Effect of short-term treatment with regular or high doses of omeprazole on the detection of Helicobacter pylori in bleeding peptic ulcer patients.
BACKGROUND
It is unknown whether short-term regular or high-dose omeprazole has any influence on the colonization of Helicobacter pylori in the stomach. We therefore studied the effect of 3-day treatment of 2 different doses of omeprazole.


METHODS
H. pylori-positive patients with peptic ulcer bleeding (n = 101) were randomized to receive either a regular dose (20 mg/day for 3 days) (n = 51) or a high dose of omeprazole (80 mg bolus + 8 mg/h infusion/day for 3 days) (n = 50). H. pylori status was assessed by histology and urease testing of gastric biopsies pre-entry and after 3-day therapy.


RESULTS
With the high dose of omeprazole, tests for the diagnosis of H. pylori became negative significantly more often than with the regular dose (60% versus 27.5%, P=0.001 (any test), 67.6% versus 31.7%, P=0.003 (histology) and 82.2% versus 43.6%, P=0.001 (urease test)).


CONCLUSIONS
Conversion of the H. pylori tests negative after 3-day treatment of omeprazole is dose-dependent. The diagnosis of H. pylori infection depends on the timing of biopsies in relation to the beginning of proton-pump inhibitor treatment. If samples to find H. pylori are not taken before the treatment, the presence of the bacteria may be overlooked.
Udd
M
M
Dept. of Surgery, Central Hospital of Central Finland, Helsinki, Finland. Marianne.Udd@hus.fi
Miettinen
P
P
Palmu
A
A
Julkunen
R
R
D000897:Anti-Ulcer Agents / Q000494:pharmacology* / Q000627:therapeutic use; D003938:Diagnostic Techniques, Digestive System; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004791:Enzyme Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy* / Q000382:microbiology*; D016481:Helicobacter Infections / Q000150:complications / Q000175:diagnosis*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D009853:Omeprazole / Q000494:pharmacology* / Q000627:therapeutic use; D010437:Peptic Ulcer / Q000188:drug therapy* / Q000382:microbiology* / Q000503:physiopathology; D016896:Treatment Outcome
D000897:Anti-Ulcer Agents; D004791:Enzyme Inhibitors; D009853:Omeprazole