Duodenal ulcer healing by eradication of Helicobacter pylori without anti-acid treatment: randomised controlled trial
Randomised trials have shown that duodenal ulcers treated by H 2 blockers heal faster if Helicobacter pylori is eradicated concurrently. It remains unknown whether eradication of H pylori without suppression of acid-secretion, is sufficient to allow healing. 153 patients with H pylori infection and...
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Veröffentlicht in: | The Lancet (British edition) 1994-02, Vol.343 (8896), p.508-510 |
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description | Randomised trials have shown that duodenal ulcers treated by H
2 blockers heal faster if
Helicobacter pylori is eradicated concurrently. It remains unknown whether eradication of
H pylori without suppression of acid-secretion, is sufficient to allow healing. 153 patients with
H pylori infection and duodenal ulcer were randomised to receive either a 1-week course of bismuth subcitrate, tetracycline, and metronidazole (76), or omeprazole for 4 weeks with the same three-drug regimen for the first week (77). Endoscopy and antral biopsies were done at entry and 4 weeks after treatment. 132 patients were suitable for analysis. Duodenal ulcers healed in 60 (92%; 95% Cl 86-100%) patients taking bismuth, tetracycline, and metronidazole compared with 63 (95%; 88-100%) taking omeprazole in addition to the three other drugs. H pylori was eradicated in 61 (94%; 88-100%) who received only three drugs compared with 66 (98%; 96-100%) who received omeprazole as well. Symptoms were reduced more effectively during the first week in patients who received omeprazole (p=0·003). We conclude that a 1-week regimen of bismuth, tetracycline, and metronidazole for patients with
H pylori and duodenal ulcer eradicates the organism and heals the ulcer in most patients. Concurrent administration of omeprazole reduces ulcer pain more rapidly but has no effect on ulcer healing. |
doi_str_mv | 10.1016/S0140-6736(94)91460-5 |
format | Article |
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2 blockers heal faster if
Helicobacter pylori is eradicated concurrently. It remains unknown whether eradication of
H pylori without suppression of acid-secretion, is sufficient to allow healing. 153 patients with
H pylori infection and duodenal ulcer were randomised to receive either a 1-week course of bismuth subcitrate, tetracycline, and metronidazole (76), or omeprazole for 4 weeks with the same three-drug regimen for the first week (77). Endoscopy and antral biopsies were done at entry and 4 weeks after treatment. 132 patients were suitable for analysis. Duodenal ulcers healed in 60 (92%; 95% Cl 86-100%) patients taking bismuth, tetracycline, and metronidazole compared with 63 (95%; 88-100%) taking omeprazole in addition to the three other drugs. H pylori was eradicated in 61 (94%; 88-100%) who received only three drugs compared with 66 (98%; 96-100%) who received omeprazole as well. Symptoms were reduced more effectively during the first week in patients who received omeprazole (p=0·003). We conclude that a 1-week regimen of bismuth, tetracycline, and metronidazole for patients with
H pylori and duodenal ulcer eradicates the organism and heals the ulcer in most patients. Concurrent administration of omeprazole reduces ulcer pain more rapidly but has no effect on ulcer healing.</description><identifier>ISSN: 0140-6736</identifier><identifier>EISSN: 1474-547X</identifier><identifier>DOI: 10.1016/S0140-6736(94)91460-5</identifier><identifier>PMID: 7906759</identifier><identifier>CODEN: LANCAO</identifier><language>eng</language><publisher>London: Elsevier Ltd</publisher><subject>Adult ; Aged ; Antacids - pharmacology ; Antacids - therapeutic use ; Bacterial diseases ; Bacterial diseases of the digestive system and abdomen ; Biological and medical sciences ; Biopsy ; Bismuth ; Drug Resistance, Microbial ; Drug therapy ; Drug Therapy, Combination ; Duodenal Ulcer - diagnosis ; Duodenal Ulcer - drug therapy ; Duodenal Ulcer - microbiology ; Duodenal Ulcer - pathology ; Endoscopy, Gastrointestinal ; Female ; Helicobacter Infections - complications ; Helicobacter Infections - drug therapy ; Helicobacter Infections - microbiology ; Helicobacter pylori ; Human bacterial diseases ; Humans ; Infectious diseases ; Male ; Medical research ; Medical sciences ; Metronidazole - pharmacology ; Metronidazole - therapeutic use ; Middle Aged ; Omeprazole - pharmacology ; Omeprazole - therapeutic use ; Organometallic Compounds - pharmacology ; Organometallic Compounds - therapeutic use ; Pain - drug therapy ; Pain - etiology ; Stomach Diseases - complications ; Stomach Diseases - drug therapy ; Tetracycline - pharmacology ; Tetracycline - therapeutic use ; Ulcers ; Wound Healing - drug effects</subject><ispartof>The Lancet (British edition), 1994-02, Vol.343 (8896), p.508-510</ispartof><rights>1994</rights><rights>1994 INIST-CNRS</rights><rights>Copyright Lancet Ltd. Feb 26, 1994</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c416t-a2b95f44c316ee8c2bd352245d375a2c42db57d6d2b0355106827fbe9883891a3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0140673694914605$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=3953266$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7906759$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hosking, S.W.</creatorcontrib><creatorcontrib>Chung, S.C.S.</creatorcontrib><creatorcontrib>Yung, M.Y.</creatorcontrib><creatorcontrib>Li, A.K.C.</creatorcontrib><creatorcontrib>Sung, J.J.Y.</creatorcontrib><creatorcontrib>Ling, T.K.W.</creatorcontrib><creatorcontrib>Cheng, A.F.B.</creatorcontrib><title>Duodenal ulcer healing by eradication of Helicobacter pylori without anti-acid treatment: randomised controlled trial</title><title>The Lancet (British edition)</title><addtitle>Lancet</addtitle><description>Randomised trials have shown that duodenal ulcers treated by H
2 blockers heal faster if
Helicobacter pylori is eradicated concurrently. It remains unknown whether eradication of
H pylori without suppression of acid-secretion, is sufficient to allow healing. 153 patients with
H pylori infection and duodenal ulcer were randomised to receive either a 1-week course of bismuth subcitrate, tetracycline, and metronidazole (76), or omeprazole for 4 weeks with the same three-drug regimen for the first week (77). Endoscopy and antral biopsies were done at entry and 4 weeks after treatment. 132 patients were suitable for analysis. Duodenal ulcers healed in 60 (92%; 95% Cl 86-100%) patients taking bismuth, tetracycline, and metronidazole compared with 63 (95%; 88-100%) taking omeprazole in addition to the three other drugs. H pylori was eradicated in 61 (94%; 88-100%) who received only three drugs compared with 66 (98%; 96-100%) who received omeprazole as well. Symptoms were reduced more effectively during the first week in patients who received omeprazole (p=0·003). We conclude that a 1-week regimen of bismuth, tetracycline, and metronidazole for patients with
H pylori and duodenal ulcer eradicates the organism and heals the ulcer in most patients. Concurrent administration of omeprazole reduces ulcer pain more rapidly but has no effect on ulcer healing.</description><subject>Adult</subject><subject>Aged</subject><subject>Antacids - pharmacology</subject><subject>Antacids - therapeutic use</subject><subject>Bacterial diseases</subject><subject>Bacterial diseases of the digestive system and abdomen</subject><subject>Biological and medical sciences</subject><subject>Biopsy</subject><subject>Bismuth</subject><subject>Drug Resistance, Microbial</subject><subject>Drug therapy</subject><subject>Drug Therapy, Combination</subject><subject>Duodenal Ulcer - diagnosis</subject><subject>Duodenal Ulcer - drug therapy</subject><subject>Duodenal Ulcer - microbiology</subject><subject>Duodenal Ulcer - pathology</subject><subject>Endoscopy, Gastrointestinal</subject><subject>Female</subject><subject>Helicobacter Infections - complications</subject><subject>Helicobacter Infections - drug therapy</subject><subject>Helicobacter Infections - 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2 blockers heal faster if
Helicobacter pylori is eradicated concurrently. It remains unknown whether eradication of
H pylori without suppression of acid-secretion, is sufficient to allow healing. 153 patients with
H pylori infection and duodenal ulcer were randomised to receive either a 1-week course of bismuth subcitrate, tetracycline, and metronidazole (76), or omeprazole for 4 weeks with the same three-drug regimen for the first week (77). Endoscopy and antral biopsies were done at entry and 4 weeks after treatment. 132 patients were suitable for analysis. Duodenal ulcers healed in 60 (92%; 95% Cl 86-100%) patients taking bismuth, tetracycline, and metronidazole compared with 63 (95%; 88-100%) taking omeprazole in addition to the three other drugs. H pylori was eradicated in 61 (94%; 88-100%) who received only three drugs compared with 66 (98%; 96-100%) who received omeprazole as well. Symptoms were reduced more effectively during the first week in patients who received omeprazole (p=0·003). We conclude that a 1-week regimen of bismuth, tetracycline, and metronidazole for patients with
H pylori and duodenal ulcer eradicates the organism and heals the ulcer in most patients. Concurrent administration of omeprazole reduces ulcer pain more rapidly but has no effect on ulcer healing.</abstract><cop>London</cop><pub>Elsevier Ltd</pub><pmid>7906759</pmid><doi>10.1016/S0140-6736(94)91460-5</doi><tpages>3</tpages></addata></record> |
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subjects | Adult Aged Antacids - pharmacology Antacids - therapeutic use Bacterial diseases Bacterial diseases of the digestive system and abdomen Biological and medical sciences Biopsy Bismuth Drug Resistance, Microbial Drug therapy Drug Therapy, Combination Duodenal Ulcer - diagnosis Duodenal Ulcer - drug therapy Duodenal Ulcer - microbiology Duodenal Ulcer - pathology Endoscopy, Gastrointestinal Female Helicobacter Infections - complications Helicobacter Infections - drug therapy Helicobacter Infections - microbiology Helicobacter pylori Human bacterial diseases Humans Infectious diseases Male Medical research Medical sciences Metronidazole - pharmacology Metronidazole - therapeutic use Middle Aged Omeprazole - pharmacology Omeprazole - therapeutic use Organometallic Compounds - pharmacology Organometallic Compounds - therapeutic use Pain - drug therapy Pain - etiology Stomach Diseases - complications Stomach Diseases - drug therapy Tetracycline - pharmacology Tetracycline - therapeutic use Ulcers Wound Healing - drug effects |
title | Duodenal ulcer healing by eradication of Helicobacter pylori without anti-acid treatment: randomised controlled trial |
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