Evidence-based clinical practice guidelines for peptic ulcer disease 2015

Area of Science:

• Gastroenterology
• Clinical Practice Guidelines

Background:

• Peptic ulcer disease management requires updated clinical practice guidelines.
• The Japanese Society of Gastroenterology (JSGE) previously issued guidelines in 2014.

Purpose of the Study:

• To provide an English version of the revised evidence-based clinical practice guidelines for peptic ulcer disease.
• To address key aspects of peptic ulcer disease including bleeding, H. pylori eradication, NSAID-induced ulcers, and complications like perforation and stenosis.

Main Methods:

• Development of 90 clinical questions (CQs) based on the JSGE 2014 guidelines.
• Comprehensive literature search from 1983 to June 2012 across Medline, Cochrane, and Igaku Chuo Zasshi databases.
• Application of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system for guideline development.

Main Results:

• Guidelines cover seven key areas: bleeding ulcers, H. pylori eradication, non-eradication therapy, drug-induced ulcers, non-H. pylori/non-NSAID ulcers, surgical treatment, and conservative management for perforation/stenosis.
• Therapeutic strategies prioritize ulcer complications, followed by medical interventions.
• Treatment algorithms differentiate based on etiology (NSAID-related, H. pylori-positive, or other) and patient factors.

Conclusions:

• The guidelines offer a structured approach to peptic ulcer disease management, integrating evidence-based recommendations.
• Treatment pathways emphasize initial management of complications, followed by etiological treatment and maintenance therapy to prevent relapse.
• The English version facilitates broader access to JSGE's updated recommendations for clinicians worldwide.