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BioMed Research International
Volume 2014, Article ID 658108, 10 pages
http://dx.doi.org/10.1155/2014/658108
Review Article

Diagnosis, Treatment, and Outcome in Patients with Bleeding Peptic Ulcers and Helicobacter pylori Infections

1Division of Gastroenterology, Department of Internal Medicine, Cathay General Hospital, Taipei 10650, Taiwan
2School of Medicine, Fu-Jen Catholic University, New Taipei City 24205, Taiwan
3Division of Gastroenterology, Department of Internal Medicine, Hsinchu Cathay General Hospital, No. 678, Section 2, Junghua Road, Hsinchu 30060, Taiwan
4School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan

Received 15 April 2014; Accepted 10 June 2014; Published 30 June 2014

Academic Editor: Deng-Chyang Wu

Copyright © 2014 Ting-Chun Huang and Chia-Long Lee. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Upper gastrointestinal (UGI) bleeding is the most frequently encountered complication of peptic ulcer disease. Helicobacter pylori (Hp) infection and nonsteroidal anti-inflammatory drug (NSAID) administration are two independent risk factors for UGI bleeding. Therefore, testing for and diagnosing Hp infection are essential for every patient with UGI hemorrhage. The presence of the infection is usually underestimated in cases of bleeding peptic ulcers. A rapid urease test (RUT), with or without histology, is usually the first test performed during endoscopy. If the initial diagnostic test is negative, a delayed 13C-urea breath test (UBT) or serology should be performed. Once an infection is diagnosed, antibiotic treatment is advocated. Sufficient evidence supports the concept that Hp infection eradication can heal the ulcer and reduce the likelihood of rebleeding. With increased awareness of the effects of Hp infection, the etiologies of bleeding peptic ulcers have shifted to NSAID use, old age, and disease comorbidity.