Long-term nonsteroidal anti-inflammatory drug use and gastroduodenal injury

The role of Helicobacter pylori

David S. Loeb, Nicholas J. Talley, David A. Ahlquist, Herschel A. Carpenter, Alan R. Zinsmeister

Research output: Contribution to journalArticle

125 Citations (Scopus)

Abstract

To evaluate the association of Helicobacter pylori infection with gastroduodenal ulceration and symptoms in rheumatoid arthritis patients chronically ingesting nonsteroidal anti-inflammatory drugs (NSAIDs), a population-based study was performed. Residents of Olmsted County, Minnesota, and surrounding counties, 40 years of age and over with active rheumatoid arthritis taking therapeutic doses of NSAIDs daily for 6 months or more were evaluated (n = 50). An endoscopic score from 0 to 5 was assigned and independently confirmed. Biopsies were obtained from the antrum and gastric body for the presence of H. pylori. A symptom score based on the frequency and severity of dyspeptic symptoms was calculated. Substantial mucosal injury (≥ grade 2) was observed at endoscopy in 33 patients (66%); 14 (28%) had chronic ulcers. Eleven of the community patients with rheumatoid arthritis (22%) were H. pylori positive; adjusting for age, the prevalence of H. pylori was not significantly different to that in 67 healthy controls (25%). One or more upper gastrointestinal symptoms were reported by 19 of the community patients (38%). Adjusting for age, community rheumatoid arthritis patients with H. pylori were not more likely to have visible mucosal damage or dyspepsia, but were significantly more likely to have histological gastritis (P < 0.01). The results suggest that, in primarily asymptomatic persons from the community with rheumatoid arthritis taking daily NSAIDs for 6 months or more, H. pylori infection is not related to the severity of visible mucosal injury.

Original languageEnglish (US)
Pages (from-to)1899-1905
Number of pages7
JournalGastroenterology
Volume102
Issue number6
StatePublished - 1992

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Helicobacter pylori
Anti-Inflammatory Agents
Rheumatoid Arthritis
Wounds and Injuries
Pharmaceutical Preparations
Helicobacter Infections
Pyloric Antrum
Dyspepsia
Gastritis
Endoscopy
Ulcer
Biopsy
Population

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Loeb, D. S., Talley, N. J., Ahlquist, D. A., Carpenter, H. A., & Zinsmeister, A. R. (1992). Long-term nonsteroidal anti-inflammatory drug use and gastroduodenal injury: The role of Helicobacter pylori. Gastroenterology, 102(6), 1899-1905.

Long-term nonsteroidal anti-inflammatory drug use and gastroduodenal injury : The role of Helicobacter pylori. / Loeb, David S.; Talley, Nicholas J.; Ahlquist, David A.; Carpenter, Herschel A.; Zinsmeister, Alan R.

In: Gastroenterology, Vol. 102, No. 6, 1992, p. 1899-1905.

Research output: Contribution to journalArticle

Loeb, DS, Talley, NJ, Ahlquist, DA, Carpenter, HA & Zinsmeister, AR 1992, 'Long-term nonsteroidal anti-inflammatory drug use and gastroduodenal injury: The role of Helicobacter pylori', Gastroenterology, vol. 102, no. 6, pp. 1899-1905.
Loeb DS, Talley NJ, Ahlquist DA, Carpenter HA, Zinsmeister AR. Long-term nonsteroidal anti-inflammatory drug use and gastroduodenal injury: The role of Helicobacter pylori. Gastroenterology. 1992;102(6):1899-1905.
Loeb, David S. ; Talley, Nicholas J. ; Ahlquist, David A. ; Carpenter, Herschel A. ; Zinsmeister, Alan R. / Long-term nonsteroidal anti-inflammatory drug use and gastroduodenal injury : The role of Helicobacter pylori. In: Gastroenterology. 1992 ; Vol. 102, No. 6. pp. 1899-1905.
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