REINFECTION AND DUODENAL-ULCER RELAPSE IN SOUTH-EAST ASIAN PATIENTS FOLLOWING SUCCESSFUL HELICOBACTER-PYLORI ERADICATION - RESULTS OF A 2-YEAR FOLLOW-UP

Objectives: To determine the reinfection rate of Helicobacter pylori a nd duodenal ulcer relapse rate in a group of patients followed up long term. Design: Prospective study. Patients and methods: Patients were followed up endoscopically at 3, 6, 12 and 24 months after successful H. pylori eradication and duodenal ulcer healing. H. pylori status was determined by culture, rapid urease lest, Gram's slain of a fresh tis sue smear and histological examination of antral biopsies and rapid ur ease test and histological examination of corpus biopsies. Main outcom e measures: Duodenal ulcer healing, H. pylori reinfection. Results: Th irty-eight patients with duodenal ulcer disease (35 active, 3 healed) had successfully eradicated H. pylori following treatment with omepraz ole/amoxycillin (n = 11), omeprazole/amoxycillin/metronidazole (n = 16 ) and colloidal bismuth subcitrate/ amoxycillin/metronidazole (n = 11) . All patients with active duodenal ulcer had healed ulcers at the end of therapy. Thirty-five of 38 patients were seen according to schedul e up to 2 years; two patients were seen up to 12 months and one up to 6 months only. Reinfection with H. pylori was not recorded in any of o ur patients. Shallow duodenal ulcers were noted in three patients at 1 -year follow-up, two of whom admitted to taking non-steroidal anti-inf lammatory drugs (NSAIDs); H. pylori status was negative in all three. Subsequent follow-up revealed spontaneous healing of the ulcers in all three patients. At 2 years, one patient whose H. pylori status was ne gative had recurrence oi duodenal ulcer. All of the three patients who defaulted subsequent to follow-up were negative for H. pylori and had healed ulcers on follow-up endoscopy at 6 and 12 months. Conclusion: Reinfection rate with H. pylori was zero in a group of South-East Asia n patients who had successfully eradicated the infection. Duodenal ulc er relapse was also low (2.9%) in this group of patients at 2 years.