HISTOLOGICAL MATURITY OF HEALED DUODENAL ULCER AND ULCER RECURRENCE AFTER TREATMENT WITH OMEPRAZOLE OR CIMETIDINE

We investigated the relationship between histological maturity of heal ed duodenal ulcer and ulcer recurrence after treatment with omeprazole or cimetidine for 4 weeks. The healing rates, 92.5 and 72.4% in omepr azole-treated and cimetidine-treated groups, respectively, showed no s ignificant difference between groups (P > 0.05). Histologically, the r egenerating mucosa of healed ulcer was divided into three categories: good, fair and poor patterns. Of the healed cases, 22 (59.5%) of 37 om eprazole-treated and 12 (28.6%) of 42 cimetidine-treated ulcers achiev ed a good pattern, showing significant difference between groups (P = 0.01). The recurrence rate at 3 months showed statistically significan t difference (P < 0.05) between two groups: 5.4% in omeprazole-treated and 23.8% in cimetidine-treated patients. During the period between 3 and 6 months after healing, the difference in recurrence rate between omeprazole-treated and cimetidine-treated groups was statistically no t significant (12.5% and 25%, respectively, P > 0.05), though the cumu lative recurrence rate at 6 months showed a significant difference bet ween groups (17.6% vs 44.7%, P = 0.027). All the recurrent cases of bo th groups had a fair or poor pattern of regenerating mucosa. The diffe rence in recurrence rate was statistically significant between the hea led ulcers with a good pattern and that with a fair or poor patterns b oth at 3 months and between 3 and 6 months after healing (P < 0.001 in each). We concluded that better histological maturity of regenerating mucosa may contribute to the lower early recurrence in omeprazole-tre ated cases than in cimetidine-treated cases.