RELAPSED DUODENAL-ULCER AFTER CURE OF HELICOBACTER-PYLORI INFECTION

We report a patient-a 42-year-old man-who had suffered from recurrent duodenal ulcer for about 20 years. Successful curative therapy for Hel icobacter pylori infection was performed for 2 weeks with new triple o meprazole, anoxicillin, clarithromycin (OAC) treatment in October 1995 , and cure of the infection was repeatedly confirmed by histology, cul ture, and the C-13 urea breath test. One month after the curative ther apy, recurrence of a small duodenal ulcer was observed and in February another duodenal ulcer and reflux esophagitis occurred, with severe s ymptoms, despite the continuous administration of ranitidine. None of the examinations to reconfirm cure of the infection revealed the prese nce of H. pylori. As the patient experienced continual psychological s tress and smoked more frequently during the recurrent episode and had not used nonsteroidal anti-inflammatory drugs, stress and smoking appe ared to play important roles in the relapse of duodenal ulcer in this patient after cure of H. pylori infection.