HELICOBACTER-PYLORI ERADICATION WITH SHORT-TERM THERAPY LEADS TO DUODENAL-ULCER HEALING WITHOUT THE NEED FOR CONTINUED ACID SUPPRESSION THERAPY

Objective: To determine whether duodenal ulcers continue to heal follo wing successful Helicobacter pylori eradication with short-term eradic ation therapy without further acid suppression therapy. Methods: Patie nts with endoscopically proven duodenal ulcers who were H. pylori posi tive were randomized to receive omeprazole 40 mg each morning and clar ithromycin 500 mg three times daily or famotidine 40 mg twice daily an d clarithromycin 500 mg three times daily for 2 weeks. No acid-suppres sing agents nor ulcer-healing drugs such as bismuth compounds or sucra lfate were prescribed after that. Patients were re-examined endoscopic ally at week 2 at the end of treatment, and at week 6, 4 weeks after t he completion of treatment. Results: Thirty of 44 (68.2%) patients fro m both treatment arms, in whom the bacteria were subsequently noted to have been eradicated, had healed ulcers at week 2; at Week 6, 42 of 4 4 (95.5%) were noted to have healed ulcers without further acid-suppre ssing or ulcer-healing treatment. Conclusion: Although a short-term ac id-suppressing treatment is insufficient to heal ulcers, where an impo rtant putative factor such as H. pylori is eliminated, the ulcer heali ng process continues without further need for acid-suppressing or ulce r-healing agents.