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Enfermedad de la úlcera péptica enfermedad péptica.
Peter Malfertheiner1, Francis K L Chan, Kenneth E L McColl
1Department of Gastroenterology, Hepatology, and Infectious Diseases, Otto-von-Guericke University, Magdeburg, Germany. peter.malfertheiner@med.ovgu.de
Lancet (London, England)
|August 18, 2009
Resumen
La incidencia de la enfermedad de úlcera péptica ha disminuido debido a los avances en los supresores de ácido y el tratamiento de Helicobacter pylori. Sin embargo, los antiinflamatorios no esteroideos (AINE) y la aspirina todavía causan úlceras, lo que requiere estrategias de manejo continuo.
Área de la Ciencia:
- Gastroenterología y Gastroenterología.
- Epidemiología La epidemiología.
- Farmacología Farmacología.
Sus antecedentes:
- Históricamente, la enfermedad de úlcera péptica ha causado una morbilidad y mortalidad significativas.
- Las últimas décadas muestran una marcada disminución en la incidencia de la enfermedad de úlcera péptica.
- Los factores clave incluyen potentes supresores de ácido y el descubrimiento de Helicobacter pylori.
Objetivo del estudio:
- Revisar la revolución en la comprensión y el manejo de la enfermedad de úlcera péptica en los últimos 25 años.
- Examinar el impacto de los medicamentos antiinflamatorios no esteroideos (AINE) y la aspirina en dosis bajas en la enfermedad ulcerosa.
- Discutir estrategias para las úlceras inducidas por fármacos y las úlceras H. pylori-negativas, NSAID-negativas.
Principales métodos:
- Revisión de las tendencias epidemiológicas en la enfermedad de la úlcera péptica.
- Análisis del impacto del descubrimiento de Helicobacter pylori en la comprensión y el tratamiento de la enfermedad.
- Examen del papel de los AINE y la aspirina en la actual patogénesis de las úlceras.
- Discusión de estrategias terapéuticas y preventivas para las úlceras inducidas por medicamentos.
Principales resultados:
- Una disminución significativa en las tasas de enfermedad de úlcera péptica atribuida a los supresores de ácido y la erradicación de H. pylori.
- Los antiinflamatorios no esteroideos (AINE) y la aspirina en dosis bajas son ahora las principales causas de úlceras pépticas.
- Las úlceras H. pylori negativas y AINE negativas representan un desafío clínico raro pero creciente.
Conclusiones:
- Los avances en la medicina han transformado el manejo de la enfermedad de úlcera péptica.
- El uso de AINE y aspirina continúa impulsando la enfermedad ulcerosa, lo que requiere prevención y tratamiento específicos.
- Se necesita más investigación para el manejo de casos complejos de úlceras, incluidas las úlceras H. pylori-negativas, NSAID-negativas.
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