Arrest of chronic acid suppressant drug use after successful Helicobacter pylori eradication in patients with peptic ulcer disease: a six-month follow-up study.
BACKGROUND
It remains controversial whether successful H. pylori eradication leads to relief of dyspepsia and the subsequent arrest or tapering of acid-suppressant drug therapy, or to an aggravation of acid-related dyspepsia requiring more acid-suppressant drug intake.


OBJECTIVE
To evaluate prospectively the effect of H. pylori eradication on the requirement of acid-suppressant drug or antacids and the evolution of dyspeptic symptoms in chronic acid-suppressant drug users with peptic ulcer disease.


METHODS
The use of acid-suppressant drugs, rescue antacids and predominant symptoms were recorded prospectively during 24 weeks after H. pylori eradication therapy in 75 peptic ulcer disease patients.


RESULTS
In 71 patients with complete follow-up, ulcers were healed at follow-up endoscopy and H. pylori was successfully eradicated. After 6 months, 93% (66 out of 71) of chronic acid-suppressant drug users had stopped acid-suppressant drug intake. The mean daily acid-suppressant drug dosage per patient decreased from 1.72 at entry to 0.03 units acid-suppressant drug (98%; P < 0.0001) during follow-up. The mean number of antacid tablets/day/patient was 0.26 during follow-up for the relief of mild inter-current dyspeptic symptoms. Medication use was not different in peptic ulcer disease patients with or without gastro-oesophageal reflux disease at baseline. The prevalence of gastro-oesophageal reflux disease decreased from 42% before to 35% after H. pylori eradication (N.S.).


CONCLUSIONS
Successful H. pylori eradication in peptic ulcer disease patients almost completely eliminates the need for acid-suppressant drug regardless of the presence or absence of gastro-oesophageal reflux disease at entry.
Hurenkamp
G J
GJ
Department of General Practice, Academic Medical Centre, Meibergdreef 9, Amsterdam, the Netherlands. g.j.hurenkamp@amc.uva.nl
Grundmeijer
H G
HG
Van Der Ende
A
A
Tytgat
G N
GN
Assendelft
W J
WJ
Van Der Hulst
R W
RW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000863:Antacids / Q000008:administration & dosage* / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D004415:Dyspepsia / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D005744:Gastric Acid; D005764:Gastroesophageal Reflux / Q000517:prevention & control; D016481:Helicobacter Infections / Q000150:complications* / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000472:pathogenicity; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000188:drug therapy* / Q000382:microbiology
D000863:Antacids; D000897:Anti-Ulcer Agents