THE ECONOMIC AND QUALITY-OF-LIFE BENEFITS OF HELICOBACTER-PYLORI ERADICATION IN CHRONIC DUODENAL-ULCER DISEASE - A COMMUNITY-BASED STUDY

A policy of Helicobacter pylori eradication in patients with duodenal ulceration on long-term acid-suppressing therapy was evaluated in a pr ospective study amongst a general practice population, with particular reference to economic and quality-of-life benefits. One hundred and s ixty-eight patients on long-term acid-suppressing therapy had chronic duodenal ulcer disease of whom gs were eligible for the study; 45 pati ents attended for review, with 42 testing positive for H pylori (as as sessed by C-13-urea breath test). The median duration of acid-suppress ing therapy was six years (maximum 15 years); 47.6% of the patients we re using additional antacids and 80.9% still experienced epigastric di scomfort. Two-thirds (28/42) of the patients eradicated H pylori. Succ essful eradication was associated with a highly significant reduction in all symptoms. At 12 months follow-up, heartburn had decreased from 28.7% to 7.1%, epigastric discomfort from 75% to 3.6%, nausea from 32. 1% to 0% and wind from 50% to 0%. Of the patients that eradicated H py lori 96.4% reported an improvement in their general health compared to none of those that remained H pylori positive. Successful H pylori er adication therapy scored higher on satisfaction ratings than long-term acid-suppressing therapy. Eradication of H pylori resulted in 27/28 p atients being able to discontinue acid-suppressing therapy, representi ng a 5.8% reduction in the use of such drugs per year in the local gen eral practice population. A policy of H pylori eradication in chronic duodenal ulcer disease reduces the use of long-term acid-suppression t herapy in general practice. This has important financial implications as well as offering considerable symptomatic benefits to the patients and improving their quality of life.