Emerging Trends and their Impacts on Peptic Ulcer Diseases: Treatments
and Techniques

Pranjal   Kumar   Singh; T.S.      Easwari
doi:10.2174/1574885517666220307115813
Abstract

Background: Peptic ulcer disease (PUD) is prevalent in almost all parts of the world. PUD complications are a major source of health care expenses; however, they are preventable. The major factors responsible for the incidence of PUD and its complication have changed over the past few decades after the identification of non-steroidal inflammatory drugs (NSAIDs) and Helicobacter pylori bacterial infection along with a marked increase in the use of proton-pump inhibitors (PPIs) as drug therapy. The management of PUD has become more complex and challenging due to antimicrobial resistance.
Objectives: The objective of the study was to highlight current therapy and novel techniques used in the treatment of peptic ulcer diseases.
Methods: An exhaustive literature search has been conducted across PubMed, Google, Scopus and Web of Science electronic databases to extract the crucial information from the relevant literature.
Results: In the present review, we have discussed PUD and its pathophysiology. The recent trends in PUD and possible treatments with novel techniques have also been discussed. The type and presence of ulcers cannot be predicted accurately based on symptoms. The available treatment approaches for peptic ulcers based on their clinical presentation and etiology are anti-secretory therapy, endoscopy to reveal ulcers, followed by drug therapy, and triple therapy for H. pylori infection.
Conclusion: Thus, the popular and effective methods are very beneficial in controlling PUD. The treatment based on diagnosis is the foremost requirement for ameliorating any disorder. In this article, the emerging techniques and advancements in the treatment and diagnosis of PUD have been reviewed.
Keywords: Peptic ulcer, proton pump inhibitor, perforation, acidity, dyspepsia, NSAIDs, H. pylori.
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Graphical Abstract

[1] 
Xie J, Wang C, Wang N, et al. Graphdiyne nanoradioprotector with efficient free radical scavenging ability for mitigating radiation-induced gastrointestinal tract damage. Biomaterials  2020; 244 ,119940
[http://dx.doi.org/10.1016/j.biomaterials.2020.119940] [PMID:  32200103] 
[2] 
Wang H, Wei CX, Min L, Zhu LY. Good or bad: Gut bacteria in human health and diseases. Biotechnol Biotechnol Equip  2018; 32(5): 1075-80.
[http://dx.doi.org/10.1080/13102818.2018.1481350] 
[3] 
Pickard JM, Zeng MY, Caruso R, Núñez G. Gut microbiota: Role in pathogen colonization, immune responses, and inflammatory disease. Immunol Rev  2017; 279(1): 70-89.
[http://dx.doi.org/10.1111/imr.12567] [PMID:  28856738] 
[4] 
Sunkara T, Rawla P, Yarlagadda KS, Gaduputi V. Eosinophilic gastroenteritis: Diagnosis and clinical perspectives. Clin Exp Gastroenterol  2019; 12: 239-53.
[http://dx.doi.org/10.2147/CEG.S173130] [PMID:  31239747] 
[5] 
Aceves S, Collins MH, Rothenberg ME, et al. Consortium of Eosinophilic Gastrointestinal Disease Researchers (CEGIR). Advancing patient care through the Consortium of Eosinophilic Gastrointestinal Disease Researchers (CEGIR). J Allergy Clin Immunol  2020; 145(1): 28-37.
[http://dx.doi.org/10.1016/j.jaci.2019.11.012] [PMID:  31758958] 
[6] 
Dobos NM, Warrillow SJ. Gastrointestinal problems in intensive care. Anaesth Intensive Care Med  2021; 22(2): 95-100.
[http://dx.doi.org/10.1016/j.mpaic.2020.12.007] 
[7] 
Rai A, Gajula B, Kumar N, Malik A. Gastric perforation secondary to fungal gastritis in an immuno-competent adult. Cureus  2021; 13(2) ,e13156
[http://dx.doi.org/10.7759/cureus.13156] [PMID:  33692925] 
[8] 
Prabhu V, Shivani A. An overview of history, pathogenesis and treatment of perforated peptic ulcer disease with evaluation of prognostic scoring in adults. Ann Med Health Sci Res  2014; 4(1): 22-9.
[http://dx.doi.org/10.4103/2141-9248.126604] [PMID:  24669326] 
[9] 
Malik TF, Gnanapandithan K, Singh K. Peptic Ulcer DiseaseStatPearls. Treasure Island, FL: StatPearls Publishing 2021.
[10] 
Malfertheiner P, Schulz C. Peptic ulcer: Chapter closed? Dig Dis  2020; 38(2): 1-5.
[PMID:  31905355] 
[11] 
Panigrahi MK, Singh A, Uthansingh K, et al. Clinical profile and risk factor of peptic ulcer disease in coastal eastern India. J Med Sci Clin Res  2018; 06(07): 615-20.
[12] 
Gupta M, Kapoor B, Gupta R, Singh N. Plants and phytochemicals for treatment of peptic ulcer: An overview. S Afr J Bot  2021; 138: 105-14.
[http://dx.doi.org/10.1016/j.sajb.2020.11.030] 
[13] 
Serafim C, Araruna ME, Júnior EA, Diniz M, Hiruma-Lima C, Batista L. A review of the role of flavonoids in peptic ulcer (2010-2020). Molecules  2020; 25(22): 5431.
[http://dx.doi.org/10.3390/molecules25225431] [PMID:  33233494] 
[14] 
Ismail M, Khan F, Noor S, Shafi A. Management of gastrointestinal disorders and the pharmacist’s role: Peptic ulcer disease.  Oxford: Elsevier 2019; pp. 389-407.
[15] 
Ahmad AA, Kasim KF. Ma’Radzi AH, Gopinath SCB. Peptic ulcer: Current prospects of diagnostic and nanobiotechnological trends on pathogenicity. Process Biochem  2019; 85: 51-9.
[http://dx.doi.org/10.1016/j.procbio.2019.06.024] 
[16] 
Anwar I, Sadeeqa S. Peptic ulcer: Mini review with respect to case. Int J Vaccines Vaccin  2018; 5(2): 39-40.
[17] 
Ban T, Khan PA, Fathima A. Effect of leaves and fruits of Moringa oleifera Lam on gastric and duodenal ulcers in rats. Br J Med Health Res  2016; 3(9): 137-48.
[18] 
Drini M. Peptic ulcer disease and non-steroidal anti-inflammatory drugs. Aust Prescr  2017; 40(3): 91-3.
[http://dx.doi.org/10.18773/austprescr.2017.037] [PMID:  28798512] 
[19] 
Goldstein JL, Cryer B. Gastrointestinal injury associated with NSAID use: A case study and review of risk factors and preventative strategies. Drug Healthc Patient Saf  2015; 7: 31-41.
[http://dx.doi.org/10.2147/DHPS.S71976] [PMID:  25653559] 
[20] 
Asali AM, Alghamdi MA, Fallatah SA, Alholaily WA, Aldandan RG, Alnosair AH, et al. Risk factors leading to peptic ulcer disease: Systematic review in literature. Int J Community Med Public Health  2018; 5(10): 4617-24.
[http://dx.doi.org/10.18203/2394-6040.ijcmph20183869] 
[21] 
Araújo MB, Borini P, Guimarães RC. Etiopathogenesis of peptic ulcer: Back to the past? Arq Gastroenterol  2014; 51(2): 155-61.
[http://dx.doi.org/10.1590/S0004-28032014000200016] [PMID:  25003270] 
[22] 
Desai JK, Goyal RK, Parmar NS. Pathogenesis of peptic ulcer disease and current trends in therapy. Indian J Physiol Pharmacol  1997; 41(1): 3-15.
[PMID:  10225026] 
[23] 
Graham DY, Khalaf N. Peptic ulcer disease.In: Pitchumoni C, Dharmarajan T, Eds Geriatric gastroenterology. Cham: Springer 2019.
[http://dx.doi.org/10.1007/978-3-319-90761-1_63-1] 
[24] 
Halter F, Tarnawski AS, Schmassmann A, Peskar BM. Cyclooxygenase 2-implications on maintenance of gastric mucosal integrity and ulcer healing: Controversial issues and perspectives. Gut  2001; 49(3): 443-53.
[http://dx.doi.org/10.1136/gut.49.3.443] [PMID:  11511570] 
[25] 
Di Saverio S, Bassi M, Smerieri N, et al. Diagnosis and treatment of perforated or bleeding peptic ulcers: 2013 WSES position paper. World J Emerg Surg  2014; 9(1): 45.
[http://dx.doi.org/10.1186/1749-7922-9-45] [PMID:  25114715] 
[26] 
Kuna L, Jakab J, Smolic R, Raguz-Lucic N, Vcev A, Smolic M. Peptic ulcer disease: A brief review of conventional therapy and herbal treatment options. J Clin Med  2019; 8(2): 1-19.
[http://dx.doi.org/10.3390/jcm8020179] [PMID:  30717467] 
[27] 
Scarpignato C, Gatta L, Zullo A, et al. SIF-AIGO-FIMMG Group; Italian Society of Pharmacology, the Italian Association of Hospital Gastroenterologists, and the Italian Federation of General Practitioners. Effective and safe proton pump inhibitor therapy in acid-related diseases - A position paper addressing benefits and potential harms of acid suppression. BMC Med  2016; 14(1): 179.
[http://dx.doi.org/10.1186/s12916-016-0718-z] [PMID:  27825371] 
[28] 
Ahmed M, Mansoor T, Rab AZ, Rizvi SAA. Risk factors influencing postoperative outcome in patients with perforated peptic ulcer: A prospective cohort study. Eur J Trauma Emerg Surg  2022; 48(1): 81-6.
[http://dx.doi.org/10.1007/s00068-020-01597-6] [PMID:  33590271] 
[29] 
Ciftci F, Erözgen F. Patients with perforated peptic ulcers: Risk factors for morbidity and mortality. Int Surg  2018; 103(11-12): 578-84.
[http://dx.doi.org/10.9738/INTSURG-D-15-00180.1] 
[30] 
Søreide K, Thorsen K, Harrison EM, et al. Perforated peptic ulcer. Lancet  2015; 386(10000): 1288-98.
[http://dx.doi.org/10.1016/S0140-6736(15)00276-7] [PMID:  26460663] 
[31] 
Dadfar A, Edna TH. Epidemiology of perforating peptic ulcer: A population-based retrospective study over 40 years. World J Gastroenterol  2020; 26(35): 5302-13.
[http://dx.doi.org/10.3748/wjg.v26.i35.5302] [PMID:  32994689] 
[32] 
Gona SK, Alassan MK, Marcellin KG, et al. Postoperative morbidity and mortality of perforated peptic ulcer: Retrospective cohort study of risk factors among black Africans in Côte d’Ivoire. Gastroenterol Res Pract  2016; 2016 ,2640730
[33] 
Bertleff MJ, Lange JF. Perforated peptic ulcer disease: A review of history and treatment. Dig Surg  2010; 27(3): 161-9.
[http://dx.doi.org/10.1159/000264653] [PMID:  20571260] 
[34] 
Chi TY, Zhu HM, Zhang M. Risk factors associated with nonsteroidal anti-inflammatory drugs (NSAIDs)-induced gastrointestinal bleeding resulting on people over 60 years old in Beijing. Medicine (Baltimore)  2018; 97(18) ,e0665
[http://dx.doi.org/10.1097/MD.0000000000010665] [PMID:  29718891] 
[35] 
Goh V. Coprescribing proton-pump inhibitors with nonsteroidal anti-inflammatory drugs: Risks versus benefits. J Pain Res  2018; 11: 361-74.
[36] 
Tarasconi A, Coccolini F, Biffl WL, et al. .Perforated and bleeding
	peptic ulcer : WSES guidelines. 2020; 9: 1-25. 
[37] 
Aitila P, Mutyaba M, Okeny S, et al. Prevalence and risk factors of helicobacter pylori infection among children aged 1 to 15 Years at holy innocents children’s hospital, mbarara, South Western Uganda. J Trop Med  2019; 2019 ,9303072
[38] 
Lim SL, Canavarro C, Zaw MH, et al. Irregular meal timing is associated with helicobacter pylori infection and gastritis. Nutr  2013; 2013 ,714970
[http://dx.doi.org/10.5402/2013/714970] 
[39] 
Matsumoto H, Shiotani A, Graham DY. Current and future treatment of helicobacter pylori infections. Adv Exp Med Biol  2019; 1149: 211-25.
[http://dx.doi.org/10.1007/5584_2019_367] [PMID:  31016626] 
[40] 
Savoldi A, Carrara E, Graham DY, Conti M, Tacconelli E. Prevalence of antibiotic resistance in helicobacter pylori: A systematic review and meta-analysis in world health organization regions. Gastroenterology  2018; 155(5): 1372-1382.e17.
[http://dx.doi.org/10.1053/j.gastro.2018.07.007] [PMID:  29990487] 
[41] 
Jaka H, Mueller A, Kasang C, Mshana SE. Predictors of triple therapy treatment failure among H. pylori infected patients attending at a tertiary hospital in Northwest Tanzania: A prospective study. BMC Infect Dis  2019; 19(1): 447.
[http://dx.doi.org/10.1186/s12879-019-4085-1] [PMID:  31113384] 
[42] 
Qaria MA, Qumar S, Sepe LP, Ahmed N. Cholesterol glucosylation-based survival strategy in Helicobacter pylori. Helicobacter  2021; 26(2) ,e12777
[http://dx.doi.org/10.1111/hel.12777] [PMID:  33368895] 
[43] 
Zhang Q, Wu W, Zhang J, Xia X. Eradication of Helicobacter pylori: The power of nanosized formulations. Nanomedicine (Lond)  2020; 15(5): 527-42.
[http://dx.doi.org/10.2217/nnm-2019-0329] [PMID:  32028847] 
[44] 
Kavitt RT, Lipowska AM, Anyane-Yeboa A, Gralnek IM. Diagnosis and treatment of peptic ulcer disease. Am J Med  2019; 132(4): 447-56.
[http://dx.doi.org/10.1016/j.amjmed.2018.12.009] [PMID:  30611829] 
[45] 
Yeğen BC. Lifestyle and peptic ulcer disease. Curr Pharm Des  2018; 24(18): 2034-40.
[http://dx.doi.org/10.2174/1381612824666180510092303] [PMID:  29745325] 
[46] 
Tulchinsky TH. In: Chapter 22 -Warren, Marshall, Helicobacter pylori, Peptic Ulcers and Gastric Cancer.In: Tulchinsky THBT-CS in PH.  USA: Academic Press 2018; pp. 543-60.

[47] 
Mahmood KT, Sara S, Shifa H. Eating habits a risk factor to peptic ulcer. J Pharm Sci Res  2011; 3(1): 903-10.
[48] 
Hasneen DF, Zaki NL, Abbas MS, Soliman AS, Ashoush IS, Fayed AE. Comparative evaluation of some herbs and their suitability for skimmed milk yoghurt and cast Kariesh cheese fortification as functional foods. Ann Agric Sci  2020; 65(1): 6-12.
[http://dx.doi.org/10.1016/j.aoas.2020.05.001] 
[49] 
Chen S, Wang J, Li Y. Is alcohol consumption associated with gastroesophageal reflux disease? J Zhejiang Univ Sci B  2010; 11(6): 423-8.
[50] 
Mandalari G, Bisignano C, Cirmi S, Navarra M. Effectiveness of citrus fruits on helicobacter pylori. Evid Based Complement Alternat Med  2017; 2017 ,8379262
[http://dx.doi.org/10.1155/2017/8379262] [PMID:  28408943] 
[51] 
Vomero ND, Colpo E. Nutritional care in peptic ulcer. Arq Bras Cir Dig  2014; 27(4): 298-302.
[http://dx.doi.org/10.1590/S0102-67202014000400017] [PMID:  25626944] 
[52] 
Fokunang CN, Tembe E, Frederick K, Ngadjui B. Overview of non-steroidal anti-inflammatory drugs (nsaids) in resource limited countries. Toxicology  2018; 4(1): 5-13.
[53] 
Kim TJ, Kim ER, Hong SN, et al. Effectiveness of acid suppressants and other mucoprotective agents in reducing the risk of occult gastrointestinal bleeding in nonsteroidal anti-inflammatory drug users. Sci Rep  2019; 9(1): 11696.
[http://dx.doi.org/10.1038/s41598-019-48173-6] [PMID:  31406189] 
[54] 
Li Z, Wang Z, Shen B, Chen C, Ding X, Song H. Effects of aspirin on the gastrointestinal tract: Pros vs. cons. Oncol Lett  2020; 20(3): 2567-78.
[http://dx.doi.org/10.3892/ol.2020.11817] [PMID:  32782574] 
[55] 
Vella V, Hons BP, Clin P, Aberdeen P. Drug-induced peptic ulcer disease. J Malta College Pharm Practice  2005; 10: 15-9.
[56] 
Watanabe T, Fujiwara Y, Chan FKL. Current knowledge on non-steroidal anti-inflammatory drug-induced small-bowel damage: A comprehensive review. J Gastroenterol  2020; 55(5): 481-95.
[http://dx.doi.org/10.1007/s00535-019-01657-8] [PMID:  31865463] 
[57] 
Sánchez AB, Clares B, Rodríguez-Lagunas MJ, Fábrega MJ, Calpena AC. Study of melatonin as preventive agent of gastrointestinal damage induced by sodium diclofenac. Cells  2020; 9(1): 1-17.
[http://dx.doi.org/10.3390/cells9010180] [PMID:  31936877] 
[58] 
Vertzoni M, Augustijns P, Grimm M, et al. Impact of regional differences along the gastrointestinal tract of healthy adults on oral drug absorption: An UNGAP review. Eur J Pharm Sci  2019; 134: 153-75.
[http://dx.doi.org/10.1016/j.ejps.2019.04.013] [PMID:  30991092] 
[59] 
Chatterjee A, Bandyopadhyay SK. Herbal remedy: An alternate therapy of nonsteroidal anti-inflammatory drug induced gastric ulcer healing. Ulcers  2014; 2014 ,361586
[60] 
Takeuchi K, Amagase K. Roles of prostaglandin E and EP receptors in mucosal protection and ulcer healing in the gastrointestinal tract. Arch Dig Disord  2017; 1(2): 8-16.
[61] 
Sumathy C, Vijayakumar N. Review on antiulcerogenic activity of musa sapientum on experimental peptic ulcers in rats. World J Pharm Res  2015; 4(5): 832-46.
[62] 
Magierowski M, Magierowska K, Kwiecien S, Brzozowski T. Gaseous mediators nitric oxide and hydrogen sulfide in the mechanism of gastrointestinal integrity, protection and ulcer healing. Molecules  2015; 20(5): 9099-123.
[http://dx.doi.org/10.3390/molecules20059099] [PMID:  25996214] 
[63] 
Patil KR, Mahajan UB, Unger BS, et al. Animal models of inflammation for screening of anti-inflammatory drugs: Implications for the discovery and development of phytopharmaceuticals. Int J Mol Sci  2019; 20(18): 4367-71.
[http://dx.doi.org/10.3390/ijms20184367] [PMID:  31491986] 
[64] 
Yasuda H, Matsuo Y, Sato Y, et al. Treatment and prevention of gastrointestinal bleeding in patients receiving antiplatelet therapy. World J Crit Care Med  2015; 4(1): 40-6.
[http://dx.doi.org/10.5492/wjccm.v4.i1.40] [PMID:  25685721] 
[65] 
Knopp-Sihota JA, Cummings GG, Homik J, Voaklander D. The association between serious upper gastrointestinal bleeding and incident bisphosphonate use: A population-based nested cohort study. BMC Geriatr  2013; 13(1): 36.
[http://dx.doi.org/10.1186/1471-2318-13-36] [PMID:  23602075] 
[66] 
Tseng CL, Chen YT, Huang CJ, et al. Short-term use of glucocorticoids and risk of peptic ulcer bleeding: A nationwide population-based case-crossover study. Aliment Pharmacol Ther  2015; 42(5): 599-606.
[http://dx.doi.org/10.1111/apt.13298] [PMID:  26096497] 
[67] 
Gutermann IK, Niggemeier V, Zimmerli LU, Holzer BM, Battegay E, Scharl M. Gastrointestinal bleeding and anticoagulant or antiplatelet drugs: Systematic search for clinical practice guidelines. Medicine (Baltimore)  2015; 94(1) ,e377
[http://dx.doi.org/10.1097/MD.0000000000000377] [PMID:  25569664] 
[68] 
Cheung KS, Leung WK. Gastrointestinal bleeding in patients on novel oral anticoagulants: Risk, prevention and management. World J Gastroenterol  2017; 23(11): 1954-63.
[http://dx.doi.org/10.3748/wjg.v23.i11.1954] [PMID:  28373761] 
[69] 
Sartori S, Trevisani L, Nielsen I, Tassinari D, Panzini I, Abbasciano V. Randomized trial of omeprazole or ranitidine versus placebo in the prevention of chemotherapy-induced gastroduodenal injury. J Clin Oncol  2000; 18(3): 463-7.
[http://dx.doi.org/10.1200/JCO.2000.18.3.463] [PMID:  10653861] 
[70] 
Torrisi JM, Schwartz LH, Gollub MJ, Ginsberg MS, Bosl GJ, Hricak H. CT findings of chemotherapy-induced toxicity: What radiologists need to know about the clinical and radiologic manifestations of chemotherapy toxicity. Radiology  2011; 258(1): 41-56.
[http://dx.doi.org/10.1148/radiol.10092129] [PMID:  21183492] 
[71] 
Nikshoar M, Rastegarpour A, Kolahi A. The characteristics of gastroduodenal perforations in crack-heroin users social determinants of health research centre. Aust J Basic Appl Sci  2013; 7(4): 703-7.
[72] 
Ogasawara O, Kojima T, Miyazu M, Sobue K. Impact of the stress ulcer prophylactic protocol on reducing the unnecessary administration of stress ulcer medications and gastrointestinal bleeding: A single-center, retrospective pre-post study. J Intensive Care  2020; 8(1): 10.
[http://dx.doi.org/10.1186/s40560-020-0427-8] [PMID:  31988751] 
[73] 
Plummer MP, Blaser AR, Deane AM. Stress ulceration: Prevalence, pathology and association with adverse outcomes. Crit Care  2014; 18(2): 213.
[http://dx.doi.org/10.1186/cc13780] [PMID:  25029573] 
[74] 
Alshami A, Barona SV, Varon J, Surani S. Gastrointestinal stress ulcer prophylaxis in the intensive care unit, where is the data? World J Metaanal  2019; 7(3): 72-6.
[http://dx.doi.org/10.13105/wjma.v7.i3.72] 
[75] 
Zhang W, Lu H, Graham DY. An update on Helicobacter pylori as the cause of gastric cancer. Gastrointest Tumors  2014; 1(3): 155-65.
[http://dx.doi.org/10.1159/000365310] [PMID:  26672968] 
[76] 
Nishizawa T, Suzuki H. Gastric carcinogenesis and underlying molecular mechanisms: Helicobacter pylori and novel targeted therapy. Biomed Res Int  2015; 2015 ,794378
[77] 
Bauer B, Meyer TF. The human gastric pathogen Helicobacter pylori and its association with gastric cancer and ulcer disease. Ulcers 2011. ,340157
[78] 
Kaul V. Gastric cancer risk in helicobacter pylori infected patients. World J Gastrointest Oncol  2015; 4(1): 196-205.
[79] 
Burkitt MD, Duckworth CA, Williams JM, Pritchard DM. Helicobacter pylori-induced gastric pathology: Insights from in vivo and ex vivo models. Dis Model Mech  2017; 10(2): 89-104.
[http://dx.doi.org/10.1242/dmm.027649] [PMID:  28151409] 
[80] 
Muzaheed. Helicobacter pylori oncogenicity: Mechanism, prevention, and risk factors. lIn: Sci World J   2020; 2020 ,3018326
[81] 
Chan KS, Wang YL, Chan XW, Shelat VG. Outcomes of omental patch repair in large or giant perforated peptic ulcer are comparable to gastrectomy. Eur J Trauma Emerg Surg  2021; 47(6): 1745-52.
[PMID:  31612272] 
[82] 
Ansari D, Torén W, Lindberg S, Pyrhönen H-S, Andersson R. Diagnosis and management of duodenal perforations: A narrative review. Scand J Gastroenterol  2019; 54(8): 939-44.
[http://dx.doi.org/10.1080/00365521.2019.1647456] [PMID:  31353983] 
[83] 
Kumar P, Khan HM, Hasanrabba S. Treatment of perforated giant gastric ulcer in an emergency setting. World J Gastrointest Surg  2014; 6(1): 5-8.
[http://dx.doi.org/10.4240/wjgs.v6.i1.5] 
[84] 
Chung KT, Shelat VG. Perforated peptic ulcer - an update. World J Gastrointest Surg  2017; 9(1): 1-12.
[http://dx.doi.org/10.4240/wjgs.v9.i1.1] [PMID:  28138363] 
[85] 
Scotti E, Boué S, Lo Sasso G, et al. Exploring the microbiome in health and disease: Implications for toxicology. Toxicol Res Appl  2017; 1 ,2397847317741884
[http://dx.doi.org/10.1177/2397847317741884] 
[86] 
Ierardi E, Losurdo G, Fortezza RF, Principi M, Barone M, Leo AD. Optimizing proton pump inhibitors in Helicobacter pylori treatment: Old and new tricks to improve effectiveness. World J Gastroenterol  2019; 25(34): 5097-104.
[http://dx.doi.org/10.3748/wjg.v25.i34.5097] [PMID:  31558859] 
[87] 
Hussein M, Alzoubaidi D, Lopez MF, et al. Hemostatic spray powder TC-325 in the primary endoscopic treatment of peptic ulcer-related bleeding: Multicenter international registry. Endoscopy  2021; 53(1): 36-43.
[http://dx.doi.org/10.1055/a-1186-5360] [PMID:  32459000] 
[88] 
Khoder G, Menhali AA, Yassir FAL, Karam SM. Potential role of probiotics in the management of gastric ulcer. Exp Ther Med  2016; 12(1): 3-17.
[http://dx.doi.org/10.3892/etm.2016.3293] 
[89] 
Goderska K, Agudo Pena S, Alarcon T. Helicobacter pylori treatment: Antibiotics or probiotics. Appl Microbiol Biotechnol  2018; 102(1): 1-7.
[http://dx.doi.org/10.1007/s00253-017-8535-7] [PMID:  29075827] 
[90] 
Buckley M, Lacey S, Doolan A, Goodbody E, Seamans K. The effect of Lactobacillus reuteri supplementation in Helicobacter pylori infection: A placebo-controlled, single-blind study. BMC Nutr  2018; 4(1): 48.
[http://dx.doi.org/10.1186/s40795-018-0257-4] [PMID:  32153909] 
[91] 
Jain A, Jain P, Parihar DK. Comparative study of in-vitro antidiabetic and antibacterial activity of non-conventional curcuma species. J Biol Active Prod Nat  2019; 9(6): 457-64.
[http://dx.doi.org/10.1080/22311866.2019.1710253] 
[92] 
Jain A, Parihar DK. Antibacterial, biofilm dispersal and antibiofilm potential of alkaloids and flavonoids of Curcuma. Biocatal Agric Biotechnol  2018; 16: 677-82.
[http://dx.doi.org/10.1016/j.bcab.2018.09.023] 
[93] 
Jain A, Parihar DK. Molecular marker based genetic diversity study of wild, cultivated and endangered species of Curcuma from Chhattisgarh region for in situ conservation. Biocatal Agric Biotechnol  2019; 18 ,101033
[http://dx.doi.org/10.1016/j.bcab.2019.101033] 
[94] 
Kumar V, Rathore K, Jain P, Ahmed Z. Biological activity of Bauhinia racemose against diabetes and interlinked disorders like obesity and hyperlipidemia. Clin Phytosci  2017; 3(1): 7.
[http://dx.doi.org/10.1186/s40816-017-0044-9] 
[95] 
Kumar V, Jain P, Rathore K, Ahmed Z. Biological evaluation of Pupalia lappacea for antidiabetic, antiadipogenic, and hypolipidemic activity both in vitro and in vivo. Scientifica (Cairo)  2016; 2016 ,1062430
[http://dx.doi.org/10.1155/2016/1062430] [PMID:  26942038] 
[96] 
Rathore K, Singh V, Jain P, Rao SP, Ahmed Z, Thakur VS. In-vitro and in-vivo antiadipogenic, antidiabetic and hypolipidemic activity of Diospyros melanoxylon (Roxb.). J Ethnopharmacol  2014; 155: 1171-6.
[http://dx.doi.org/10.1016/j.jep.2014.06.050] [PMID:  25010927] 
[97] 
Jain P, Satapathy T, Pandey RK. Acaricidal activity and clinical safety of arecoline hydrobromide on calves infested with cattle tick Rhipicephalus microplus (Acari: Ixodidae). Vet Parasitol  2021; 298 ,109490
[http://dx.doi.org/10.1016/j.vetpar.2021.109490] [PMID:  34271319] 
[98] 
Jain P, Satapathy T, Pandey RK. First report on efficacy of Citrus limetta seed oil in controlling cattle tick Rhipicephalus microplus in red Sahiwal calves. Vet Parasitol  2021; 296 ,109508
[http://dx.doi.org/10.1016/j.vetpar.2021.109508] [PMID:  34218174] 
[99] 
Jain P, Satapathy T, Kumar R. Acaricidal activity and biochemical analysis of Citrus limetta seed oil for controlling ixodid tick rhipicephalus microplus infesting cattle. Syst Appl Acarol  2021; 2021: 26.
[http://dx.doi.org/10.11158/saa.26.7.13] 
[100] 
Jain P, Satapathy T, Pandey RK. Rhipicephalus microplus (acari: Ixodidae): Clinical safety and potential control by topical application of cottonseed oil (Gossypium sp.) on cattle. Exp Parasitol  2020; 219 ,108017
[http://dx.doi.org/10.1016/j.exppara.2020.108017] [PMID:  33039477] 
[101] 
Jain P, Satapathy T, Pandey RK. Rhipicephalus microplus: A parasite threatening cattle health and consequences of herbal acaricides for upliftment of livelihood of cattle rearing communities in Chhattisgarh. Biocatal Agric Biotechnol  2020; 26 ,101611
[http://dx.doi.org/10.1016/j.bcab.2020.101611] 
[102] 
Jain P, Satapathy T, Pandey RK. Efficacy of arecoline hydrobromide against cattle tick Rhipicephalus (Boophilus) microplus. Int J Acarol  2020; 46(4): 268-75.
[http://dx.doi.org/10.1080/01647954.2020.1765018] 
[103] 
Jain P, Satapathy T, Pandey RK. First report on ticks (Acari: Ixodidae) controlling activity of cottonseed oil (Gossypium Sp.). Int J Acarol  2020; 46(4): 263-7.
[http://dx.doi.org/10.1080/01647954.2020.1767203] 
[104] 
Jain P, Satapathy T, Pandey RK. A mini review of methods to control ticks population infesting cattle in Chhattisgarh with special emphasis on herbal acaricides. IJNPR  2020; 11(12): 217-23.
[105] 
Sharwan G, Jain P, Pandey R, Shukla SS. Toxicity and safety profiles of methanolic extract of Pistacia integerrima J.L. stewart ex brandis (pi) for wistar rats. J Pharmacopuncture  2016; 19(3): 253-8.
[http://dx.doi.org/10.3831/KPI.2016.19.027] [PMID:  27695635] 
[106] 
Jain P, Pandey R, Shukla SS. Reproductive and developmental toxicity study of talisadya churna: An ancient polyherbal formulation. IAJPR  2016; 6(5): 5641-53.
[107] 
Jain P, Pandey R, Shukla SS. Acute and subacute toxicity studies of polyherbal formulation talisadya churna in experimental animal model. MJPMS  2015; 1(1): 7-10.
[108] 
Sharwan G, Jain P, Pandey R, Shukla SS. Toxicity profile of traditional herbal medicine. J Ayu Herb Med  2015; 1(3): 81-90.
[109] 
Jain P, Rao SP, Singh V, Pandey R, Shukla SS. Acute and subacute
toxicity studies of an ancient ayurvedic formulation: Agnimukha
	churna. CJPS 2014; (1): 18-22. 
[110] 
Rao SP, Amrit I, Jain P, Singh V. Antiulcer activity of Agnimukha churna. Int J Ayurveda Pharma Res  2014; 2(2): 40-6.
[111] 
Jain P. Secondary metabolites for antiulcer activity. Nat Prod Res  2016; 30(6): 640-56.
[PMID: 25920371] 
[112] 
Gölder S, Neuhas L, Freuer D, et al. Over-the-scope clip in peptic ulcer bleeding: Clinical success in primary and secondary treatment and factors associated with treatment failure. Endosc Int Open  2019; 7(6): E846-54.
[http://dx.doi.org/10.1055/a-0898-3357] 
[113] 
Grupka MJ, Benson J. Endoscopic clipping. J Dig Dis  2008; 9(2): 72-8.
[http://dx.doi.org/10.1111/j.1751-2980.2008.00325.x] [PMID:  18419639] 
[114] 
Becq A, Rahmi G, Perrod G, Cellier C. Hemorrhagic angiodysplasia of the digestive tract: Pathogenesis, diagnosis, and management. Gastrointest Endosc  2017; 86(5): 792-806.
[http://dx.doi.org/10.1016/j.gie.2017.05.018] 
[115] 
Karaman A, Baskol M, Gursoy S, et al. Epinephrine plus argon plasma or heater probe coagulation in ulcer bleeding. World J Gastroenterol  2011; 17(36): 4109-12.
[http://dx.doi.org/10.3748/wjg.v17.i36.4109] 
[116] 
Cho YS. New endoscopic techniques in treating gastrointestinal bleeding. Gastrointest Interv  2018; 7(3): 131-5.
[http://dx.doi.org/10.18528/gii180025] 
[117] 
Jacques J, Legros R, Chaussade S, Sautereau D. Endoscopic haemostasis: An overview of procedures and clinical scenarios. Dig Liver Dis  2014; 46(9): 766-76.
[http://dx.doi.org/10.1016/j.dld.2014.05.008] [PMID:  25022337] 
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DOI https://dx.doi.org/10.2174/1574885517666220307115813	Print ISSN 1574-8855
Publisher Name Bentham Science Publisher	Online ISSN 2212-3903
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