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Update in Gastroenterology and Hepatology

Norton J. Greenberger, MD; and Prateek Sharma, MD
[+] Article and Author Information

From Harvard Medical School, Cambridge, Massachusetts, and University of Kansas School of Medicine, Kansas City, Kansas.


Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Norton J. Greenberger, MD, Division of Gastroenterology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, ngreenberger@partners.org.

Current Author Addresses: Dr. Greenberger: Division of Gastroenterology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115.

Dr. Sharma: Division of Gastroenterology, University of Kansas School of Medicine, 3901 Rainbow Boulevard, Kansas City, KS 66160.

Current Author Addresses: Dr. Greenberger: Division of Gastroenterology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115.

Dr. Sharma: Division of Gastroenterology, University of Kansas School of Medicine, 3901 Rainbow Boulevard, Kansas City, KS 66160.


Ann Intern Med. 2006;145(4):294-298. doi:10.7326/0003-4819-145-4-200608150-00009
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This year's Update in Gastroenterology and Hepatology reviews a range of important findings, including new data on the prevalence of Barrett esophagus, use of clopidogrel in patients with previous bleeding from aspirin, the accuracy of fecal occult blood testing (FOBT) in screening for colorectal cancer, and the benefits and risks of using aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) for colorectal cancer prevention. A nonabsorbable antibiotic, rifaximin, was reported to be effective for prophylaxis against travelers' diarrhea. Population data shed new light on risk factors for outbreaks of Clostridiumdifficile–associated diarrhea, the natural history of nonalcoholic fatty liver disease (NAFLD), and the role of smoking in chronic pancreatitis. In addition, a meta-analysis suggested that surgery is a safe and effective treatment for obesity. Changes to clinical practice emerging from these articles are shown in the Table .

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Aspirin and Clopidogrel
Posted on August 16, 2006
Gauranga C. Dhar
Primary care physician (GP)
Conflict of Interest: None Declared

Although clopidogrel alone or in combination with low dose aspirin has got no significant benefit in patients with cardiovascular risk factors (Ref: Scientific Session of American College of Cardiology, March 11-14, Atlanta), even appears to create harmful side effects who have only CVD risk factors (Ref: CHARISMA study), we have to use this drug for many indications e.g. patients with major gastrointestinal intolerance of aspirin or hypersensitive to the same and some other indications as well.

If we use proton pump inhibitor like esomeprazole along with aspirin to prevent recurrent ulcer bleeding, why not to use the same drugs along with clopidogrel where clopidogrel also may induce recurrent ulceration in patients with previously damaged gastric mucosa?

Conflict of Interest:

None declared

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