pylori infection and history of H. pylori eradication in bleeding PUD were significantly lower than in nonbleeding PUD. When H. pylori status and aspirin/antiplatelet agent use were combined, the highest risk of bleeding peptic ulcers was found among H. pylori-negative selleck products patients with a history of aspirin/antiplatelet agent use compared with H. pylori-positive patients with no history of aspirin/antiplatelet agent use. Testing for H. pylori should be performed in patients admitted for upper gastrointestinal (GI) bleeding, even

though a high number of emergency admissions are attributable to NSAIDs or aspirin use, especially in the elderly. Previous studies have shown that H. pylori infection increases the risk of NSAID-related

GI injury [5]. This finding is in line with a previous meta-analysis indicating that prophylactic H. pylori eradication may help reduce the risk of both gastric and duodenal ulcers and their complications, including bleeding in chronic users of NSAIDs [6]. In patients with recent upper GI bleeding, diagnosing H. pylori infection is imperative, but Selleck isocitrate dehydrogenase inhibitor difficult. In fact, the hemorrhage itself (given the pH buffering effect of blood in the GI tract) and the use of PPI and antibiotics may influence the results of invasive and noninvasive testing in diagnosing H. pylori. According to a single-center Italian study [7], invasive diagnostic invasive methods can be used to identify H. pylori infection in patients with bleeding peptic ulcers. This observational,

prospective study assessed the prevalence of H. pylori infection in occasional and chronic low-dose aspirin (NSAID/ASA) users admitted 上海皓元医药股份有限公司 for a bleeding peptic ulcer who had undergone a very early upper endoscopy. A concomitant search for H. pylori by serology, rapid urease test, histologic examination, and bacterial culture was conducted. Forty-four (55.0%) patients were considered infected. The most efficient test used to detect H. pylori infection was culture of the biopsy specimens with a sensitivity of 86.4% a specificity of 100% and 92.5% accuracy. Previous studies have found that mortality from peptic ulcer complications range between 4 and 30%. Mortality, up to eightfold, increased when treatment was delayed for more than 24 hours; complications increased by threefold. Laparoscopic simple closure operations for peptic ulcer perforation are now widely accepted worldwide, favoring the less-invasive simple closure technique with postoperative H. pylori eradication. A systematic review and meta-analysis of patients with duodenal ulcer perforation compared the simple closure method plus postoperative H. pylori eradication therapy to simple closure and antisecretory noneradication therapy, showing that H. pylori eradication after simple closure of duodenal ulcer perforation provided better results than the operation plus antisecretory noneradication therapy for preventing ulcer recurrence [8].