Short-term changes in Helicobacter pylori gastritis and bulbitis during and after 2 weeks of treatment with omeprazole and amoxicillin in duodenal ulcer patients

Objective: To evaluate the dynamics of histological changes in the mucosa o f the stomach and duodenal bulb during and after completion of a 14-day cou rse of Hp-eradication dual treatment with high-dose omeprazole and amoxicil lin. Patients: 12 patients (mean age 53 +/- 16 years SD, 9 male, 3 female) with an acute Hp-positive duodenal ulcer were included in this open, prospective , single-centre study. Method: Patients were given omeprazole 40 mg b. i. d. and amoxicillin 1,500 mg b. i. d. for a period of 14 days. Endoscopic biopsies were obtained on days 3, 7, 14, 28, 42 as well as at following endoscopies performed a mean of 17 months after treatment. Results: The Hp-eradication rate achieved 4 weeks after treatment was 82%. On day 14, 88% of the ulcers were healed. Already on day 7 Hp had almost co mpletely disappeared from the antrum, corpus and duodenal bulb, and the act ivity of gastritis in the antrum and corpus and the activity of bulbitis in the duodenal bulb was almost nonexistent. The decrease in the grade of gas tritis was much lower by day 42. Conclusions: Our study shows for the first time that in all patients signs of primarily successful Hp-eradication treatment during the first days of t reatment are consistently demonstrable and complete already after one week of therapy, irrespective of the subsequent cure or persistence of Hp-infect ion. In the patients with persistence of Hp-infection Hp-colonization and a ctivity of gastritis quickly increased within 2-4 weeks after cessation of treatment. Checks to evaluate complete eradication or recrudescence of Hp-i nfection should be carried out not earlier than 28 days after cessation of treatment.