ERADICATION OF HELICOBACTER-PYLORI REDUCES THE POSSIBILITY OF REBLEEDING IN PEPTIC-ULCER DISEASE

A close relationship has been found between Helicobacter pylori and pe ptic ulcer disease. Furthermore, eradication of H. pylori is associate d with low recurrence rates. The aim of the present study was to exami ne whether eradication of H. pylori has any impact on the complication s of ulcers, such as bleeding. Thirty-one patients hospitalized for du odenal ulcer bleeding, undergoing conservative treatment and with a pr evious history of bleeding, comprised the group studied. AII patients had emergency endoscopy, and tests for H. pylori proved to be positive in all. After discharge, patients were given omeprazole 20 mg daily f or 4 weeks for ulcer healing, which was achieved in all patients(100%) . After this, patients were randomized to receive either omeprazole 20 mg t.i.d. alone (group O, n = 15) or the combination of omeprazole 20 mg t.i.d. + amoxicillin 500 mg q.i.d. (group O + A, n = 16) for 2 wee ks. Endoscopy was performed 4 weeks after treatment ended to check for eradication of H. pylori and again when rebleeding or symptomatic rel apse occurred. Groups O and O + A were similar in age, sex, smoking ha bits, and NSAID use. The follow-up period was 12 months for both group s. Eradication was achieved in 2 of 15(13.3%) patients in group O and in 13 of 16(81.3%) patients in group O + A (p <.001). Five patients re bled during follow-up. All of them belonged to group O and were patien ts in whom eradication had failed. In contrast, none of group O + A ha d rebleeding (p = 018). We conclude that in patients with duodenal ulc er bleeding, eradication of H. pylori is associated with significant r eduction of further bleeding episodes. Therefore, eradication should b e considered in all such patients.