CRIM 2653 Lecture Notes - Lecture 39: Mesenteric Ischemia, Gastric Mucosa, Helicobacter Pylori
23 May 2020
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Ulcer recurrence < 10%/ yr following h. pylori eradication. Low-dose asa combined with coxib has similar pud rate vs. nsaids alone. *so if you have to use these drugs, use the lowest dose and for the shortest possible timeframe. General: history: abdominal pain, ex. ulcer, mesenteric ischemia, malignancy, retching (mallory-weiss tear, medications : nsaid/asa/cox inhibitor, family or personal history of coagulopathy, comorbid illness ex. liver, cardiac disease, prior surgery for pud, arterial bypass graft. *ppis shut down acid production within hours, and work by inhibiting those k+ and h+ pumps in stomach = this is the irreversible binding. Ppis: reduce acid secretion (increase ph), block final step in acid production, by inhibition of h+-k+ atpase, high ph promotes stable clot (which is required for hemostasis) *incr. risk of c-difficile assoc. diarrhea, drops in vit b12 and mg levels, and incr. risk of fractures, and community acquired pneumonia.
