HELICOBACTER-PYLORI AND ACUTE BLEEDING PEPTIC-ULCER

Objective: The prevalence of Helicobacter pylori in chronic peptic ulc er is well known. In this study the frequency of H. pylori infection w as investigated in patients with acute bleeding peptic ulcer. Design a nd setting: Prospective study in a district hospital. Patients: Sevent y consecutive patients with acute bleeding peptic ulcer. Interventions : Diagnosis was verified on admission by endoscopy, and healing was ex amined at follow-up. Previous history of ulcer disease, presence of dy speptic symptoms and consumption of non-steroidal anti-inflammatory dr ugs were recorded. Main outcome measures: H. pylori infection was dete cted by two serological tests in samples obtained on admission for the acute bleeding episode, and at follow-up 1-3 months later. Results: W ith a commercial latex immunoassay, 53% of the patients with gastric u lcer and 62% with duodenal ulcer were shown to possess H. pylori antib odies. In the other test, a standard enzyme-linked immunosorbent assay based on cell surface protein antigens of H. pylori with high sensiti vity and specificity, 81% of gastric ulcer patients and 85% of duodena l ulcer patients were shown to have H. pylori antibodies. Conclusion: The results indicate that H. pylori infection plays a major aetiologic al role in patients with acute bleeding peptic ulcer.