Efficacy of omeprazole one year after cure of Helicobacter pylori infection in duodenal ulcer patients.
OBJECTIVE
We have previously shown that, in duodenal ulcer patients, pH control by omeprazole is less pronounced after cure of Helicobacter pylori infection. The present study was designed to test the hypothesis that this response to omeprazole persists 1 yr after cure of H. pylori infection.


METHODS
In 12 duodenal ulcer patients, intragastric acidity was measured with a glass electrode during treatment with omeprazole (20 mg) once daily before, and 4-6 wk and 1 yr after, cure of H. pylori infection. H. pylori infection was assessed by [13C]urea breath test, culture, histology (Warthin Starry stain), and rapid urease test.


RESULTS
Cure of H. pylori infection resulted in a lowered pH during omeprazole treatment. This effect persisted after 1 yr. Median 24-h gastric pH before H. pylori treatment was 5.6; 4-6 wk after cure of the infection it was 2.9 (p = 0.003), and 1 yr after cure of the infection it remained unchanged (pH = 2.5; p = 0.5). Accordingly, twice as much time was spent above pH 3 and pH 4 before H. pylori treatment than 1 or 12 months after cure (percent of time > or = pH 3: 82.7 vs. 49.7 vs. 43.1; percent of time > or = pH 4: 72.7 vs. 38.3 vs. 26.4).


CONCLUSIONS
In duodenal ulcer patients, cure of H. pylori infection resulted in a marked rapid and persistent decrease of the pH increasing effect of omeprazole. Therefore, H. pylori is a determinant of the pH achieved in response to omeprazole treatment in duodenal ulcer patients.
Labenz
J
J
Department of Internal Medicine and Gastroenterology, Elisabeth Hospital Essen, Germany.
Tillenburg
B
B
Peitz
U
U
Börsch
G
G
Idström
J P
JP
Verdú
E
E
Stolte
M
M
Blum
A L
AL
D000328:Adult; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D001706:Biopsy; D004381:Duodenal Ulcer / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D005745:Gastric Acidity Determination; D005753:Gastric Mucosa / Q000473:pathology; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000627:therapeutic use*; D012074:Remission Induction; D013997:Time Factors
D000897:Anti-Ulcer Agents; D009853:Omeprazole