Evansville Vanderburgh Public Library

A new strategy to address loss of submarine qualifications in submariners who are Helicobacter pylori positive and diagnosed with peptic ulcer disease, background to the change in policy, Robert P. Jackman ; Jeffrey J. Costello

eng

Includes bibliographical references (p. 16-20)

federal national government publication

illustrations

no index present

non fiction

A new strategy to address loss of submarine qualifications in submariners who are Helicobacter pylori positive and diagnosed with peptic ulcer disease

bibliographydictionaries

227880379

Robert P. Jackman ; Jeffrey J. Costello

Naval Submarine Medical Research Laboratory report, no. 1210

background to the change in policy

PROBLEM: It was USN policy to disqualify submariners from returning to submarine duty for two years following a peptic ulcer. This resulted in a loss of experienced personnel which was considered to be unnecessary given the current medical advances in peptic ulcer therapy. This is an evaluation of the medical literature to provide background to why the current USN policy of disqualifying submariners from submarine duty following the diagnosis of peptic ulcer disease has been changed. FINDINGS: The medical literature shows that infection with Helicobacter pylori is causally related to the majority of both duodenal and gastric ulcer cases. The second most common cause of peptic ulcer results from the use of non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin, Advil, etc). Repeated studies have demonstrated that eradication of Helicobacter pylori infection in patients with peptic ulcer disease results in a dramatic reduction of ulcer recurrence from as high as 74 to 95% to between 1.1% and 8%. This recurrence rate includes duodenal, gastric, and complicated ulcers. Re-infection with Helicobacter pylori is uncommon in western countries, with rates ranging between zero and 6.25% during the first year. Longer term studies reveal annual re-infection rates of 0.36% to 1.5%. APPLICATION: Results indicate that it is reasonable to return submariners to duty with a low expectation of complications contingent upon eradication of the bacteria Helicobacter pylori and complete healing of the peptic ulcer

Loss of submarine qualifications in submariners who are Helicobacter pylori positive and diagnosed with peptic ulcer disease, background to the change in policy