The impact of Helicobacter pylori eradication on peptic ulcer healing.
OBJECTIVE
Current literature was reviewed analyzing the outcome of peptic ulcer healing in relation to the results of the posttherapeutic Helicobacter pylori (HP) status.


METHODS
Literature was reviewed along with an analysis of 60 studies, comprising a total of 4329 patients.


RESULTS
Successful Helicobacter pylori eradication was found to induce a better response in peptic ulcer healing, regardless of diagnosis: gastric ulcer 88% vs 73% (odds ratio [OR] 2.7, p < 0.01), duodenal ulcer 95% vs 76% (OR 5.6, p < 0.0001), and peptic ulcer 95% vs 76% (OR 6.6, p < 0.0001), for patients having their HP infection successfully cured versus those remaining HP-positive, respectively (Fisher's exact test). For all evaluated time points (< or = 6, 7-8, and 10-12 wk after beginning treatment), HP-negative patients had higher healing rates than HP-positive patients (95% vs 82%, 94% vs 69%, and 96% vs 78% with corresponding OR of 4.2, 6.5, and 7.4, all p < 0.0001, Fisher's exact test). The use of concomitant acid suppression therapy during initial HP eradication provided a benefit on peptic ulcer healing only for patients with persistent HP infection (improved healing rates of 78% vs 67%; otherwise rates were 94-96%). Likewise, prolonged acid inhibition in HP treatment failures after the initial HP treatment phase resulted in 7-20% improved healing rates, whereas patients becoming HP-negative did not profit.


CONCLUSIONS
Successful HP eradication therapy accelerates peptic ulcer healing even without concomitant acid suppression.
Department of Gastroenterology, Robert-Bosch Hospital, Stuttgart, Germany.
G
G
Treiber
J R
JR
Lambert
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000863:Antacids / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D001562:Benzimidazoles / Q000627:therapeutic use; D004381:Duodenal Ulcer / Q000188:drug therapy / Q000382:microbiology; D005744:Gastric Acid / Q000378:metabolism; D016481:Helicobacter Infections / Q000628:therapy*; D016480:Helicobacter pylori; D006801:Humans; D064747:Lansoprazole; D016017:Odds Ratio; D009853:Omeprazole / Q000031:analogs & derivatives / Q000627:therapeutic use; D000077402:Pantoprazole; D010437:Peptic Ulcer / Q000188:drug therapy / Q000382:microbiology*; D011899:Ranitidine / Q000627:therapeutic use; D013276:Stomach Ulcer / Q000188:drug therapy / Q000382:microbiology; D013454:Sulfoxides / Q000627:therapeutic use; D016896:Treatment Outcome; D014945:Wound Healing
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000863:Antacids; D000897:Anti-Ulcer Agents; D001562:Benzimidazoles; D013454:Sulfoxides; D064747:Lansoprazole; D011899:Ranitidine; D000077402:Pantoprazole; D009853:Omeprazole