title: Helicobacter pylori eradication prevents recurrence after simple closure of perforated duodenal ulcer.
abstract: OBJECTIVE
  Evidence remains inconclusive as to whether eradication of Helicobacter pylori prevents ulcer relapse after simple closure of a perforated duodenal ulcer. This study was conducted to determine the effect of H. pylori eradication using a quadruple drug regimen along with a probiotic on ulcer recurrence after perforation closure.
  
  
  METHODS
  A total of 93 patients who had presented with perforated duodenal ulcer and had a simple closure of a duodenal perforation comprised the study group. Three months postoperatively, patients who were found to be positive for H. pylori infection (n = 60) were administered quadruple therapy consisting of omeprazole, clarithromycin, amoxicillin and colloidal bismuth subcitrate for 10 days along with the probiotic Lactobacillus sporogenes for 14 days. Diagnosis of H. pylori was carried out by urease test and histology. Patients were followed for 18 months. Recurrence of ulcer was analyzed for correlation with H. pylori status.
  
  
  RESULTS
  Of 60 patients who received H. pylori eradication therapy, 53 were available for subsequent follow up. H. pylori eradication was achieved in 43/53 (81.1%) patients. The ulcer recurrence in the eradicated group was 18.6% (8/43) compared to 70% (7/10) in the noneradicated group (P = 0.003).
  
  
  CONCLUSIONS
  Eradication of H. pylori significantly reduces the relapse of duodenal ulcer after simple closure of perforation. Anti H. pylori therapy must be recommended for all H. pylori positive patients after simple closure of a perforated duodenal ulcer.
authors.affiliation: Department of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.
authors.forename: Ashitha C
authors.initials: AC
authors.lastname: Bose
authors.forename: Vikram
authors.initials: V
authors.lastname: Kate
authors.forename: Nilakantan
authors.initials: N
authors.lastname: Ananthakrishnan
authors.forename: Subhash Chandra
authors.initials: SC
authors.lastname: Parija
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004381:Duodenal Ulcer / Q000382:microbiology / Q000517:prevention & control*; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D010439:Peptic Ulcer Perforation / Q000382:microbiology / Q000517:prevention & control*; D011446:Prospective Studies; D012008:Recurrence