Cure of duodenal ulcer associated with eradication of Helicobacter pylori.
50 patients with intractable duodenal ulcer were randomly assigned to 4 weeks of treatment with colloidal bismuth subcitrate (CBS) alone (26 patients) or with amoxicillin and metronidazole (24 patients). 5 patients (all on triple therapy) withdrew because of side-effects. In 17 of the 45 patients who completed the treatment, Helicobacter pylori was eradicated, and there was no ulcer relapse during the first 12 months of follow-up. The ulcer relapse rate was significantly higher (17 of 21 [89%]) among patients who remained positive for H pylori. 9 patients who remained positive for H pylori and had ulcer relapses within 6 months of treatment with CBS alone, were subsequently given triple therapy. 7 of the 9 showed H pylori eradication and no relapses within the next 12 months. The 2 patients still H pylori-positive after triple therapy had further ulcer relapses. H pylori eradication, without altering acid output, will become the mainstay of duodenal ulcer treatment because it cures the disease.
Rauws
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EA
Department of Gastroenterology and Hepatology, Academic Medical Centre, Amsterdam, The Netherlands.
Tytgat
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GN
D000284:Administration, Oral; D000658:Amoxicillin / Q000008:administration & dosage / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002167:Campylobacter / Q000302:isolation & purification; D002169:Campylobacter Infections / Q000150:complications / Q000188:drug therapy*; D004334:Drug Administration Schedule; D004341:Drug Evaluation; D004359:Drug Therapy, Combination; D004381:Duodenal Ulcer / Q000150:complications / Q000188:drug therapy*; D005500:Follow-Up Studies; D005753:Gastric Mucosa / Q000382:microbiology; D006801:Humans; D008795:Metronidazole / Q000008:administration & dosage / Q000627:therapeutic use; D009942:Organometallic Compounds / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence
D000897:Anti-Ulcer Agents; D009942:Organometallic Compounds; D008795:Metronidazole; D000658:Amoxicillin; C002791:bismuth tripotassium dicitrate