Does smoking predispose to peptic ulcer relapse after eradication of Helicobacter pylori?
OBJECTIVE
To investigate whether smoking would increase ulcer recurrence after eradication of Helicobacter pylori (H. pylori) without maintenance acid-suppression therapy.


METHODS
A total of 287 patients, 256 patients with duodenal ulcers and 31 patients with gastric ulcers, were followed-up for up to 18 months after ulcer healing and successful eradication of H. pylori. There were 83 smokers (defined as smoking > or = 10 cigarettes/day) and 204 patients who never smoked or stopped smoking after the diagnosis of peptic ulcer disease. None were taking nonsteroidal anti-inflammatory drugs or receiving maintenance acid suppression therapy. Endoscopy was repeated either at the end of the follow-up period or when ulcer symptoms recurred.


RESULTS
Of the 83 smokers, 3 (3.6%) had ulcer recurrence, which included two duodenal ulcers and one gastric ulcer. Of the 204 nonsmokers, 4 (2.0%) had ulcer relapse, and all being recurrent duodenal ulcers. Four smokers (4.8%) and nine nonsmokers (4.4%) had recurrence of H. pylori infection after 10-18 months. There was no significant difference in ulcer relapse or recurrence of H. pylori infection between smokers and nonsmokers.


CONCLUSIONS
Cigarette smoking did not increase the recurrence of peptic ulcers after eradication of H. pylori.
Chan
F K
FK
Department of Medicine, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong.
Sung
J J
JJ
Lee
Y T
YT
Leung
W K
WK
Chan
L Y
LY
Yung
M Y
MY
Chung
S C
SC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000658:Amoxicillin / Q000627:therapeutic use; D000863:Antacids / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D001729:Bismuth / Q000627:therapeutic use; D004381:Duodenal Ulcer / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005500:Follow-Up Studies; D016481:Helicobacter Infections / Q000188:drug therapy; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000627:therapeutic use; D010406:Penicillins / Q000627:therapeutic use; D012008:Recurrence; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D013276:Stomach Ulcer / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D013392:Sucralfate / Q000627:therapeutic use; D014945:Wound Healing
D000863:Antacids; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000897:Anti-Ulcer Agents; D010406:Penicillins; D013392:Sucralfate; D000658:Amoxicillin; D009853:Omeprazole; D001729:Bismuth