my personal edition > h. pylori/ulcer > news


  E-Mail this DGReview to a colleague

DGReview

Peptic Ulcer Disease Patients Seem To Benefit More from Helicobacter Pylori Eradication Than Other Gastro Patients

One year after eradication of Helicobacter Pylori, abdominal pain in patients with peptic ulcer disease (PUD) is significantly more improved than in gastritis and/or duodenitis (G/D) patients, say Norwegian researchers.

At the same time both groups showed improvement in reflux symptoms, indigestion and the ability to eat and sleep. No chronic diarrhoea was induced.

"Further study of the effect of H.Pylori eradication in G/D patients is warranted," conclude investigators at the Institute of Medicine, Division of Gastroenterology, Haukeland University Hospital, Bergen.

While dyspepsia is known to improve markedly in PUD patients following H.Pylori eradication, it rarely improves in those with functional dyspepsia.

This randomised study compared symptom severity and change in gastrointestinal symptoms between PUD and G/D diagnosed patients a year after eradication.

One hundred and eighty three subjects were recruited for the study. They each received one of four triple treatments including ranitidine bismuth and metronidazole, and either oxytetracycline or spiramycine.

The 14C-urea breath test was used to assess eradication. Gastrointestinal Symptom Rating Scale (GSRS) and the Ulcer Esophagitis Subjective Symptoms Scale (UESS) questionnaires was used to evaluate gastro-intestinal (GI) symptoms.

Before H.Pylori eradication therapy, both PUD and G/D subjects had similar severity of symptoms. One year later, 99% of those with PUD and 75% of G/D subjects reported feeling better about their main upper GI complaint.

Measured by GSRS abdominal pain score in the PUD group was found to decrease by 48% and by 78% as measured by UESS. In the G/D group the decrease was 25% (GSRS) and 47% (UESS).

On the same scales, reflux symptoms in the PUD group decreased by 41and 63% and indigestion by 30 and 47%.

In the G/D subjects the decrease was 28, 45, 20 and 34%, respectively.

Eating discomfort decreased by 60% in PUD and by 35% in G/D.

In the PUD group, sleep quality score improved by 68% and constipation decreased by 22%.

Compared to baseline such differences in symptoms were highly significant.
Scand J Gastroenterol 2002 Dec;37:12:1386-94. "Patients with endoscopic gastritis and/or duodenitis improve markedly following eradication of Helicobacter pylori, although less so than patients with ulcers."

E-Mail this DGReview to a colleague

To print, use this version