RECURRENCE OF DUODENAL-ULCER AFTER HELICOBACTER-PYLORI ERADICATION ISRELATED TO HIGH ACID OUTPUT

Background: Helicobacter pylori eradication reduces the recurrence of duodenal ulcers, It is unclear why duodenal ulcers rarely recur in the absence of reinfection with H. pylori or NSAID treatment. Methods: Ba sal, gastrin-releasing peptide- and pentagastrin-stimulated peak acid outputs in patients with ulcer relapse after H. pylori eradication wer e measured, and compared with patients without ulcer relapse after H. pylori eradication, Results: Pentagastrin-stimulated peak acid output was significantly higher in H. pylori-positive patients with duodenal ulcers than in H. pylori-negative controls, and fell significantly aft er H. pylori eradication, In H. pylori-negative patients with recurren t duodenal ulcers, pentagastrin-stimulated peak acid output was signif icantly higher than in controls and similar to H. pylori-positive pati ents with duodenal ulcers. Conclusions: These findings suggest that du odenal ulcer relapse after eradication of H. pylori may be related to high pentagastrin-stimulated peak acid output. In this subset of patie nts with duodenal ulcers, maintenance anti-secretory treatment may be necessary to prevent relapse.