Prevalence Of Peptic Ulcer Research Articles

Potency and acceptability of oral misoprostol compared with vaginal misoprostol prior to first trimester abortions

Present study was done to assess the effectiveness and acceptability of oral misoprostol compared with vaginal misoprostol for cervical priming before termination of first trimester pregnancy. Recently, prostaglandin E1 analogue misoprostol has caught much attention as cervical priming agent. Prostaglandins are used in different doses and different routes considering the different available results. Misoprostol was originally marketed for prevention of peptic ulcers caused by Prostaglandin synthetase inhibitor (NSAIDS) but now it has a widespread role in obstetric practice specially as a cervical priming agent. The aim of present study is to compare oral misoprostol versus vaginal misoprostol for cervical ripening and to assess its acceptability among women.

Cloning and expression of Helicobacter pylori Neutrophil-activating protein fused to the 6xHis tag in Escherichia coli

Helicobacter pylori (Hp) has been strongly implicated as a causative factor in peptic ulcer disease, and in significantly increasing the risk of developing gastric cancer. Commercial vaccines nowadays have shown less efficiency on preventing the disease caused by Hp. Therefore, this study was performed to clone nap gene from Hp and over-express the encoded protein (NAP) in E. coli cells. NAP (Neutrophil-activating protein) has been considered as a potential antigen of Hp, can be used to produce peptic ulcer prevention vaccine. The obtained results showed that E. coli OmniMAX and E. coli BL21 (DE3) strains carrying recombinant plasmid pET11a-nap were cloned successfully and remained stable in medium supplemented with ampicillin. Over-expression of NAP protein fused with 6xHis in E. coli was demonstrated via SDS-PAGE and Western blot. The result revealed that the highest target protein production level (29.73%) was obtained in the medium added 0.5 mM IPTG at 37 oC after 6 hours of induction. This is the preliminary research for over-production and purification of Hp-NAP protein that may be used in further applications.

Assessment of Knowledge Regarding Prevention of Peptic Ulcer among Adolescents in Selected College at Shimla, Himachal Pradesh, India

Introduction: Gastrointestinal system is the most essential system of the body which has got a relation withdiet in turn helps in maintaining normal growth and development and normal functioning of the body.Materials and Method: In order to achieve the objectives of the study, a descriptive study approach wasadopted for the study. A closed ended questionnaire was used to assess the knowledge of adolescents onpeptic ulcer and its prevention. Probability multi-stage sampling technique was appropriate to select 200adolescents from a selected pre-university colleges of Shimla as the sample.Results: The assessment of knowledge among adolescents regarding peptic ulcer and its prevention revealsthat the highest percentage (47.5%) of the students had moderate level of knowledge regarding preventionof peptic ulcer, 18..5% of adolescents had good knowledge, 0.5% had excellent knowledge and 33.5% hadpoor knowledge regarding peptic ulcer. The overall knowledge on peptic ulcer and its preventive measures is49.58% with mean and standard deviation 15.87+ 4.082. The area-wise analysis revealed that the adolescentsscored highest in the area prevention of peptic ulcer (50.89%) with mean and standard deviation 4.58+1.56..Findings of the study revealed that knowledge among adolescents regarding prevention of peptic ulcer ismoderate.Conclusion: Prevention is always considered as better than cure, the identification and understanding of therisk factors is the important step of preventing peptic ulcer.

Study to Assess the Effectiveness of STP on Risk Factors and Prevention of Peptic Ulcer

Study to Assess the Effectiveness of STP on Risk Factors and Prevention of Peptic Ulcer

Efficacy of Combined Crude Extract of Curcuma longa and Moringa oleifera in the Prevention of Peptic Ulcer in Albino Rats

Aim: This study is aimed at investigating the prophylactic efficacy of combined extract of Curcuma longa and Moringa oleifera leaf against indomethacin–induced ulcer in albino rats.
 Place and Duration of Study: This research was carried out in Ibadan Nigeria between November 2017 and January, 2018.
 Methods: Fifty (50) healthy male albino rats with body weights between 150 and 200 g were used for this study. They were randomly divided into ten groups of five rats each. Group I was administered omeprazole for seven days, group II was administered Moringa oleifera leaf solution for seven days, group III was administered Curcuma longa solution for seven days, group IV was administered Curcuma longa + Moringa oleifera leaf solution for seven days and group V was administered distilled water for seven days. This group served as the control group. Groups VI, VII, VIII, IX and X were treated similarly as groups I, II, III, IV and V respectively but were treated for fourteen days. At the end of the administration, the animals were fasted for 18 hours and 50 mg/kg of indomethacin was administered orally (p.o) to the rats. After 8 hours of indomethacin administration, the animals were anesthetized by chloroform anesthesia and sacrificed and the stomach removed and opened along the greater curvature, rinsed with copious volume of normal saline and pinned on a board to expose the stomach clearly.
 Results: Animals treated with combined extracts of Curcuma longa + Moringa oleifera leaf showed significantly increased ulcer inhibition (71.64%, 75.57%) when compared with those of Curcuma longa (44.10%, 46.53%) and Moringa oleifera leaf (53.43%, 57.58) respectively but showed no significant difference when compared with that of omeprazole (72.60%, 74.29%), the reference drug after 7 and 14 days pre-treatment respectively.
 Conclusion: The combined extract has a greater prophylactic efficacy against indomethacin-induced ulcer than individual extracts and gave similar result as omeprazole. The combined extract of Curcuma longa + Moringa oleifera leaf could be used as a prophylaxis against peptic ulcer disease.

Evaluation of upper gastrointestinal system in acromegaly

PurposeAcromegaly causes multiple comorbidities, including gastrointestinal disorders. The present study evaluated the frequency of hiatal hernia and other upper gastrointestinal pathologies in patients with acromegaly, given that visceromegaly and reduced nitric oxide levels in acromegaly may impact diaphragm and lower esophageal sphincter function and thus possibly the development of hiatal hernia. MethodsThirty-nine acromegaly patients followed our center for the previous 6months were recruited. Upper gastrointestinal endoscopy was performed once in all patients to evaluate hiatal hernia, esophagitis, gastroduodenitis and ulcer. ResultsTwenty-three patients were male and 16 female. Upper gastrointestinal endoscopy found hiatal hernia, esophagitis and gastroduodenitis or gastric ulcer in 3 (7.6%), 2 (1.7%) and 31 (79.4%) patients, respectively. Pathologic examination of gastric antrum biopsy found intestinal metaplasia in 12 (30.7%) patients, and Helicobacter pylori was positive in 13 (33.3%). There were no significant correlations between age, gender, disease duration or preoperative adenoma size on the one hand and hiatal hernia or other endoscopic findings on the other. Similarly, neither surgical success nor recurrence was associated with endoscopic findings. ConclusionsThe study showed that prevalence of gastritis, duodenitis, peptic ulcer and intestinal metaplasia is higher and prevalence of hiatal hernia lower in acromegaly patients than in the healthy population. Various unknown disease-related pathophysiological conditions may play a role; there is a need for further studies.

Cytoprotective agent for peptic ulcer prevention in patients taking dual antiplatelet agents: A randomized, double-blind placebo-controlled trial.

Long-term use of dual antiplatelets is increasing, and most patients need primary peptic ulcer prophylaxis. The long-term use of proton pump inhibitors (PPIs) is associated with adverse events. We evaluated the efficacy of rebamipide for peptic ulcer prevention. This randomized controlled trial was conducted between July 2014 and November 2017. Patients receiving dual antiplatelets for ≥1year with no history of peptic ulcer bleeding or perforation were recruited and randomly assigned to the rebamipide (300mg/day) group or the placebo group. Patients who used proton pump inhibitors were excluded. The primary endpoint was a new mucosal break on esophagogastroduodenoscopy at 3 or 12months after treatment initiation. The secondary endpoints were hematocrit changes from the baseline, gastrointestinal bleeding, and chest pain. Antiplatelet function was assessed. In total, 95 eligible patients were identified; 12 were excluded, and 83 patients were randomized, with 66 (79.5%) and 59 (71.1%) patients eligible at the 3- and 12-month follow ups, respectively. The baseline characteristics were equivalent between the groups. During the 12months of follow up, 13 patients (43.3%) taking rebamipide and 19 (65.5%) taking the placebo experienced mucosal injury (P=0.07). Two patients (6.7%) taking rebamipide and eight (27.6%) taking the placebo had peptic ulcers ≥5mm or <5mm with pigmented spots (P=0.03). The changes in hematocrit were not different between the two groups. Neither bleeding ulcers nor chest pain was observed. Rebamipide is safe and may prevent peptic ulcers ≥5mm in diameter or those with pigmented spots in patients receiving dual antiplatelets for 1year (NCT02166008).

Su1260 – Low Prevalence of Helicobacter Pylori-Positive Peptic Ulcers in the United States

Su1260 – Low Prevalence of Helicobacter Pylori-Positive Peptic Ulcers in the United States

Risk factors for peptic ulcer disease in patients with end-stage renal disease receiving dialysis.

BackgroundCompared to the general population, patients with end-stage renal disease have more gastrointestinal symptoms and a higher prevalence of peptic ulcer. Risk factors for peptic ulcer disease in patients with end-stage renal disease, however, remain poorly defined. This study aims to better identify those risk factors.MethodsWe analyzed 577 patients with end-stage renal disease from 2004 to 2016. We excluded patients with life-threatening conditions. All patients underwent upper endoscopy. We analyzed patient medical records, medication history, and endoscopic findings. Independent sample t test, chi-square test, Fisher’s exact test, and multiple logistic regression analysis were used in statistical analyses.ResultsOf the 577 patients with end-stage renal disease, 174 had peptic ulcer disease (gastric or duodenal ulcer). Patients on hemodialysis had a higher prevalence of peptic ulcer disease than those on peritoneal dialysis. Patients with peptic ulcer disease had lower serum albumin level and higher blood urea nitrogen level than those without peptic ulcer disease. Positive scores on two or more nutritional indices (albumin, serum cholesterol, uric acid, and creatinine levels) were associated with peptic ulcer disease in end-stage renal disease.ConclusionHemodialysis, hypoalbuminemia, and multiple malnutrition indices were associated with the prevalence of peptic ulcer disease in patients with end-stage renal disease receiving dialysis.

Peptic Ulcer Disease: A Brief Review of Conventional Therapy and Herbal Treatment Options.

Peptic ulcer is a chronic disease affecting up to 10% of the world’s population. The formation of peptic ulcers depends on the presence of gastric juice pH and the decrease in mucosal defenses. Non-steroidal anti-inflammatory drugs (NSAIDs) and Helicobacter pylori (H. pylori) infection are the two major factors disrupting the mucosal resistance to injury. Conventional treatments of peptic ulcers, such as proton pump inhibitors (PPIs) and histamine-2 (H2) receptor antagonists, have demonstrated adverse effects, relapses, and various drug interactions. On the other hand, medicinal plants and their chemical compounds are useful in the prevention and treatment of numerous diseases. Hence, this review presents common medicinal plants that may be used for the treatment or prevention of peptic ulcers.

Prescription des mesures adjuvantes aux corticothérapies systémiques prolongées en fonction de la spécialité du prescripteur

IntroductionIn order to prevent some glucocorticoid-induced adverse events, adjuvant measures are often associated with prescription of long-term (≥3 months) systemic glucocorticoid therapy. The main objective of this study was to study the association between prescription of these measures and the medical specialty of the prescriber. MethodsA cross-sectional study was conducted through the website www.cortisone-info.fr. Patients visiting this website and receiving long-term glucocorticoid therapy were asked to fill a questionnaire asking them, among other things, the specialty of the physician who initiated glucocorticoids and the adjuvant measures they were prescribed at treatment initiation. ResultsIn all, 1383 patients answered the questionnaire and 843 (61%) questionnaires were analyzed (women: 70.6%, median age: 59 [44–70] years, current glucocorticoid dosage: 12.5 [5–30] mg/day, maximum dose: 42 [20–60] mg/day). The main prescribers were rheumatologists (30.5%) and internists (17.3%). Most adjuvant measures were heterogeneously prescribed and depended largely on the specialty of the prescribing physician. Some probably unnecessary measures in most patients (potassium supplementation, prevention of peptic ulcer, low-sodium diet) were frequently prescribed while other consensual measures (prevention of osteoporosis, vaccinations) were prescribed to less than half of patients. In multivariable analyses, most of the studied measures were more frequently prescribed by internists than by colleagues of other specialties. Pneumologists more often vaccinated patients against influenza or pneumococcus than their colleagues. ConclusionAdjuvant measures to long-term glucocorticoid therapy are heterogeneously prescribed. The prescriptions depend largely on the medical specialty of the prescribing physician.

A Study to assess the Effectiveness of Structured Teaching Programme (STP) on Knowledge regarding risk factors and prevention of Peptic ulcer among the middle age Population in selected urban area at Mehsana City

A Study to assess the Effectiveness of Structured Teaching Programme (STP) on Knowledge regarding risk factors and prevention of Peptic ulcer among the middle age Population in selected urban area at Mehsana City

Assessment of Knowledge Regarding Prevention of Peptic Ulcer among Adolescents in Selected College at Shimla, Himachal Pradesh, India

Assessment of Knowledge Regarding Prevention of Peptic Ulcer among Adolescents in Selected College at Shimla, Himachal Pradesh, India

High prevalence of asymptomatic peptic ulcers diagnosed during screening endoscopy in patients with cirrhosis.

Background:Peptic ulcer disease (PUD) is more prevalent in cirrhotics and this may aggravate prognosis. We investigated the prevalence of PUD in cirrhotics and its potential association with Helicobacter pylori (H. pylori) infection, the underlying etiology and severity of liver disease, and other manifestations of portal hypertension (PH).Methods:We enrolled consecutive asymptomatic cirrhotic patients who underwent screening endoscopy in a tertiary hospital during a 12-month period. We recorded the presence of PUD and the endoscopic findings associated with PH. H. pylori infection was documented through either histology or CLO-test. The diagnosis of cirrhosis was based on elastography, liver biopsy or a combination of clinical, biochemical and imaging data.Results:One hundred patients (M/F: 54/46, mean age: 61±14 years) were included in the analysis. Viral hepatitis (37%) and alcohol (22%) were the most common causes of cirrhosis. Child-Pugh stage was A/B/C: 60/35/5. PUD was found in 19 patients (14 gastric, 5 duodenal). H. pylori infection was diagnosed in 54%. Varices were detected in 59% (39% needed treatment). PH gastropathy was present in 81% (severe in 33%). The presence of PUD was unrelated to the etiology and the severity of liver disease or to other endoscopic manifestations of PH. No correlation was found between PUD and H. pylori infection.Conclusions:A high prevalence of PUD was observed in our cirrhotic patients, although they were asymptomatic and had no known risk factors of ulcerogenicity. The value of screening endoscopy for the early diagnosis and treatment of PUD in cirrhotics deserves further investigation.

Role of Clinical Decision and Management of Patients Admitted with Perforated Peptic Ulcer to Damascus Hospital (Al Moujtahed), Damascus, Syria

As far as we know, there has been no previous published studies concerning the incidence of perforated peptic ulcer (stomach, duodenum) and its related risk factors in Syria, and their managements in association with the current Syrian conflict, that precipitated limited access to admitting such cases to over populated beds. This study addressing the burden shouldered by Health professionals, and aimed to determine the Prevalence of perforated peptic ulcer (PPU) in patients admitted to Damascus Hospital between 24/11/2015-4/11/2017, needless to mention also describe the values of making the diagnosis on clinical bases, and based on the principles that we are under the insult of our current dilemma namely civil conflict in Syria, precipitated shortening of all necessities to provide good and acceptable management with hope of achieving absolute cure.

Prevalence of Peptic Ulcer Disease in Patients with Chronic Obstructive Pulmonary Disease in a Teaching Hospital

Objective: Chronic obstructive pulmonary disease is major cause of chronic morbidity and mortality throughout the world. Peptic ulcer disease is not uncommon in patients with chronic medical condition like chronic obstructive pulmonary disease. Patients who smoke or have chronic obstructive pulmonary disease carry higher risk of developing peptic ulcer disease. The aim of this study was to saw the prevalence of peptic ulcer disease as well as prevalence variation in relation with severity of chronic obstructive pulmonary disease. Methods: This was cross sectional observational study from January, 2013 to January, 2014 in department of Medicine, Rajshahi Medical College Hospital, Rajshahi who fulfilled the inclusion &amp; exclusion criteria were selected in this study. Data was collected in a prefixed questionnaire form and data collection sheet after taking informed consent of the patient. All the patients were investigated with spirometry, chest X-ray, complete blood count, electrocardiogram, echocardiography and endoscopy upper gastrointestinal tract. Results: Among the study population 100% patient was male. Most of them were 51-60 years (42.4%) with mean aged was 56.48 ± 7.64 years. Endoscopic finding was normal (55, 85.94%), gastritis (02, 3.12%), gastric erosion (03, 4.69%), peptic ulcer (03, 4.69%) and peptic ulcer with active bleeding (01, 1.56%).Prevalence of peptic ulcer disease in this study was 14.06%.Conclusion: Prevalence of peptic ulcer was more in chronic obstructive pulmonary disease patient than normal population. The prevalence of peptic ulcer diseases also increases with the severity of the disease.TAJ 2017; 30(1): 30-35

Peptic Ulcer among Patient with Ischemic Heart Disease at Taif City

Objectives: A peptic ulcer is a common problem that occurred because of H. pylori infection and the use of nonsteroidal anti-inflammatory drugs. Epigastric pain is the most common symptom. It is characterized by burning sensation occur after meals. This study was conducted to assess peptic ulcer among patient with ischemic heart disease at TAIF city. Methods: We conducted a cross sectional study on 426 ischemic heart disease patients. The data were collected through interview with the patients and self-report questionnaire which include a set of socio-demographic variables (gender, age, sex, weight, city, smoking, drinking tea and coffee) and clinical variables (systolic, diastolic, pulse, respiratory rate, oxygen saturation) in 1/8/2017 to 17/9/2017 and approved by King Faisal medical complex in Taif city. Both genders above 40 years were included and excluded patients below them and patients without ischemic heart disease. Statistical analysis was performed using SPSS. Results: Of the 426 ischemic heart disease patients at TAIF city who were investigated, 229 (53.8%) were female and 197 (46.2) were male. The mean age was 64.5 years (SD=12), ranging from 25 to 100 years. As for BMI, 297(69.7%) had overweight and obese. The mean systolic was 143.49 (SD=22.9). The mean diastolic was 76.31. In total, 24.2% of patients were classified as Peptic ulcer and 75.8% had Non-Peptic ulcer symptoms. No statistical significance was found between the mean of Non-Peptic ulcer and Peptic ulcer patients in terms of oxygen saturation, systolic, diastolic, age, pulse and respiratory rate. A significant statistical relation was found for City that they lived in (P=.027), type of oils that he/she use it for cooking at home (P=.008), stress (P=0.002) and sex (P=.032) for Non-Peptic ulcer symptoms and Peptic ulcer symptoms. Conclusion: This study demonstrated a low prevalence of peptic ulcer among ischemic heart disease patients at TAIF city. Insomnia was associated with gender, type of oil, stress and city that they lived in but no significant association with BMI, taking aspirin, doing exercise and smoking.

Time trends in the prevalence of cancer and non-cancer diseases among older U.S. adults: Medicare-based analysis.

Longer lifespan is accompanied by a larger number of chronic diseases among older adults. Because of a growing proportion of older adults in the U.S., this brings the problem of age-related morbidity to the forefront as a major contributor to rising medical expenditures. We evaluated 15-year time trends (from 1998 to 2013) in the prevalence of 48 acute and chronic non-cancer diseases and cancers in older U.S. adults aged 65+ and estimated the annual percentage changes of these prevalence trends using SEER-Medicare and HRS-Medicare data. We found that age-adjusted prevalence of cancers of kidney, pancreas, and melanoma, as well as diabetes, renal disease, limb fracture, depression, anemia, weight deficiency, dementia/Alzheimer's disease, drug/medications abuse and several other diseases/conditions increased over time. Conversely, prevalence of myocardial infarction, heart failure, cardiomyopathy, pneumonia/influenza, peptic ulcer, and gastrointestinal bleeding, among others, decreased over time. There are also diseases whose prevalence did not change substantially over time, e.g., a group of fast progressing cancers and rheumatoid arthritis. Analysis of trends of multiple diseases performed simultaneously within one study design with focus on the same time interval and the same population for all diseases allowed us to provide insight into the epidemiology of these conditions and identify the most alarming and/or unexpected trends and trade-offs. The obtained results can be used for health expenditures planning for growing sector of older adults in the U.S.

The effects of proton pump inhibitor on hepatic vascular responsiveness and hemodynamics in cirrhotic rats

BackgroundLiver cirrhosis is associated with increased intrahepatic resistance due to hepatic fibrosis and exaggerated vasoconstriction. Recent studies have indicated that proton pump inhibitors (PPIs), in addition to acid suppression, modulate vasoactive substances and vasoresponsiveness. PPIs are frequently prescribed in patients with cirrhosis due to a higher prevalence of peptic ulcers, however other impacts are unknown. MethodsLiver cirrhosis was induced in Sprague–Dawley rats with common bile duct ligation (BDL). On the 29th day after BDL and after hemodynamic measurements, the intrahepatic vascular responsiveness to high concentrations of endothelin-1 (ET-1) was evaluated after preincubation with (1) Krebs solution (vehicle), (2) esomeprazole (30 μM), or (3) esomeprazole plus Nω-nitro l-arginine (NNA, a non-selective NO synthase (NOS) inhibitor, 10−4 M). After perfusion, the hepatic protein expressions of endothelial NOS (eNOS), inducible NOS (iNOS), cyclooxygenase (COX)-1, COX-2, endothelin-1, DDAH-1 (dimethylarginine dimethylaminohydrolase-1, ADMA inhibitor), DDAH-2, ADMA (asymmetrical dimethyl arginine, NOS inhibitor) were evaluated. In the chronic model, the BDL rats received (1) vehicle; or (2) esomeprazole (3.6 mg/kg/day, oral gavage) from the 1st to 28th day after BDL. On the 29th day and after hemodynamic measurements, plasma liver biochemistry and liver fibrosis were evaluated. ResultsEsomeprazole did not affect hepatic ET-1 vasoresponsiveness. The hepatic protein expressions of the aforementioned factors were not significantly different among the groups. There were no significant differences in hemodynamics, liver biochemistry and hepatic fibrosis after chronic esomeprazole administration. ConclusionPPIs did not affect hepatic vasoresponsiveness or the release of vasoactive substances. Furthermore, they did not influence hemodynamics, liver biochemistry or severity of hepatic fibrosis in the cirrhotic rats.

Impact d’une évaluation des pratiques professionnelles sur la pertinence des prescriptions d’inhibiteurs de la pompe à protons à l’hôpital

IntroductionProton pump inhibitors (PPI) are widely prescribed for unrecognized indications, at high a dose and for a long duration, in spite of side effects and numerous drug interactions. In 2009, the HAS (French Health Authority) published recommendations of good prescription but the latter are poorly respected. In this context of over prescription and additional cost for the society, we performed a professional practice evaluation of on the model of the Deming wheel. The objective of this work was to optimize the relevance of the prescriptions of the IPP in two services of internal medicine and geriatrics through an evaluation of the professional practices. All PPI prescriptions introduced in outpatient visits or during hospitalization were analyzed. Patients and methodsData collection was prospective, over two periods of 2 months and included 163 (first phase), then 139 patients (second phase). An assessment grid of PPI prescriptions was completed by physicians regarding the active substance, the dose, the duration and the indication of the prescription. The relevance of the prescription corresponded to PPI with a conformed indication and duration and to the prescriptions no recommended stopped. Following the first period of data collection, information was given to medical students and physicians on the relevance of their prescriptions with regard to the current recommendations and informative flyers were offered with the aim of improving the practices before the second period of evaluation (second phase). ResultsDuring the first phase, only 25% of the pre-hospital prescriptions and 33% of the hospital prescriptions respected the HAS recommendations. The main indication of the PPI was the prevention of peptic ulcers in a context of associated drug estimated at risk. An improvement of the global relevance of prescription was observed after awareness of the physicians: 26% relevance during the first phase and 60% in the second one (P<0.012). During the second phase, the part of PPI prescriptions introduced at hospital decreased from 33 to 17% and the discontinuation of the not corresponding prescriptions increased from 6 to 33%, with an additional information given to the general practitioner (P<0.001). However, during the second phase, 33% of the prescriptions introduced in hospitalization were always not corresponding and 61% of the not corresponding prescriptions begun in outpatient visits were always pursued on discharge, probably due to the lack of sufficient information to stop the prescription. ConclusionOur study underlines the frequent disrespect of the indications in the prescription of PPI. Interestingly, a professional practices evaluation improved the relevance of the prescriptions with a more frequent withdrawal of the not corresponding exposure and a decrease in global not corresponding prescriptions. Our study suggests that it is crucial to regularly inform physicians on the good prescription of PPI. Patient information focused on the indications and the limited duration of PPI prescription, potentially severe side effects of chronic exposure and on the risk of drug interactions also remains necessary in order to facilitate the stop of the exposure and restrict self-medication.