Effect of Helicobacter pylori eradication on peptic ulcer disease complicated with outlet obstruction.
BACKGROUND
At present, the prevalence of Helicobacter pylori (H. pylori) in complicated peptic ulcer and the effect of H. pylori eradication on complicated peptic ulcer have not been fully established. In this study, we report the prevalence of H. pylori in peptic ulcer patients complicated with gastric outlet obstruction, effectiveness of oral eradication therapy on these patients, and their long-term follow up.


METHODS
Ten consecutive patients presenting with clinically and endoscopically significant obstructed peptic ulcers were included in this study. During each endoscopy, seven gastric biopsy specimens were obtained and analyzed for H. pylori colonization.


RESULTS
The antral mucosal biopsy specimens were positive for H. pylori in nine patients. H. pylori infection was eradicated and complete ulcer healing was observed in all patients. The mean follow-up period was 14 (7-24) months. One patient had duodenal perforation and underwent surgical intervention following medical treatment, despite the eradication of H. pylori. Ulcer recurrence was noted in two (22.2%) of nine patients, and in one of them the recurrent ulcer was complicated with obstruction (11. 1%). The mean time to ulcer recurrence was 17 months (range, 10-24 months). The biopsies and CLOtests were H. pylori negative at the time of ulcer or erosion recurrence in two patients.


CONCLUSIONS
We suggest that H. pylori eradication may improve the resolution in obstructive ulcer cases with colonization.
Taskin
V
V
Departments of Gastroenterology, Pathology, and Surgery, Inonu University School of Medicine, Malatya, Turkey.
Gurer
I
I
Ozyilkan
E
E
Sare
M
M
Hilmioglu
F
F
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D001729:Bismuth / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D017219:Gastric Outlet Obstruction / Q000150:complications*; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D008875:Middle Aged; D009853:Omeprazole / Q000627:therapeutic use; D009942:Organometallic Compounds / Q000627:therapeutic use; D010437:Peptic Ulcer / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D012459:Salicylates / Q000627:therapeutic use; D013752:Tetracycline / Q000627:therapeutic use; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D009942:Organometallic Compounds; D012459:Salicylates; D008795:Metronidazole; C015715:bismuth subsalicylate; D013752:Tetracycline; D009853:Omeprazole; D001729:Bismuth