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Management of Peptic Ulcer Disease in Patients Taking Antithrombotic Agents

Bang CS, Gong EJ

The Korean journal of helicobacter and upper gastrointestinal research, 2026

Abstract

The management of peptic ulcer disease (PUD) in patients receiving antithrombotic therapy requires balancing bleeding and thrombotic risk. The shift from Helicobacter pylori-dominant to drug-induced PUD combined with increasing antithrombotic use has created a new high-risk population that demands particular attention. In this review, we synthesize the current evidence from Korean and international guidelines, focusing on practical management strategies for the acute treatment and long-term prevention of PUD. Key recommendations include individualized risk assessment of bleeding and thrombotic risks, timely resumption of antithrombotic agents following successful hemostasis, and mandatory proton pump inhibitor co-therapy for high-risk patients. Multidisciplinary collaboration and evidence-based approaches are necessary to optimize patient outcomes while minimizing gastrointestinal and cardiovascular complications.

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