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Successful eradication of Helicobacter pylori prevents relapse of peptic ulcer disease
Author(s) -
Tomita T.,
Fukuda Y.,
Tamura K.,
Tanaka J.,
Hida N.,
Kosaka T.,
Hori K.,
Sakagami T.,
Satomi M.,
Shimoyama T.
Publication year - 2002
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.16.s2.24.x
Subject(s) - medicine , helicobacter pylori , gastroenterology , clarithromycin , amoxicillin , proton pump inhibitor , gastritis , peptic , omeprazole , peptic ulcer , antibiotics , microbiology and biotechnology , biology
Background: The NIH consensus conference in 1994 recommended that all patients with peptic ulcers should be tested and treated for Helicobacter pylori . Recent studies have shown that the eradication of H. pylori is associated with a significant reduction in the relapse rate of peptic ulcers, but there are few reports about long‐term outcome. Aims: To evaluate the relapse rate of peptic ulcer in the long‐term follow‐up of patients after H. pylori eradication therapy. Patients and methods: Patients infected with H. pylori (445; 88 duodenal ulcer, 357 gastric ulcer) were randomly divided into three groups. In group A, patients received `conventional treatment' including acid decreasing therapy with a histamine H2‐receptor antagonist or proton pump inhibitor (PPI). In group B, patients received `dual therapy' including one antibiotic plus acid‐decreasing therapy. In group C, patients received `triple therapy' with PPI plus amoxicillin and clarithromycin. Eradication of H. pylori infection was assessed by histology of biopsy specimens from both the antrum and body corpus at 4 weeks, and 6 and 12 months after stopping therapy. Endoscopy was performed at intervals of 6 months for 5 years. Results: Intention‐to‐treat eradication rates for the duodenal ulcer patients were 0% for group A, 46% for group B and 80% for group C; eradication rates for the gastric ulcer patients were 0%, 33% and 83% respectively. No recurrence was noted in the duodenal ulcer patients and only 4% of gastric ulcers recurred after successful eradication during follow‐up for 5 years. In contrast, in patients with persistent H. pylori infection all DU and 92% of gastric ulcers recurred. Conclusion: Eradication of H. pylori infection changes the natural course of peptic ulcer.