Premium
Does eradication of Helicobacter pylori alone heal duodenal ulcers?
Author(s) -
ZhiZheng Ge,
D Z Zhang,
Shu–Dong Xiao,
Y Chen,
Yun-Biao Hu
Publication year - 2000
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.1365-2036.2000.00673.x
Subject(s) - medicine , gastroenterology , helicobacter pylori , clarithromycin , omeprazole , breath test , tinidazole , duodenum , regimen , urea breath test , endoscopy , duodenal ulcer , amoxicillin , surgery , metronidazole , antibiotics , helicobacter pylori infection , microbiology and biotechnology , biology
Bakcground: Eradication of Helicobacter pylori infection prevents duodenal ulcer (DU) relapse, but it remains uncertain whether eradication of H. pylori alone heals duodenal ulceration. Aim: To test the hypothesis that eradication of H. pylori infection is accompanied by healing of duodenal ulcer. Methods: A total of 115 consecutive patients with endoscopically confirmed H. pylori ‐infected duodenal ulcer were randomly assigned to one of two groups. Group BTC patients received a 1‐week course of colloidal bismuth subcitrate 220 mg b.d., tinidazole 500 mg b.d., clarithromycin 250 mg b.d. Group OBTC patients received omeprazole 20 mg daily for 4 weeks with the BTC regimen during the first week. Endoscopy with antral biopsies and 13 C‐urea breath test (UBT) were performed before and 4 weeks after completion of the 7‐day triple or quadruple therapy. Results: Eight patients dropped out (four in BTC and four in OBTC). Duodenal ulcer healing rates on an intention‐to‐treat basis in BTC and OBTC were 86% (95% CI: 77–95%) and 90% (95% CI: 82–98%), respectively. The eradication rates of H. pylori on an intention‐to‐treat basis in BTC and OBTC were 88% (95% CI: 79–96%) and 91% (95% CI: 84–99%), respectively. There were no statistically significant differences in ulcer healing rates and eradication rates between these two groups ( P > 0.05). Epigastric pain resolved more rapidly in patients assigned to OBTC compared with those assigned to BTC. Both of the two regimens were well tolerated with only minor side‐effects (3% of the 115 patients) and the compliance was good. Conclusions: BTC is a very effective H. pylori eradication regimen. Almost all duodenal ulcers heal spontaneously after cure of H. pylori infection using a 1‐week low‐dose bismuth‐based triple therapy. Treating duodenal ulcer with simultaneous administration of omeprazole achieves ulcer pain relief more rapidly.