Duodenal Ulcer Relapse Is Not Always Associated with Recurrence of <i>H. pylori</i> Infection: A Prospective Three‐Year Follow‐Up Study

Martino, Gina; Paoletti, M.; Marcheggiano, Adriana; D’Ambra, G.; Fave, Gianfranco Delle; Annibale, Bruno

doi:10.1046/j.1523-5378.1999.99285.x

Cited by 11 publications

(9 citation statements)

References 23 publications

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“…We found that the annual recurrence rate of peptic ulcers after H. pylori eradication was 1.9% (crude recurrence rate; 3%). The recurrence rates reported in the literature are lower than [5,6], similar to [7–11], or slightly higher than ours [12,13]. Differences in results of studies with a higher relapse rate may arise from methodological differences, such as selection of ulcer patients (study subjects include only active ulcer) and exclusion of patients who received maintenance treatment by antiulcer drugs.…”

Section: Discussionsupporting

confidence: 62%

Recurrent Peptic Ulcers in Patients Following Successful Helicobacter pylori Eradication: A Multicenter Study of 4940 Patients

et al. 2004

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Section: Discussionsupporting

confidence: 62%

Recurrent Peptic Ulcers in Patients Following Successful Helicobacter pylori Eradication: A Multicenter Study of 4940 Patients

et al. 2004

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“…Zollinger–Ellison Syndrome, hypersecretory duodenal ulcer). Some of the patients were included in other study protocols 9 , . 14 In detail, we diagnosed seven Zollinger–Ellison Syndrome patients, 14 hypersecretory duodenal ulcer disease patients and 78 duodenal ulcer patients with acid secretion in the normal range (Table 1) As reported before, we defined patients to be affected by hypersecretory duodenal ulcer when both basal and pentagastrin‐stimulated acid output were above the normal range (10 meq/h for basal acid output, 44.5 meq/h for pentagastrin acid output), with normal gastrin values 14 .…”

Section: Methodsmentioning

confidence: 99%

“…and metronidazole 250 mg t.d.s. for the first 2 weeks), as previously published 9 . The effect of the therapy on H. pylori infection was determined at 3 months by endoscopy and gastric biopsies on 92 patients (14 hypersecretory duodenal ulcer and 78 duodenal ulcer); 78 patients (86%) were successfully cured.…”

Section: Methodsmentioning

confidence: 99%

Occurrence and relapse of bleeding from duodenal ulcer: respective roles of acid secretion and Helicobacter pylori infection

Capurso¹,

Annibale²,

Osborn³

et al. 2001

Aliment Pharmacol Ther

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BACKGROUNDHelicobacter pylori infection and gastric acid hypersecretion together with NSAID consumption, are the main factors involved in gastroduodenal injury and bleeding. 1 Peptic ulcer is the most common cause of non-variceal upper gastrointestinal bleeding, accounting for 50±60% of cases. Bleeding episodes are frequent in duodenal ulcer patients, with a prevalence of 15±20% and a mortality up to 7%. 2 Patients who have bled once are considered to be at a higher risk of re-bleeding. Of duodenal ulcer patients, 95% have H. pylori infection of the gastroduodenal mucosa and its cure signi®cantly reduces the rate of both ulcer and bleeding recurrence in those patients with previous bleeding episodes. 3±6 Acid secretion has been found to be elevated in patients with bleeding from peptic ulcer. 7 Recent reports have shown that duodenal ulcer can also recur in the absence of H. pylori infection or NSAID consumption. 8, 9 SUMMARYBackground: Helicobacter pylori infection, gastric acid hypersecretion and NSAID consumption may cause peptic ulcer. Aim: To investigate the respective roles of H. pylori and acid secretion in bleeding duodenal ulcer. Patients and methods: A total of 99 duodenal ulcer patients were referred for evaluation of acid secretion: seven with Zollinger±Ellison Syndrome; 14 with hypersecretory duodenal ulcer, de®ned by the coexistence of elevated basal acid output and pentagastrin acid output; and 78 duodenal ulcer patients with normal acid output. All non-Zollinger±Ellison Syndrome patients were H. pylori-positive and cured of infection. All patients were followed-up for a 36-month period, to assess the occurrence of bleeding episodes. Results: Twenty-nine patients had at least one bleeding episode in the 4 years before the study. Bleeding was more frequent in males and in patients on NSAIDs. The

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“…Of these patients, eight were H. pylori positive and five were H. pylori negative. No significant difference was found between H. pylori‐ positive and negative groups, suggesting that there were other factors, such as acidity of gastric juice and glycoprotein in gastric mucus, that participated in the development of peptic ulcers, that is, the recurrence of peptic ulcers is not necessarily associated with H. pylori reinfection 7,8 …”

Section: Discussionmentioning

confidence: 92%

Five‐year follow‐up study after Helicobacter pylori eradication: Reinfection and peptic ulcer status

Zhou

Lin

Shen

et al. 2003

Chinese Journal of Digestive Diseases

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OBJECTIVE: To investigate the prevalence of peptic ulcers and Helicobactor pylori reinfection 5 years after H. pylori eradication. METHODS: One thousand and six adults were randomly sampled from the general population in a high‐incidence region of gastric cancer. Of these, 552 subjects were confirmed to be H. pylori‐positive by using both the rapid urease test and the Warthin−Starry stain. All H. pylori‐positive subjects were randomly divided into two groups: (i) the eradication group, who received 1 week of omeprazole‐based triple therapy; and (ii) the control group, who received placebo tablets. Four weeks after the cessation of treatment, 13C‐urea breath tests demonstrated that H. pylori had been successfully eradicated in 88.9% of patients in the eradication group, whereas 96.4% of patients remained H. pylori positive in the control group. Subjects in both groups were followed up using endoscopy at the end of the first and fifth year after treatment. The H. pylori infection status was determined by using the rapid urease test and Warthin−Starry staining. RESULTS: The response rates to endoscopy at the end of the first and fifth year were 89.3 and 83.11%, respectively. The prevalence of peptic ulcers in the eradication group and control group were 9.87 and 7.61% before treatment, 3.70 and 12.58% 1 year after treatment (P < 0.05), and 5.86 and 14.93% 5 years after treatment (P < 0.05), respectively. The recurrence rates of peptic ulcers in the eradication group and the control group were 3.70 and 38.10% 1 year after treatment, and 14.81 and 42.86% 5 years after treatment, respectively. The rates of H. pylori infection 1 and 5 years after treatment in the eradication group were 13.58, and 19.82%, respectively. In the control group, the rates of H. pylori infection were 91.97 and 83.26% 1 and 5 years after treatment, respectively. CONCLUSIONS: The prevalence of peptic ulcers decreased significantly after the eradication of H. pylori. The reinfection rate after H. pylori eradication was 4−5% per year. Helicobacter pylori infection status remained constant in almost 85% of cases.

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Duodenal Ulcer Relapse Is Not Always Associated with Recurrence of H. pylori Infection: A Prospective Three‐Year Follow‐Up Study

Abstract: Recurrence of H. pylori infection is very low where treatment is effective, but a DU relapse, not related to acid hypersecretion, can occur in a small percentage of cured patients.

Cited by 11 publications

References 23 publications

Recurrent Peptic Ulcers in Patients Following Successful Helicobacter pylori Eradication: A Multicenter Study of 4940 Patients

Recurrent Peptic Ulcers in Patients Following Successful Helicobacter pylori Eradication: A Multicenter Study of 4940 Patients

Occurrence and relapse of bleeding from duodenal ulcer: respective roles of acid secretion and Helicobacter pylori infection

Five‐year follow‐up study after Helicobacter pylori eradication: Reinfection and peptic ulcer status

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