Duodenal erosions after eradication of Helicobacter pylori infection

Background: There is interest in the development of GERD after Helicobacter pylori eradication. In contrast, the development of duodenal erosions afte r therapy has received scant attention. Patients were examined after eradic ation of H pylori Infection to determine the frequency of posttherapy duode nal erosions (primary outcome) and whether there was a relation between dev elopment of duodenal and esophageal erosions. Additionally, factors were se arched for that would identify patients at increased risk for duodenal eros ions. Methods: A single-center, endoscopist-blinded, observational study was cond ucted of 196 patients in whom H pylori was eradicated. The presence of esop hageal or duodenal erosions was evaluated 4 weeks and 6 months after eradic ation. Serum gastrin and pepsinogen I (PG I) and II (PG II) levels were als o determined for 83 patients entering the study during Its final year. Results: Multiple small duodenal erosions developed In 8.6% of patients aft er H pylori eradication and were more common in patients with pre-eradicati on duodenal ulcer (27.8%) compared with those with gastric ulcer (6.7%) or atrophic gastritis (1.4%) (p < 0.05). Duodenal erosions were associated wit h high levels of PG I before and after eradication. The frequency of duoden al erosions decreased over time (3.1% by 6 months). Conclusion: Duodenal erosions occur after H pylori eradication and appear t o be related to duodenal ulcer and increased PG I levels, both of which are associated with Increased acid secretion. Measurement of PG I may help to identify patients who have duodenal erosions develop after H pylori therapy for studies of the pathogenesis of these lesions.