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H. PYLORI HOLDS UP AS A CAUSE OF DUODENAL ULCER.

Back in February, an Austrian group reported that eradication of Helicobacter pylori in patients with duodenal ulcer was associated with a much-reduced ulcer recurrence rate (see Journal Watch accession number 930212001). The team used amoxicillin and metronidazole, plus ranitidine, but did not use bismuth compounds, because bismuth can help heal ulcers independently of its ability to eradicate H. pylori. Thus, the study showed that antibiotic treatment alone can prevent ulcer recurrence.

After this report came out, some observers argued that the duration of follow-up (one year) was too short to show that eradication of H. pylori really reduced ulcer recurrence. The Austrians now report the results of follow- up endoscopy at two years.

Among 53 patients with persistent H. pylori infection, there were 102 recurrences of duodenal ulcer. In contrast, among 46 patients who had H. pylori eradicated, there was only one recurrent ulcer.

Comment: The evidence is now very strong that H. pylori is a causal agent in gastritis, gastric ulcers, and duodenal ulcers.

— ALK

Published in Journal Watch General Medicine November 5, 1993

Citation(s):

Schutze K et al. More on the eradication of Helicobacter pylori and the recurrence of duodenal ulcer letter . N Engl J Med 1993 Oct 28 329 1356-1356.

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