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PDE5 inhibitors and gastric mucosa: implications for the management of peptic ulcer disease

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Abstract

Peptic ulcer disease (PUD) continues to be a cause of significant morbidity and mortality worldwide. Almost two-thirds of PUD cases are asymptomatic. In symptomatic patients, epigastric pain is the most common presenting symptom of PUD, which is manifested by nausea, abdominal fullness, bloating, and dyspepsia. Most PUD cases are associated with the use of COX inhibitors or Helicobacter pylori infection, or both. The traditional management of PUD includes the use of proton pump inhibitors to reduce the gastric acid secretion and antibacterial drugs to combat H. pylori. Timely diagnosis and treatment of PUD are vital to reduce the risk of associated morbidity and mortality, as is prevention of PUD among patients at high risk, including COX inhibitors users and those infected with H. pylori. PDE5 inhibitors have been used for the management of erectile dysfunction and pulmonary hypertension for decades. In recent years, studies have mentioned tremendous pleiotropic effects of PDE5 inhibitors on gastrointestinal, urogenital, musculoskeletal, reproductive, cutaneous, and neurologic disorders. Recent data shows that PDE5 inhibition augments gastric mucosa protection, and here, we review the most recent findings regarding the use of PDE5 inhibitors for the prevention and management of PUD.

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Authors and Affiliations

  1. Department of Medical Laboratories Techniques, Al-Mustaqbal University College, Hillah, Babylon, Iraq

    Abduladheem Turki Jalil

  2. College of Dentistry, Wasit University, Al-Kut, Wasit, Iraq

    Maysoon Mohammed Hassan

  3. National University of Science and Technology, Nasiriyah, Dhi-Qar, Iraq

    Rand Ali Ziyad

  4. Department of Pharmacology, Al-Turath University College, Baghdad, Iraq

    Ihsan Jasim

  5. Depaetment of Medical Laboratory Technology, College of Medical Technology, The Islamic University, Najaf, Iraq

    Rahman Zabibah

  6. College of Medical Technology, Al-Farahidi University, Baghdad, Iraq

    Ali Fadhil

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  1. Abduladheem Turki Jalil
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  2. Maysoon Mohammed Hassan
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  3. Rand Ali Ziyad
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  4. Ihsan Jasim
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M.M.H and R.A.Z wrote the manuscript. I.J and R.Z scientifically revised the manuscript. A.F linguistically edited the manuscript. A.T.J prepared the figure. All authors reviewed the manuscript. The authors confirm that no paper mill and artificial intelligence was used.

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Correspondence to Abduladheem Turki Jalil.

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Jalil, A.T., Hassan, M.M., Ziyad, R.A. et al. PDE5 inhibitors and gastric mucosa: implications for the management of peptic ulcer disease. Naunyn-Schmiedeberg's Arch Pharmacol 396, 2261–2267 (2023). https://doi.org/10.1007/s00210-023-02503-8

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