EFFICACY OF OMEPRAZOLE ONE-YEAR AFTER CURE OF HELICOBACTER-PYLORI INFECTION IN DUODENAL-ULCER PATIENTS

Objective: We have previously shown that, in duodenal ulcer patients, pH control by omeprazole is less pronounced after cure of Helicobacter pylori infection. The present study was designed to test the hypothes is that this response to omeprazole persists 1 yr after cure of H. pyl ori infection. Methods: In 12 duodenal ulcer patients, intragastric ac idity was measured with a glass electrode during treatment with omepra zole (20 mg) once daily before, and 4-6 wk and 1 yr after, cure of H. pylori infection. H. pylori infection was assessed by [C-13]urea breat h test, culture, histology (Warthin Starry stain), and rapid urease te st. Results: Cure of H. pylori infection resulted in a lowered pH duri ng omeprazole treatment. This effect persisted after 1 yr. Median 24-h gastric pH before H. pylori treatment was 5.6; 4-6 wk after cure of t he infection it was 2.9 (p = 0.003), and 1 yr after cure of the infect ion it remained unchanged (pH = 2.5; p = 0.5). Accordingly, twice as m uch time was spent above pH 3 and pH 4 before H. pylori treatment than 1 or 42 months after cure (percent of time greater than or equal to p H 3: 82.7 vs. 49.7 vs. 43.1; percent of time greater than or equal to pH 4: 72.7 vs. 38.3 vs. 26.4). Conclusion: In duodenal ulcer patients, cure of H. pylori infection resulted in a marked sapid and persistent decrease of the pH increasing effect of omeprazole. Therefore, H. pyl ori is a determinant of the pH achieved in response to omeprazole trea tment in duodenal ulcer patients.