Eradication of Helicobacter pylori for the Prevention of Peptic Ulcer Rebleeding
Version of Record online: 30 JUL 2007
Volume 12, Issue 4, pages 279–286, August 2007
How to Cite
Gisbert, J. P., Calvet, X., Feu, F., Bory, F., Cosme, A., Almela, P., Santolaria, S., Aznárez, R., Castro, M., Fernández, N., García-Grávalos, R., Cañete, N., Benages, A., Montoro, M., Borda, F., Pérez-Aisa, A. and Piqué, J. M. (2007), Eradication of Helicobacter pylori for the Prevention of Peptic Ulcer Rebleeding. Helicobacter, 12: 279–286. doi: 10.1111/j.1523-5378.2007.00490.x
- Issue online: 30 JUL 2007
- Version of Record online: 30 JUL 2007
- Helicobacter pylori;
- peptic ulcer bleeding;
- H2-receptor antagonist;
- proton pump inhibitor;
- upper gastrointestinal hemorrhage;
- upper gastrointestinal bleeding
Aim: To evaluate the effect of Helicobacter pylori eradication on ulcer bleeding recurrence in a prospective, long-term study including more than 400 patients.
Methods: Patients with peptic ulcer bleeding were prospectively included. H. pylori infection was confirmed by rapid urease test, histology or 13C-urea breath test. Several eradication regimens were used. Ranitidine 150 mg was administered daily until eradication was confirmed by breath test 8 weeks after completing eradication therapy. Patients with therapy failure received a second or third course of therapy. Patients with eradication success did not receive maintenance anti-ulcer therapy, and were controlled yearly with a repeated breath test.
Results: Four hundred and twenty-two patients were followed up for at least 12 months, with a total of 906 patient-years of follow up. Mean age was 59 years, and 35% were previous nonsteroidal anti-inflammatory drug (NSAID) users. Sixty-nine percent had duodenal, 24% gastric, and 7% pyloric ulcer. Recurrence of bleeding was demonstrated in two patients at 1 year (incidence: 0.22% per patient-year of follow up), which occurred after NSAID use in both cases.
Conclusion: Peptic ulcer rebleeding does not occur in patients with complicated ulcers after H. pylori eradication. Maintenance anti-ulcer (antisecretory) therapy is not necessary if eradication is achieved.