Primary prevention

Your Organizational Guidance

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MaagklachtenPublished by: NHGLast published: 2025

Reduction of nonsteroidal anti-inflammatory drug (NSAID) and alcohol use can reduce the incidence and severity of gastritis.[38] Patients at increased risk for NSAID-related gastrointestinal (GI) complications include those with a prior history of a GI event (ulcer, hemorrhage), age over 60 years, high dosage of NSAIDs, and concurrent use of corticosteroids or anticoagulants.[27][28]​ Caution in the use of NSAIDs and careful monitoring of these patients is advised.[39] Critically ill patients are at risk of developing stress-induced GI bleeding.[8] The main risk factors for stress-induced GI bleeding are mechanical ventilation for >48 hours and the presence of a coagulopathy (platelet count <50 × 10³/microliter, partial thromboplastin time >2 times the upper limit of the normal range, international normalized ratio >1.5).[8] For patients at risk, prophylactic therapy with H2 antagonists or a proton-pump inhibitor (PPI) has demonstrated efficacy.[40] Sucralfate or misoprostol are alternative treatments to prevent stress ulcerations of the gastric mucosa in patients at risk.[8]

For patients undergoing gastric surgery for malignancy or peptic ulcer disease, use of a Roux-en-Y limb or isoperistaltic jejunal interposition procedure reduces the risk of iatrogenic bile-reflux gastritis and esophagogastric injury.[4][7]

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