ROLE OF GASTROINTESTINAL ENDOSCOPY BASED ON THE UPDATED EVIDENCE-BASED CLINICAL PRACTICE GUIDELINES FOR PEPTIC ULCER DISEASE 2020

Abstract

Helicobacter pylori infection and the use of drugs, including nonsteroidal anti-inflammatory drugs (NSAIDs) and low-dose aspirin (LDA), are the major risk factors for the development of peptic ulcers. However, in Japan, the prevalence of peptic ulcer is rapidly decreasing due to a reduction in the H. pylori infection rate to 30-40％ and increased use of potent acid secretion inhibitors, such as proton pump inhibitors and potassium-competitive acid blockers. In addition to peptic ulcer, prevalent use of NSAIDs and LDA increases the aging of society and the rate of drug-induced gastric mucosal injury/ulcer in clinical practice. Accumulating data led to the updation of the evidence-based clinical practice guidelines for peptic ulcer disease in 2020, which incorporated recommendations for using new acid secretion inhibitors, selecting H. pylori eradication regimens, and treating NSAIDs/aspirin users and patients with idiopathic ulcers. Here, we discuss the usefulness of the updated guidelines for peptic ulcer management and the role of gastrointestinal endoscopy in the treatment of peptic ulcers caused by H. pylori infection and NSAID use.