Peptic ulcer recurrence after Helicobacter pylori eradication: a 5-year follow-up study.

OBJECTIVE

To investigate whether eradication of Helicobacter pylori prevents peptic ulcer recurrence in the long term.

PATIENTS AND METHODS

We treated 81 patients with endoscopically proven H. pylori-related peptic ulcers (39 with gastric ulcers and 42 with duodenal ulcers) with either amoxycillin or clarithromycin in combination with a proton-pump inhibitor or a histamine H2-receptor antagonist. The patients were followed for a recurrence of peptic ulcers for at least 5 years. Recurrence was assessed by endoscopy and the status of H. pylori was evaluated by culture, a rapid urease test and a histological examination.

RESULTS

After 5 years of follow-up, the rate of recurrence of H. pylori-related duodenal ulcers decreased significantly (P < 0.0001) in the H. pylori-eradicated patients compared with non-eradicated patients. However, in the gastric ulcer group, there was no significant reduction in the recurrence rate.

CONCLUSIONS

Our findings suggest that eradication of H. pylori significantly reduces the rate of duodenal ulcer relapse and that this relapse is associated with the presence of H. pylori. Therefore, H. pylori eradication may be considered a definitive cure for duodenal ulcers.