| Theme | Review of New Japanese Guideline for Peptic Ulcer Treatment |
|---|---|
| Title | Role of Gastroprotective Drugs in Treatment and Prevention of Peptic Ulcers : Review of New Japanese Guidelines |
| Publish Date | 2010/12 |
| [ Summary ] | We review the new Japanese Guidelines produced by the Japanese Society of Gastroenterology, and point out new evidence concerning gastroprotective drugs. Two interesting points are illustrated. One is gastric ulcer healing following Helicobacter pylori (H. pylori) eradication therapy. One week of H. pylori eradication therapy is insufficient to produce healing of gastric ulcers. There is strong evidence that proton pump inhibitors promote gastric ulcer healing following eradication therapy. However, it is unknown whether gastroprotective drugs are adequate to produce healing of ulcers after one week of eradication therapy. Rebamipide significantly promoted gastric ulcer healing following one week of eradication therapy, as compared to a placebo. Another factor is the prevention of non-steroidal antiinflammatory drug (NSAID) induced gastric ulcers. NSAIDs, including aspirin, are widely used for elderly patients. Administration of prostaglandin derivatives or PPIs has been proven to be effective for both prevention and treatment of gastric ulcers associated with NSAIDs. These drugs are recommended for treatment of NSAID-induced gastric ulcers in the Japanese guidelines. Rebamipide prevented NSAID-induced peptic ulcers as effectively as misoprostol in patients receiving long-term NSAID therapy. Rebamipide may be a useful therapeutic option for the prevention of NSAID-induced gastrointestinal ulcers because of its therapeutic effects and safety. Recent advances in diagnostic methods, including video capsule endoscopy and balloon endoscopy, have enabled us to examine the entire small intestine. We recognize that the prevalence of small intestinal damage in patients taking NSAIDs is high. Gastroprotective drugs may also be useful for minimal intestinal damage. |