PREVENTION OF ULCER RECURRENCE AFTER ERADICATION OF HELICOBACTER-PYLORI - A PROSPECTIVE LONG-TERM FOLLOW-UP-STUDY

Background & Aims: Short-term follow-up studies show lower relapse rat es of duodenal and gastric ulcers after successful Helicobacter pylori eradication. The aim of this study was to determine the long-term out come of ulcer disease after successful H. pylori eradication. Methods: We prospectively studied the long-term effect of H. pylori eradicatio n on ulcer recurrence rates in patients after endoscopically proven he aling of duodenal or gastric ulcers between 1984 and 1995. Patients us ing nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, or mainten ance antisecretory therapy were excluded. H. pylori infection was asse ssed by culture and histopathology of gastric biopsy specimens. After endoscopically proven ulcer healing and successful HI pylori eradicati on, 186 patients with ulcers underwent elective endoscopy every 3 mont hs during the first year of follow-up and were advised to contact us a t symptom recurrence. Thereafter, 96 patients were available for elect ive half-yearly endoscopies. The 89 patients who did not choose to und ergo the repeated endoscopies were asked about symptom recurrence and to undergo elective endoscopy in 1995. Results: Successful H. pylori e radication was achieved in 141 patients with duodenal ulcers and 45 pa tients with gastric ulcers. None of the 141 H. pylori-eradicated patie nts with duodenal ulcers had an ulcer relapse after fellow-up of 367 p atient-years. Ulcer relapses were also absent in the 45 H. pylori-erad icated patients with gastric ulcers after 113 patient-years of follow- up. Conclusions: Excluding patients taking aspirin or NSAIDs, recurren ce of duodenal or gastric ulcers is completely prevented after success ful H. pylori eradication for up to 9.8 years.