000060858 001__ 60858
000060858 005__ 20200221144318.0
000060858 0247_ $$2doi$$a10.3748/wjg.v22.i48.10477
000060858 0248_ $$2sideral$$a97879
000060858 037__ $$aART-2016-97879
000060858 041__ $$aeng
000060858 100__ $$aLué, A.
000060858 245__ $$aProtons pump inhibitor treatment and lower gastrointestinal bleeding: Balancing risks and benefits
000060858 260__ $$c2016
000060858 5060_ $$aAccess copy available to the general public$$fUnrestricted
000060858 5203_ $$aProton pump inhibitors (PPIs) represent a milestone in the treatment of acid-related diseases, and are the mainstay in preventing upper gastrointestinal bleeding in high-risk patients treated with nonsteroidal antiinflammatory drugs (NSAIDs) or low-dose aspirin. However, this beneficial effect does not extend to the lower gastrointestinal tract. PPIs do not prevent NSAID or aspirin-associated lower gastrointestinal bleeding (LGB). PPIs may increase both small bowel injury related to NSAIDs and low-dose aspirin treatment and the risk of LGB. Recent studies suggested that altering intestinal microbiota by PPIs may be involved in the pathogenesis of NSAID-enteropathy. An increase in LGB hospitalization rates may occur more frequently in older patients with more comorbidities and are associated with high hospital resource utilization, longer hospitalization, and increased mortality. Preventive strategies for NSAID and aspirin-associated gastrointestinal bleeding should be directed toward preventing both upper and lower gastrointestinal damage. Future research should be directed toward identifying patients at low-risk for gastrointestinal events associated with the use of NSAIDs or aspirin to avoid inappropriate PPI prescribing. Alternatively, the efficacy of new pharmacologic strategies should be evaluated in high-risk groups, with the aim of reducing the risk of both upper and lower gastrointestinal bleeding in these patients.
000060858 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/
000060858 590__ $$a3.365$$b2016
000060858 591__ $$aGASTROENTEROLOGY & HEPATOLOGY$$b29 / 79 = 0.367$$c2016$$dQ2$$eT2
000060858 592__ $$a1.272$$b2016
000060858 593__ $$aMedicine (miscellaneous)$$c2016$$dQ1
000060858 593__ $$aGastroenterology$$c2016$$dQ1
000060858 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000060858 700__ $$0(orcid)0000-0001-5932-2889$$aLanas, A.$$uUniversidad de Zaragoza
000060858 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000060858 773__ $$g22, 48 (2016), 10477-10481$$tWORLD JOURNAL OF GASTROENTEROLOGY$$x1007-9327
000060858 8564_ $$s715520$$uhttps://zaguan.unizar.es/record/60858/files/texto_completo.pdf$$yVersión publicada
000060858 8564_ $$s8951$$uhttps://zaguan.unizar.es/record/60858/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000060858 909CO $$ooai:zaguan.unizar.es:60858$$particulos$$pdriver
000060858 951__ $$a2020-02-21-13:40:26
000060858 980__ $$aARTICLE