| Abstrakt: |
Recurrence of peptic ulcer after successful eradication of Helicobacter pyloriis closely associated with reinfection. The aim of this study was to examine the recurrence of peptic ulcer and reinfection with H. pyloriafter successful eradication. To eradicate H. pyloriinfection, patients with active peptic ulcer disease were assigned to two treatment groups depending on the year of their enrollment AM group and OAMR group. Patients in the AM group received 400 mg of cimetidine twice per day, 300 mg of amoxicillin three times per day, and 250 mg of metronidazole three times per day for 2 weeks. Patients in the OAMR group received 20 mg of omeprazole once per day, 500 mg of amoxicillin granules three times per day, 250 mg of metronidazole three times per day, and 150 mg of roxithromycin twice per day for 1 week. After endoscopy verified ulcer scarring and successful eradication of H. pyloriinfection, study patients were followed up monthly and did not undergo acidsuppressive therapy. Endoscopy was performed at 6month intervals for the 1st year. After the 1st year, followup endoscopies were performed annually. In total, 107 patients with peptic ulcer duodenal ulcer DU, 65 gastric ulcer GU, 42 were followed up for a mean period of approximately 2 years. Recurrence of infection occurred in 10 9.3 of 107 patients AM group, 9 OAMR group, 1 after 210 patientyears of followup the recurrence rate was 4.8 per patientyear. Recurrence of H. pyloriinfection was significantly higher in the AM group 23.1 than in the OAMR group 1.5. H. pyloriinfection recurred in two patients 6 months after eradication therapy, in seven 1 year after, and in one 2 years after. Thereafter, no further cases of H. pylorirecurrence were observed. During followup periods, seven cases of ulcer recurrence were observed DU, 4 GU, 3. The rate of peptic ulcer recurrence within 2 years after eradication therapy was significantly higher than that after more than 2 years. Four cases of ulcer recurrence DU, 3 GU, 1 also had recurrence of H. pyloriinfection. One recurrent case of DU without reinfection was associated with nonsteroidal antiinflammatory drugs. The remaining two cases of GU recurred without H. pylorireinfection. In conclusion, peptic ulcer recurrence rarely occurred 3 2.9 of 103 in patients cured of H. pyloriinfection. Reinfection after apparent successful eradication was rarely noted when a powerful therapeutic regimen in eradication was used. Therefore, to eradicate H. pylori, a highly effective therapeutic regimen should always be used. |
