and Igaku Chuo Zasshi databases between 1983 and June 2012. The guideline was developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Therapy is initially provided for ulcer complications. Perforation or stenosis is treated with surgery or conservatively. Ulcer bleeding is first treated by endoscopic hemostasis. If it fails, surgery or interventional radiology is chosen. Second, medical therapy is provided. In cases of NSAID-related ulcers, use of NSAIDs is stopped, and anti-ulcer therapy is provided. If NSAID use must continue, the ulcer is treated with a proton pump inhibitor (PPI) or prostaglandin analog. In cases with no NSAID use, H. pylori-positive patients receive eradication and anti-ulcer therapy. If first-line eradication therapy fails, second-line therapy is given. In cases of non-H. pylori, non-NSAID ulcers or H. pylori-positive patients with no indication for eradication therapy, non-eradication therapy is provided. The first choice is PPI therapy, and the second choice is histamine 2-receptor antagonist therapy. After initial therapy, maintenance therapy is provided to prevent ulcer relapse.
AB - The Japanese Society of Gastroenterology (JSGE) revised the evidence-based clinical practice guidelines for peptic ulcer disease in 2014 and has created an English version. The revised guidelines consist of seven items: bleeding gastric and duodenal ulcers, Helicobacter pylori (H. pylori) eradication therapy, non-eradication therapy, drug-induced ulcer, non-H. pylori, non-nonsteroidal anti-inflammatory drug (NSAID) ulcer, surgical treatment, and conservative therapy for perforation and stenosis. Ninety clinical questions (CQs) were developed, and a literature search was performed for the CQs using the Medline, Cochrane, and Igaku Chuo Zasshi databases between 1983 and June 2012. The guideline was developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Therapy is initially provided for ulcer complications. Perforation or stenosis is treated with surgery or conservatively. Ulcer bleeding is first treated by endoscopic hemostasis. If it fails, surgery or interventional radiology is chosen. Second, medical therapy is provided. In cases of NSAID-related ulcers, use of NSAIDs is stopped, and anti-ulcer therapy is provided. If NSAID use must continue, the ulcer is treated with a proton pump inhibitor (PPI) or prostaglandin analog. In cases with no NSAID use, H. pylori-positive patients receive eradication and anti-ulcer therapy. If first-line eradication therapy fails, second-line therapy is given. In cases of non-H. pylori, non-NSAID ulcers or H. pylori-positive patients with no indication for eradication therapy, non-eradication therapy is provided. The first choice is PPI therapy, and the second choice is histamine 2-receptor antagonist therapy. After initial therapy, maintenance therapy is provided to prevent ulcer relapse.
KW - Cyclooxygenase-2
KW - Duodenal ulcer
KW - Gastric ulcer
KW - Helicobacter pylori eradication
KW - Low-dose aspirin
KW - Nonsteroidal anti-inflammatory drug
KW - Peptic ulcer
KW - Stomach ulcer
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U2 - 10.1007/s00535-016-1166-4
DO - 10.1007/s00535-016-1166-4
M3 - Review article
C2 - 26879862
AN - SCOPUS:84959138314
VL - 51
SP - 177
EP - 194
JO - Journal of Gastroenterology
JF - Journal of Gastroenterology
SN - 0944-1174
IS - 3
ER -