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
Hauptverfasser: Hosking, S.W., Chung, S.C.S., Yung, M.Y., Li, A.K.C., Sung, J.J.Y., Ling, T.K.W., Cheng, A.F.B.
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container_end_page 510
container_issue 8896
container_start_page 508
container_title The Lancet (British edition)
container_volume 343
creator Hosking, S.W.
Chung, S.C.S.
Yung, M.Y.
Li, A.K.C.
Sung, J.J.Y.
Ling, T.K.W.
Cheng, A.F.B.
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
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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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