Arrest of chronic acid suppressant drug use after successful Helicobacter pylori eradication in patients with peptic ulcer disease: a six-month follow-up study

Background: It remains controversial whether successful H. pylori eradicati on leads to relief of dyspepsia and the subsequent arrest or tapering of ac id-suppressant drug therapy, or to an aggravation of acid-related dyspepsia requiring more acid-suppressant drug intake. Aim: To evaluate prospectively the effect of H. pylori eradication on the r equirement of acid-suppressant drug or antacids and the evolution of dyspep tic symptoms in chronic acid-suppressant drug users with peptic ulcer disea se. Materials and methods: The use of acid-suppressant drugs, rescue antacids a nd predominant symptoms were recorded prospectively during 24 weeks after H . pylori eradication therapy in 75 peptic ulcer disease patients. Results: In 71 patients with complete follow-up, ulcers were healed at foll ow-up endoscopy and H. pylori was successfully eradicated. After 6 months, 93% (66 out of 71) of chronic acid-suppressant drug users had stopped acid- suppressant drug intake. The mean daily acid-suppressant drug dosage per pa tient decreased from 1.72 at entry to 0.03 units acid-suppressant drug (98% ; P < 0.0001) during follow-up. The mean number of antacid tablets/day/pati ent was 0.26 during follow-up for the relief of mild inter-current dyspepti c symptoms. Medication use was not different in peptic ulcer disease patien ts with or without gastrooesophageal reflux disease at baseline, The preval ence of gastro-oesophageal reflux disease decreased from 42% before to 35% after H. pylori eradication (N.S.). Conclusion: Successful H. pylori eradication in peptic ulcer disease patien ts almost completely eliminates the need for acid-suppressant drug regardle ss of the presence or absence of gastro-oesophageal reflux disease at entry .