DOES SMOKING PREDISPOSE TO PEPTIC-ULCER RELAPSE AFTER ERADICATION OF HELICOBACTER-PYLORI

Objectives: To investigate whether smoking would increase ulcer recurr ence after eradication of Helicobacter pylori (H. pylori) without main tenance acid-suppression therapy. Methods: A total of 287 patients, 25 6 patients with duodenal ulcers and 31 patients with gastric ulcers, w ere followed-up for up to 18 months after ulcer healing and successful eradication of H. pylori. There were 83 smokers (defined as smoking g reater than or equal to 10 cigarettes/day) and 204 patients who never smoked or stopped smoking after the diagnosis of peptic ulcer disease. None were taking nonsteroidal anti-inflammatory drugs or receiving ma intenance acid suppression therapy. Endoscopy was repeated either at t he end of the follow-up period or when ulcer symptoms recurred. Result s: Of the 83 smokers, 3 (3.6%) had ulcer recurrence, which included tw o duodenal ulcers and one gastric ulcer. Of the 204 non-smokers, 4 (2. 0%) had ulcer relapse, and all being recurrent duodenal ulcers. Four s mokers (4.8%) and nine nonsmokers (4.4%) had recurrence of H. pylori i nfection after 10-18 months. There was no significant difference in ul cer relapse or recurrence of H. pylori infection between smokers and n onsmokers. Conclusions: Cigarette smoking did not increase the recurre nce of peptic ulcers after eradication of H. pylori.