{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T11:10:23Z","timestamp":1722337823385},"reference-count":0,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2000,1,1]],"date-time":"2000-01-01T00:00:00Z","timestamp":946684800000},"content-version":"vor","delay-in-days":365,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Canadian Journal of Gastroenterology and Hepatology"],"published-print":{"date-parts":[[1999,1]]},"abstract":"<jats:p>One major cause of peptic ulceration is the use of nonsteroidal anti\u2010inflammatory drugs (NSAIDs). The precise mechanisms through which NSAIDs cause peptic ulceration are unknown, but the discovery that they reduce the production of \u2018cytoprotective\u2019 prostaglandins led to the hypothesis that coadministration of exogenous prostaglandins heals and prevents NSAID\u2010induced gastroduodenal ulcers and other mucosal lesions. Studies using high doses of misoprostol have shown that it does have a protective effect; however, gastrointestinal intolerance of this prostaglandin E<jats:sub>2<\/jats:sub> analogue is common. Early indications that acid suppression was effective in the management of NSAID\u2010related peptic ulcers came from studies showing that gastric ulcers could be healed by omeprazole in patients who continued to take NSAIDs. Other studies suggested that acid suppression reduces the incidence of mucosal lesions but that standard dose ranitidine protects only against duodenal lesions. Subsequent studies reported that higher dose H<jats:sub>2<\/jats:sub> receptor antagonist therapy can protect against both gastric and duodenal ulcers during continued NSAID therapy. An ideal therapeutic strategy would heal NSAID\u2010related ulcers and prevent the development of new NSAID\u2010related lesions and complications in patients who are unable to discontinue NSAID therapy. A number of recent studies indicate that effective acid\u2010suppressive treatment with the proton pump inhibitor omeprazole can achieve these aims. Overall, data from recent studies show that acid suppression with the proton pump inhibitor omeprazole at a dose of 20 mg daily is the most effective means of healing NSAID\u2010associated gastroduodenal lesions and that it is the most effective prophylactic therapy. In the long run, the role of omeprazole will have to be evaluated with respect to its cost effectiveness compared with other strategies and with respect to the development of less damaging NSAIDs.<\/jats:p>","DOI":"10.1155\/1999\/715703","type":"journal-article","created":{"date-parts":[[2016,3,28]],"date-time":"2016-03-28T21:01:21Z","timestamp":1459198881000},"page":"135-142","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Management of Nonsteroidal Anti\u2010Inflammatory Drug\u2010Induced Gastroduodenal Disease by Acid Suppression"],"prefix":"10.1155","volume":"13","author":[{"given":"R","family":"Lad","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D","family":"Armstrong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[1999,5]]},"container-title":["Canadian Journal of Gastroenterology and Hepatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/cjgh\/1999\/715703.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/1999\/715703","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T10:35:53Z","timestamp":1722335753000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/1999\/715703"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1999,1]]},"references-count":0,"journal-issue":{"issue":"2","published-print":{"date-parts":[[1999,1]]}},"alternative-id":["10.1155\/1999\/715703"],"URL":"https:\/\/doi.org\/10.1155\/1999\/715703","archive":["Portico"],"relation":{},"ISSN":["2291-2789","2291-2797"],"issn-type":[{"type":"print","value":"2291-2789"},{"type":"electronic","value":"2291-2797"}],"subject":[],"published":{"date-parts":[[1999,1]]},"assertion":[{"value":"1999-05-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}