Cure of duodenal ulcer associated with eradication of Helicobacter pylori

Lancet. 1990 May 26;335(8700):1233-5. doi: 10.1016/0140-6736(90)91301-p.

Abstract

50 patients with intractable duodenal ulcer were randomly assigned to 4 weeks of treatment with colloidal bismuth subcitrate (CBS) alone (26 patients) or with amoxicillin and metronidazole (24 patients). 5 patients (all on triple therapy) withdrew because of side-effects. In 17 of the 45 patients who completed the treatment, Helicobacter pylori was eradicated, and there was no ulcer relapse during the first 12 months of follow-up. The ulcer relapse rate was significantly higher (17 of 21 [89%]) among patients who remained positive for H pylori. 9 patients who remained positive for H pylori and had ulcer relapses within 6 months of treatment with CBS alone, were subsequently given triple therapy. 7 of the 9 showed H pylori eradication and no relapses within the next 12 months. The 2 patients still H pylori-positive after triple therapy had further ulcer relapses. H pylori eradication, without altering acid output, will become the mainstay of duodenal ulcer treatment because it cures the disease.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Administration, Oral
  • Amoxicillin / administration & dosage
  • Amoxicillin / therapeutic use
  • Anti-Ulcer Agents / administration & dosage
  • Anti-Ulcer Agents / therapeutic use*
  • Campylobacter / isolation & purification
  • Campylobacter Infections / complications
  • Campylobacter Infections / drug therapy*
  • Drug Administration Schedule
  • Drug Evaluation
  • Drug Therapy, Combination
  • Duodenal Ulcer / complications
  • Duodenal Ulcer / drug therapy*
  • Follow-Up Studies
  • Gastric Mucosa / microbiology
  • Humans
  • Metronidazole / administration & dosage
  • Metronidazole / therapeutic use
  • Organometallic Compounds / administration & dosage
  • Organometallic Compounds / therapeutic use*
  • Prospective Studies
  • Randomized Controlled Trials as Topic
  • Recurrence

Substances

  • Anti-Ulcer Agents
  • Organometallic Compounds
  • Metronidazole
  • Amoxicillin
  • bismuth tripotassium dicitrate