INTRAGASTRIC ACIDITY AS A PREDICTOR OF THE SUCCESS OF HELICOBACTER-PYLORI ERADICATION - A STUDY IN PEPTIC-ULCER PATIENTS WITH OMEPRAZOLE AND AMOXICILLIN

Omeprazole plus amoxicillin cures Helicobacter pylori infection. The h ypothesis was tested that low acidity is a predictor of outcome. Fifty patients- with relapsing or complicated, or both H pylori positive du odenal (n=25) or gastric ulcer (n=25) were randomly treated with eithe r omeprazole 20 mg twice daily plus amoxicillin 1 g twice daily or wit h omeprazole 40 mg twice daily plus amoxicillin 1 g twice daily over t wo weeks. After one week of combined treatment, a 24 hour gastric pH m easurement was performed in all patients. H pylori cure rate was 67%. Patients who later turned out to be cured had higher pH values during night time and after meals (p<0.05). In an explorative analysis drug c ompliance, smoking, location of the ulcer (duodenum versus stomach), a ge, and grade of body gastritis were additional predictors of the outc ome. Smoking (p=0.006), compliance (p=0.037), duodenal ulcer disease ( p=0.065), and young age (p=0.021) were related to high acidity. In con clusion, the success of eradication treatment with omeprazole and amox icillin in ulcer patients infected with H pylori depends on intragastr ic pH. Drug compliance, smoking habits, location of ulcer, age, and ac tivity of body gastritis are other predictors and in part related to i ntragastric acidity.