Current Opinions in Bleeding Peptic Ulcer Disease
Department of Surgery, Southend University Hospital, UK
- *Corresponding Author:
- Ayantunde AA
Department of Surgery, Southend University Hospital
40 Rowan Walk, Eastwood, Leigh-on-Sea Essex SS9 5PL, UK
E-mail: [email protected]
Received date: December 17, 2013; Accepted date: February 19, 2014; Published date: February 27, 2014
Citation: Ayantunde AA (2014) Current Opinions in Bleeding Peptic Ulcer Disease. J Gastroint Dig Syst 4:172. doi:10.4172/2161-069X.1000172
Copyright: © 2014 Ayantunde AA. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Peptic ulcer is the commonest cause of acute upper gastrointestinal bleeding accounting for the majority of cases of non-variceal haemorrhage. Its incidence is rising in the older population and accounts for a considerable clinical and economic burden. Methods: A MEDLINE/EMBASE based search of the literature from 1985 to 2013 inclusive was performed using the medical subject terms peptic ulcer disease, duodenal ulcer, upper gastrointestinal non-variceal bleeding, endoscopic therapy, pharmacological therapy, haemostasis, surgery for bleeding peptic ulcer. Manual retrieval of relevant articles in the reference lists of the original papers was then performed. Conclusions were drawn from published evidence on the current opinions and treatment options available for bleeding peptic ulcer disease. Results: The incidence of bleeding peptic ulcer disease and hospital admission rates has not changed significantly in the last two decades. Progress in the development and the use of endoscopic and pharmacological therapies has revolutionised the management of bleeding peptic ulcer disease. However, the improved survival accrued to these advances is offset by the mortality in the increasing elderly population with associated medical co-morbid factors. The operation for bleeding peptic ulcer disease is still being performed in small but significant number of patients who fail endoscopy. Conclusion: The management of patients with bleeding peptic ulcer disease requires a multidisciplinary approach. Clinical presentation, patient’s age, presence of co-morbidity and the endoscopic appearances of the ulcer including the presence of stigmata of recent haemorrhage are used to determine the subsequent level of care. Endoscopic therapy provides unique opportunities for early diagnosis and maintenance of primary haemostasis in bleeding peptic ulcer disease.