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Recurrent Peptic Ulcers in Patients Following Successful Helicobacter pylori Eradication: A Multicenter Study of 4940 Patients
Author(s) -
Miwa Hiroto,
Sakaki Nobuhiro,
Sugano Kentaro,
Sekine Hitoshi,
Higuchi Kazuhide,
Uemura Naomi,
Kato Mototsugu,
Murakami Kazunari,
Kato Chieko,
Shiotani Akiko,
Ohkusa Toshifumi,
Takagi Atsushi,
Aoyama Nobuo,
Haruma Ken,
Okazaki Kazuichi,
Kusugami Kazuo,
Suzuki Masayuki,
Joh Takashi,
Azuma Takeshi,
Yanaka Akinori,
Suzuki Hidekazu,
Hashimoto Hiroshi,
Kawai Takashi,
Sugiyama Toshiro
Publication year - 2004
Publication title -
helicobacter
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 79
eISSN - 1523-5378
pISSN - 1083-4389
DOI - 10.1111/j.1083-4389.2004.00194.x
Subject(s) - medicine , helicobacter pylori , gastroenterology , peptic ulcer , peptic , incidence (geometry) , helicobacter pylori infection , duodenal ulcer , surgery , physics , optics
Objective. Although curative treatment of Helicobacter pylori infection markedly reduces the relapse of peptic ulcers, the details of the ulcers that do recur is not well characterized. The aim of this study is to describe the recurrence rate and specific features of peptic ulcers after cure of H. pylori infection. Methods. This was a multicenter study involving 4940 peptic ulcer patients who were H. pylori negative after successful eradication treatment and were followed for up to 48 months. The annual incidence of ulcer relapse in H. pylori ‐cured patients, background of patients with relapsed ulcers, time to relapse, ulcer size, and site of relapsed ulcers were investigated. Results. Crude peptic ulcer recurrence rate was 3.02% (149/4940). The annual recurrence rates of gastric, duodenal and gastroduodenal ulcer were 2.3%, 1.6%, and 1.6%, respectively. Exclusion of patients who took NSAIDs led annual recurrence rates to 1.9%, 1.5% and 1.3%, respectively. The recurrence rate was significantly higher in gastric ulcer. Recurrence rates of patients who smoked, consumed alcohol, and used NSAIDs were significantly higher in those with gastric ulcer recurrence compared to duodenal ulcer recurrence (e.g. 125 of 149 [83.9%] relapsed ulcers recurred at the same or adjacent sites as the previous ulcers). Conclusions. Curative treatment of H. pylori infection is useful in preventing ulcer recurrence. Gastric ulcer is more likely to relapse than duodenal ulcer. Recurrent ulcer tended to recur at the site of the original ulcers.