AMOUNT OF HELICOBACTER-PYLORI IN GASTRIC MUCUS DURING ANTI-H-PYLORI TREATMENT

Helicobacter pylori is present in infected patients not only on the ga stric epithelial cell surface but also in gastric mucus. We developed a competitive polymerase chain reaction (cPCR) method for quantitative measurement of H. pylori in gastric mucus. The aim of this study was to determine the number of H. pylori in gastric mucus before and after anti-H. pylori treatment. Patients with duodenal ulcer were treated w ith lansoprazole alone (n = 11) or lansoprazole and amoxycillin (n = 1 2). The amount of H. pylori in gastric mucus was measured over time by a cPCR assay. Helicobacter pylori infection was also tested for using histology, culture, and the rapid urease test (RUT). Although most pa tients treated with lansoprazole alone had become H. pylori-negative b y the end of treatment when tested by histology, RUT, and culture, a l arge number of H. pylori organisms were found in the gastric mucus at that time by cPCR. These patients returned to being H. pylori positive 1 to 12 months later on the basis of histology, RUT, and culture. How ever, cPCR results indicated eradication of H. pylori by the end of tr eatment in eight of the 12 patients treated with lansoprazole and amox icillin, and these patients remained H. pylori negative on histology, RUT, culture, and cPCR 1 to 12 months later. Testing for H. pylori in gastric mucus is thus useful for precise determination of the success or failure of H. pylori eradication therapy.