title: Recurrent peptic ulcers in patients following successful Helicobacter pylori eradication: a multicenter study of 4940 patients.
abstract: OBJECTIVE
  Although curative treatment of Helicobacter pylori infection markedly reduces the relapse of peptic ulcers, the details of the ulcers that do recur is not well characterized. The aim of this study is to describe the recurrence rate and specific features of peptic ulcers after cure of H. pylori infection.
  
  
  METHODS
  This was a multicenter study involving 4940 peptic ulcer patients who were H. pylori negative after successful eradication treatment and were followed for up to 48 months. The annual incidence of ulcer relapse in H. pylori-cured patients, background of patients with relapsed ulcers, time to relapse, ulcer size, and site of relapsed ulcers were investigated.
  
  
  RESULTS
  Crude peptic ulcer recurrence rate was 3.02% (149/4940). The annual recurrence rates of gastric, duodenal and gastroduodenal ulcer were 2.3%, 1.6%, and 1.6%, respectively. Exclusion of patients who took NSAIDs led annual recurrence rates to 1.9%, 1.5% and 1.3%, respectively. The recurrence rate was significantly higher in gastric ulcer. Recurrence rates of patients who smoked, consumed alcohol, and used NSAIDs were significantly higher in those with gastric ulcer recurrence compared to duodenal ulcer recurrence (e.g. 125 of 149 [83.9%] relapsed ulcers recurred at the same or adjacent sites as the previous ulcers).
  
  
  CONCLUSIONS
  Curative treatment of H. pylori infection is useful in preventing ulcer recurrence. Gastric ulcer is more likely to relapse than duodenal ulcer. Recurrent ulcer tended to recur at the site of the original ulcers.
authors.affiliation: Department of Gastroenterology, Juntendo University School of Medicine,Tokyo, Japan.
authors.forename: Hiroto
authors.initials: H
authors.lastname: Miwa
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Sakaki
authors.forename: Kentaro
authors.initials: K
authors.lastname: Sugano
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Sekine
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Higuchi
authors.forename: Naomi
authors.initials: N
authors.lastname: Uemura
authors.forename: Mototsugu
authors.initials: M
authors.lastname: Kato
authors.forename: Kazunari
authors.initials: K
authors.lastname: Murakami
authors.forename: Chieko
authors.initials: C
authors.lastname: Kato
authors.forename: Akiko
authors.initials: A
authors.lastname: Shiotani
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Ohkusa
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takagi
authors.forename: Nobuo
authors.initials: N
authors.lastname: Aoyama
authors.forename: Ken
authors.initials: K
authors.lastname: Haruma
authors.forename: Kazuichi
authors.initials: K
authors.lastname: Okazaki
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kusugami
authors.forename: Masayuki
authors.initials: M
authors.lastname: Suzuki
authors.forename: Takashi
authors.initials: T
authors.lastname: Joh
authors.forename: Takeshi
authors.initials: T
authors.lastname: Azuma
authors.forename: Akinori
authors.initials: A
authors.lastname: Yanaka
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Suzuki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hashimoto
authors.forename: Takashi
authors.initials: T
authors.lastname: Kawai
authors.forename: Toshiro
authors.initials: T
authors.lastname: Sugiyama
mesh_terms: D000428:Alcohol Drinking; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D004381:Duodenal Ulcer / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D004386:Duodenum / Q000473:pathology; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D015994:Incidence; D007564:Japan; D008297:Male; D010437:Peptic Ulcer / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking; D013270:Stomach / Q000473:pathology; D013276:Stomach Ulcer / Q000453:epidemiology / Q000209:etiology / Q000473:pathology
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal