TREATMENT OF HELICOBACTER-PYLORI REDUCES THE RATE OF REBLEEDING IN PEPTIC-ULCER DISEASE

Background: We evaluated whether therapy designed to eradicate Helicob acter pylori infection resulted in a reduction in rebleeding in patien ts with peptic ulcer disease. Patients presenting because of major upp er gastrointestinal hemorrhage from peptic ulcer and whose ulcers heal ed in a study in which they were randomized to receive ranitidine alon e or triple therapy plus ranitidine were followed up regularly with en doscopy. No maintenance anti-ulcer therapy was given after ulcer heali ng. Methods: Patients received ranitidine, 300 mg, or ranitidine plus triple therapy. Triple therapy consisted of tetracycline, 2 g; metroni dazole, 750 mg; and bismuth subsalicylate, 5 or 8 tablets (151 mg bism uth per tablet), and was administered for the first 2 weeks of treatme nt; ranitidine therapy was continued until the ulcer had healed or 16 weeks had elapsed. After ulcer healing, no maintenance antiulcer thera py was given. Development of ulcer recurrence with or without recurren t upper gastrointestinal bleeding was evaluated. Results: Thirty-one p atients with major upper gastrointestinal bleeding from peptic ulcer w ere studied; 17 received triple therapy and 14 ranitidine alone. Major rebleeding occurred significantly (p = 0.031) more often in those in the ranitidine group (28.6%), compared with none (0%) in the triple th erapy group. Conclusion: Eradication of H. pylori infection reduces th e rate of ulcer recurrence and rebleeding in complicated ulcer disease .