Painkillers develop peptic ulcer bleeding, warns expert

By PMA RASHEED 

9 Feb 2011, The Gulf Today

EXCESSIVE use of painkillers for joint and bone diseases leads to increased incidences of peptic ulcer bleed (PUB) in the UAE, warns an expert.
The PUB is a common and potentially life-threatening complication of peptic ulcer disease.
Compared to similar cases across the world, the percentage in the UAE is high as it is a multicultural country.
Dr Saeed Al Shaikh, a Gastroenterologist at Dubai Healthcare City and Welcare Hospital, has called for regular general checkups to treat gastroesophageal reflux disease (GERD) and the PUB diseases in the emirates.
Speaking at a medical symposium organised by AstraZeneca Gulf, Dr Shaikh warned that that if not treated properly, the GERD could lead to serious complications, such as inflammation, narrowing of throat, ulcers and bleeding. “The PUB is a major development of stomach ulcers, and it occurs in all ages, especially in older people who excessively use painkillers for bone and joint diseases. It is common in the UAE as it is in other parts of the world, especially amongst elderly and ladies,” Dr Al Shaikh pointed out.
Professor Ernst Kuipers, chair of Gastroenterology, Herpetology and Internal Medicine Departments at Erasmus University Medical Centre in Netherlands, elaborated that a peptic ulcer is a deep and sharply demarcated break in the lining of the stomach.
“Currently, approximately 20 per cent of patients with the PUB may experience a re-bleed even after endoscopic treatment. Such patients are at a three-fold risk of death,” he said.
“When the disease is in the stomach it is described as a gastric ulcer and when in the duodenum (the part of the small intestine between the stomach and the jejunum) its called a duodenal ulcer. The PUB occurs when the ulcer erodes into an underlying blood vessel. In Europe, the PUB affects approximately 50 people per 100,000 people every year,” Kuipers added.
“Patients in most of the cases are not aware of the bleeding, which makes it more critical. They often see black excreta or black or dark red vomiting. If not treated, the PUB can cause death. In many cases, rebleeding occurs due to non-adherence to treatment or eating restricted foods,” he noted.
According to Kuipers, upto 15 per cent of the patients die as a result of the severe condition all over the world.
“Continuous usage of painkillers damages the superficial layer of the stomach that bleeds when the damage becomes bigger and deeper,” he revealed.
Dr Fadel Shaker, the medical manager AstraZeneca Gulf, said that until now there has not been an approved pharmacological treatment to reduce the risk of rebleeding after endoscopic treatment.
“Newly introduced Esomeprazole medication for the treatment of heartburn and other symptoms associated with gastroesophageal acid reflux (GERD) and the PUB has been approved by health authorities in Europe and the UAE,” he added.
“The medicines prevents peptic ulcer rebleeding in adults and fills a significant gap to manage the PUB after endoscopic treatment,” he pointed out.

According to him, it’s the first proton pump inhibitor (PPI) to be indicated in the UAE and Europe for prevention of rebleeding following therapeutic endoscopy for acute bleeding gastric or duodenal ulcers.