[Reinfection with Helicobacter pylori in patients with duodenal ulcer after successful eradication].
Tomasz Mach, Janina Zahradnik-Bilska
Abstract
Tomasz Mach, Janina Zahradnik-Bilska
Abstract
The study was performed in 224 patients with exacerbated chronic duodenal ulcer and with Helicobater pylori (H. pylori) infection. The infection was confirmed by histological techniques and rapid urease test. The patients were treated randomly with one of the triple therapies: 1) omeprazole with amoxicillin and clarithromycin, 2) omeprazole with clarithromycin and metronidazole or 3) colloidal bismuth with amoxicillin and metronidazole and after eradication the antiulcer drug was continued for 4 weeks. The control endoscopy was performed 6 weeks after the beginning of the therapy and during two-year follow-up. The ulcer healing, macroscopic and microscopic appearance of the gastric mucosa and H. pylori infection was examined. Endoscopy was repeated 1 and 2 years after successful eradication. The ulcer was healed in 93%, 95% and 92% of patients from groups I, II and III, respectively, and eradication of H. pylori was seen in 83-90% of cases. The treatment significantly diminished the chronic active gastritis. During 1- and 2-year follow-up the ulcer recurrences were observed in 5.3% and 13% of patients and reinfection in 7.7% and 16.7% of cases. The ulcer recurrences appeared in patients with H. pylori infection. The H. pylori reinfection rate was higher than observed in western countries.
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The study was performed in 224 patients with exacerbated chronic duodenal ulcer and with Helicobater pylori (H. pylori) infection. The infection was confirmed by histological techniques and rapid urease test. The patients were treated randomly with one of the triple therapies: 1) omeprazole with amoxicillin and clarithromycin, 2) omeprazole with clarithromycin and metronidazole or 3) colloidal bismuth with amoxicillin and metronidazole and after eradication the antiulcer drug was continued for 4 weeks. The control endoscopy was performed 6 weeks after the beginning of the therapy and during two-year follow-up. The ulcer healing, macroscopic and microscopic appearance of the gastric mucosa and H. pylori infection was examined. Endoscopy was repeated 1 and 2 years after successful eradication. The ulcer was healed in 93%, 95% and 92% of patients from groups I, II and III, respectively, and eradication of H. pylori was seen in 83-90% of cases. The treatment significantly diminished the chronic active gastritis. During 1- and 2-year follow-up the ulcer recurrences were observed in 5.3% and 13% of patients and reinfection in 7.7% and 16.7% of cases. The ulcer recurrences appeared in patients with H. pylori infection. The H. pylori reinfection rate was higher than observed in western countries.
Key concepts: Clarithromycin, Omeprazole, Metronidazole, Medicine, Gastroenterology, Helicobacter pylori, Rapid urease test, Internal medicine