Peptic ulcer recurrence after Helicobacter pylori eradication: a 5-year follow-up study.
OBJECTIVE
To investigate whether eradication of Helicobacter pylori prevents peptic ulcer recurrence in the long term.


METHODS
We treated 81 patients with endoscopically proven H. pylori-related peptic ulcers (39 with gastric ulcers and 42 with duodenal ulcers) with either amoxycillin or clarithromycin in combination with a proton-pump inhibitor or a histamine H2-receptor antagonist. The patients were followed for a recurrence of peptic ulcers for at least 5 years. Recurrence was assessed by endoscopy and the status of H. pylori was evaluated by culture, a rapid urease test and a histological examination.


RESULTS
After 5 years of follow-up, the rate of recurrence of H. pylori-related duodenal ulcers decreased significantly (P < 0.0001) in the H. pylori-eradicated patients compared with non-eradicated patients. However, in the gastric ulcer group, there was no significant reduction in the recurrence rate.


CONCLUSIONS
Our findings suggest that eradication of H. pylori significantly reduces the rate of duodenal ulcer relapse and that this relapse is associated with the presence of H. pylori. Therefore, H. pylori eradication may be considered a definitive cure for duodenal ulcers.
Fujioka
T
T
Second Department of Internal Medicine, Oita Medical University, Japan.
Uribe
R U
RU
Kubota
T
T
Murakami
K
K
Kawasaki
H
H
Nasu
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001706:Biopsy; D017291:Clarithromycin / Q000627:therapeutic use; D016145:Endoscopy, Digestive System; D005260:Female; D005500:Follow-Up Studies; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D016480:Helicobacter pylori / Q000187:drug effects / Q000302:isolation & purification*; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D010406:Penicillins / Q000627:therapeutic use; D010437:Peptic Ulcer / Q000382:microbiology / Q000473:pathology / Q000517:prevention & control*; D011446:Prospective Studies; D012008:Recurrence
D000900:Anti-Bacterial Agents; D006635:Histamine H2 Antagonists; D010406:Penicillins; D000658:Amoxicillin; D017291:Clarithromycin