title: Randomised double blind controlled study of recurrence of gastric ulcer after treatment for eradication of Helicobacter pylori infection.
abstract: OBJECTIVE
  To determine whether eradication of Helicobacter pylori infection reduces recurrence of benign gastric ulceration.
  
  
  METHODS
  Randomised, double blind, controlled study. Patients were randomised in a 1:2 ratio to either omeprazole 40 mg once daily for eight weeks or the same treatment plus amoxycillin 750 mg twice daily for weeks 7 and 8. A 12 month untreated follow up ensued.
  
  
  METHODS
  Teaching and district general hospitals between 1991 and 1994.
  
  
  METHODS
  107 patients with benign gastric ulcer associated with H pylori.
  
  
  METHODS
  Endoscopically confirmed relapse with gastric ulcer (analysed with life table methods), H pylori eradication, and healing of gastric ulcers (Mantel-Haenszel test).
  
  
  RESULTS
  172 patients were enrolled. Malignancy was diagnosed in 19; 24 were not infected with H pylori; four withdrew because of adverse events; and 18 failed to attend for start of treatment, leaving 107 patients eligible for analysis (35 omeprazole alone; 72 omeprazole plus amoxycillin). In the omeprazole/amoxycillin group 93% (67/72; 95% confidence interval 84% to 98%) of gastric ulcers healed and 83% (29/35; 66% to 94%) in the omeprazole group (P = 0.103). Eradication of H pylori was 58% (42/72; 46% to 70%) and 6% (2/35; 1% to 19%) (P < 0.001) and relapse after treatment was 22% (16/72) and 49% (17/35) (life table analysis, P < 0.001), in the two groups, respectively. The recurrence rates were 7% (3/44) after successful H pylori eradication and 48% (30/63) in those who continued to be infected (P < 0.001).
  
  
  CONCLUSIONS
  Eradication of H pylori reduces relapse with gastric ulcer over one year. Eradication rates achieved with this regimen, however, are too low for it to be recommended for routine use.
authors.affiliation: Leeds General Infirmary.
authors.forename: A T
authors.initials: AT
authors.lastname: Axon
authors.forename: C A
authors.initials: CA
authors.lastname: O'Moráin
authors.forename: K D
authors.initials: KD
authors.lastname: Bardhan
authors.forename: J P
authors.initials: JP
authors.lastname: Crowe
authors.forename: A D
authors.initials: AD
authors.lastname: Beattie
authors.forename: R P
authors.initials: RP
authors.lastname: Thompson
authors.forename: P M
authors.initials: PM
authors.lastname: Smith
authors.forename: F D
authors.initials: FD
authors.lastname: Hollanders
authors.forename: J H
authors.initials: JH
authors.lastname: Baron
authors.forename: D A
authors.initials: DA
authors.lastname: Lynch
authors.forename: M F
authors.initials: MF
authors.lastname: Dixon
authors.forename: D S
authors.initials: DS
authors.lastname: Tompkins
authors.forename: H
authors.initials: H
authors.lastname: Birrell
authors.forename: K R
authors.initials: KR
authors.lastname: Gillon
mesh_terms: D000658:Amoxicillin / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D001706:Biopsy; D004311:Double-Blind Method; 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; D013274:Stomach Neoplasms / Q000473:pathology; D013276:Stomach Ulcer / Q000188:drug therapy* / Q000382:microbiology; D014945:Wound Healing
chemical_list: D000897:Anti-Ulcer Agents; D010406:Penicillins; D000658:Amoxicillin; D009853:Omeprazole