Relapse of duodenal ulcers after successful eradication of Helicobacter pylori in gastric ulcer patients

Relapse of duodenal ulcers was observed endoscopically after Helicobacter p ylori eradication therapy for gastric ulcer patients in 2 of 32 successful cases. One patient, a 40-year-old woman, received dual therapy with lansopr azole 60mg and amoxicillin 1000mg for 2 weeks because of an intractable, ea sily-relapsing gastric ulcer accompanied by duodenal ulcer scars that had n ot relapsed fur 5 years. The If. pylori status was assessed by a rapid urea se test, light microscopy, culture, and anti-Ii pylori antibody. At 24 mont hs after the cure of if. pylori the had upper abdominal pain and showed rel apse not of the gastric ulcer but of the duodenal ulcer. The if pylori stat us remained negative. The other patient, a 44-year-old man, showed an activ e gastric ulcer and duodenal ulcer scars at the first endoscopy, He receive d the same regimen as described above. Ten weeks after completion of the er adication therapy, endoscopy showed healing of the gastric ulcer and relaps e of the duodenal ulcer despite successful eradication. These two cases sug gest that Ii. pylori eradication modifies the pathophysiological condition of gastric acid secretion and facilitates relapse of duodenal ulcers.