Will Helicobacter pylori affect short-term rebleeding rate in peptic ulcerbleeding patients after successful endoscopic therapy?

OBJECTIVE: Helicobacter pylori (H. pylori) can augment the pH-increasing ef fect of omeprazole in patients with peptic ulcer. A high intragastric pH ma y be helpful in preventing recurrent hemorrhage by stabilizing the blood cl ot at the ulcer base of bleeding peptic ulcer patients. Therefore, we hypot hesized that omeprazole may reduce short-term rebleeding rate in these pati ents with H. pylori infection after initial hemostasis had been obtained. METHODS: Between July 1996 and December 1998, 65 bleeding peptic ulcer pati ents (24 gastric ulcer, 41 duodenal ulcer) who had obtained initial hemosta sis with endoscopic therapy were enrolled in this trial. Thirty (46.2%)) of them were found to have H. pylori infection by a rapid urease test and pat hological examination. For all studied patients, omeprazole was given 40 mg intravenously every 6 h for 3 days. Thereafter, omeprazole was given 20 mg per os (p.o.) once daily for 2 months. A pH meter was inserted in the fund us of each patient under fluoroscopic guidance after intravenous omeprazole had been administered. The occurrence of rebleeding episode was observed f or 14 days. RESULTS: in patients with H. pylori infection, intragastric pH (median, 95% confidence interval [CII: 6.54, 5.90 - 6.68) was higher than in those with out H, pylori infection (6.05, 5.59-6.50, p < 0.001). However, the patients with rebleeding (2 vs 3), volume of blood transfusion (median, range: 1000 mi, 0-2250 Is 750, 0-2000), number of operations (0 rs I), mortality cause d by bleeding (0 vs 0), and hospital stay (median, range: 6 days, 3-14 is 7 , 5-16) were not statistically different from those without H. pylori infec tion. CONCLUSIONS: Omeprazole does increase intragastric pH in bleeding peptic ul cer patients with H. pylori infection. However, the presence of H. pylori i nfection does not affect the short-term rebleeding rate in these patients. (C) 1999 by Am. Cell. of Gastroenterology.