Helicobacter pylori and acute bleeding peptic ulcer.

OBJECTIVE

The prevalence of Helicobacter pylori in chronic peptic ulcer is well known. In this study the frequency of H. pylori infection was investigated in patients with acute bleeding peptic ulcer.

DESIGN AND SETTING

Prospective study in a district hospital.

PATIENTS

Seventy consecutive patients with acute bleeding peptic ulcer.

INTERVENTIONS

Diagnosis was verified on admission by endoscopy, and healing was examined at follow-up. Previous history of ulcer disease, presence of dyspeptic symptoms and consumption of non-steroidal anti-inflammatory drugs were recorded.

MAIN OUTCOME MEASURES

H. pylori infection was detected by two serological tests in samples obtained on admission for the acute bleeding episode, and at follow-up 1-3 months later.

RESULTS

With a commercial latex immunoassay, 53% of the patients with gastric ulcer and 62% with duodenal ulcer were shown to possess H. pylori antibodies. In the other test, a standard enzyme-linked immunosorbent assay based on cell surface protein antigens of H. pylori with high sensitivity and specificity, 81% of gastric ulcer patients and 85% of duodenal ulcer patients were shown to have H. pylori antibodies.

CONCLUSION

The results indicate that H. pylori infection plays a major aetiological role in patients with acute bleeding peptic ulcer.