PRELIMINARY CLINICAL-STUDY ON GASTRIC-ULCER SCARS AND ULCER RELAPSES AFTER HELICOBACTER-PYLORI ERADICATION THERAPY

To determine the effect of Helicobacter pylori eradication on the heal ing of gastric ulcers, endoscopic examinations of gastric ulcer scars and ulcer relapse after eradication therapies or antisecretory therapy were carried out in 24 H. pylori-positive patients with recurrent gas tric ulcers located in the gastric angle. Sixteen patients were initia lly treated with 2-week triple eradication therapy. Subsequently, seve n of eight noneradicated cases were retreated with triple therapy, whi ch included metronidazole. Eight patients received antisecretory monot herapy. Endoscopic examinations were performed at 4 weeks and 6 months after the treatments. Gastric ulcer scars were classified endoscopica lly into three types: Sa, a central depression surrounded by a coarse pattern; Sb, a coarse regenerated pattern; and Sc, a fine pattern indi cating matured scar of high quality. Transformations of the scar patte rns and ulcer relapse were assessed in 19 patients who showed an ulcer scar at 4 weeks after initial therapy. Thirteen cases in which H. pyl ori was successfully eradicated, either after initial or re-eradicatio n therapies, mainly showed Sc scars and had no ulcer relapse. Sa scar was mainly observed during H. pylori-positive conditions. Transformati on from the Sa to the Sc was observed after successful re-eradication. Ulcer relapses occurred in three patients who showed Sa scar after an tisecretory therapy. Although a random study would be needed to obtain a definite conclusion, we suspect that the H. pylori-negative conditi on after eradication therapies may result in good ulcer healing and ma y subsequently reduce ulcer relapse.