Effect of Helicobacter pylori eradication on the healing and recurrence of peptic ulcer: combination therapy with low-dose omeprazole and clarithromycin.
OBJECTIVE
To investigate the effect of eradication of Helicobacter pylori using combination therapy with low-dose omeprazole and clarithromycin on the healing and recurrence of peptide ulcers.


METHODS
We studied 60 patients with active duodenal ulcers and 60 with gastric ulcers who were H. pylori-positive by the rapid urease test and a histological examination of antral biopsy specimens. The eradication method used was a combination of omeprazole (20 mg a day) and clarithromycin (400 mg twice a day). The patients were followed up for 24 months after the end of the treatment. H. pylori infection and the ulcer stage were investigated by endoscopy every 6 months. We assessed the relationship between H. pylori infection, ulcer healing to a white scar and ulcer recurrence after combination therapy.


RESULTS
H. pylori was eradicated in 23 out of 120 patients (22%), with suppression in 101 out of 120 patients (84%). The rate of ulcer healing to a white scar 6 months after treatment was significantly higher and the ulcer recurrence rate within 2 years after treatment was significantly lower in patients with H. pylori suppression or eradication than in those continuously positive for the organism.


CONCLUSIONS
These results suggest that not only the eradication but also the suppression of H. pylori may improve ulcer healing and reduce the rate of relapse.
Uemura
N
N
Division of Gastroenterology, Kure Kyosai Hospital, Japan.
Okamoto
S
S
Mukai
T
T
Yamaguchi
S
S
Kaji
M
M
Hrruma
K
K
Sumii
K
K
Kajiyama
G
G
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001706:Biopsy; D017291:Clarithromycin / Q000008:administration & dosage* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D016145:Endoscopy, Digestive System; D005260:Female; D005500:Follow-Up Studies; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D016480:Helicobacter pylori / Q000187:drug effects / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000008:administration & dosage* / Q000627:therapeutic use; D010437:Peptic Ulcer / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D012008:Recurrence
D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D017291:Clarithromycin; D009853:Omeprazole