Effect of Helicobacter pylori eradication on the natural history of duodenal ulcer disease

Background-Duodenal ulcer disease is strongly associated with Helicobacter pylori infection of the gastric mucosa. Eradication of H pylori from the ga stric mucosa in adults is associated with long term healing of ulcers. Aims-To follow a cohort of children with duodenal ulcer disease for a minim um of two years after the eradication of H pylori. Patients and methods-Over a three year period, all children diagnosed with duodenal ulcer disease had their symptoms documented and their H pylori sta tus evaluated. The histories of these children were carefully screened to d etermine previous symptoms and to document previous treatment regimens. Results-Sixteen children were diagnosed with ulcers and 15 were available f or treatment and long term follow up. The median age at which symptoms firs t occurred was 10.5 years (range, 6-14) and the median duration of symptoms was 24 months (range, 2-60). Ten of the children had been treated with H, receptor antagonists for a median of 3.5 months (range, 1-60). Duodenal ulc ers healed in all children after eradication of H pylori and all children h ave remained asymptomatic for a median of 37 months (range, 26-62). No chil d has required subsequent admission to hospital. Conclusion-Eradication of H pylori is very effective in the long term heali ng of duodenal ulcer disease. H pylori eradication should be the standard t reatment for all infected children who present with duodenal ulcer disease.