ONE WEEKS ANTI-HELICOBACTER PYLORI TREATMENT FOR DUODENAL-ULCER

This open study tested whether eradication of Helicobacter pylori (H p ylori) heals duodenal ulcers as well as decreasing recurrence. H pylor i was detected in patients with endoscopic duodenal ulcers by histolog y, CLO-test, culture, and C-13-urea breath test (C-13-UBT). Tripotassi um dicitrato bismuthate (120 mg) and amoxycillin (500 mg) each four ti mes daily, were given for seven days, with 400 mg metronidazole five t imes a day on days 5-7. The C-13-UBT was repeated immediately after tr eatment and endoscopy repeated within 21 days. After treatment unheale d ulcers were reinspected one month later and healed ulcers followed u p by C-13-UBT alone for 12 months. Of 45 patients, 44 were available f or follow up. Mean pretreatment excess delta(13)CO(2) excretion was 25 .6 per mil, which fell to 2.4 per mil immediately after finishing trea tment, indicating clearance of H pylori in every patient. At the secon d endoscopy (median interval 20 days from start of treatment) 33 of 44 (75%) duodenal ulcers had healed. Ten of the remaining 11 duodenal ul cers were smaller and those 10 healed in the next two weeks with no fu rther treatment. Two patients' ulcers that initially healed with clear ance of H pylori recurred three weeks later (both had metronidazole re sistant H pylori). H pylori was eradicated in 28 of 44 (64%) patients (C-13-UBT negative for median follow up 10 2 months). Overall 41 of 43 (93%, 95% confidence intervals 81%-99%) duodenal ulcers were healed a t one month. This study suggests that one week of anti-H pylori triple treatment is effective in healing duodenal ulcers.