Effect of Sucralfate on Helicobacter pylori and Severity of Gastritis in Patients with Duodenal Ulcer

BACKGROUND: Duodenal ulcer relapse rates have been reported to be lower following healing with sucralfate. The question arises whether this is related to an effect on Helicobacter pylori. METHODS: In order to investigate this possibility, 43 patients with active duodenal ulcer were entered into a study. Endoscopy was performed at entry, following 6 weeks' treatment with sucralfate 1 g q.i.d., and at 4 and 12 weeks of post-documented healing. Antral and gastric corpus biopsies were taken for assessment of H. pylori status (CLOtest), density of infection, and severity of gastritis. In addition, 14C urea breath tests (UBT) were performed. RESULTS: Sucralfate therapy induced a significant decrease in the density of H. pylori infection, with a trend to improvement of the gastritis in the antrum, but not in the corpus. However, all patients remained CLOtest positive, and the overall gastric urease activity was unchanged following therapy. These effects did not appear to influence either initial duodenal ulcer healing or subsequent relapse rates. CONCLUSION: Sucralfate has a suppressive effect on H. pylori infection in the gastric antrum but the clinical relevance of this is uncertain.