Effi cacy of Helicobacter pylori eradication therapies on the background of metronidazole resistance in Bangladesh MM AHMAD Labaid Specialized Hospital, Dhaka, Bangladesh. J Gastroenterology and Hepatology Vol 27, Suppliment 1, Page 22 (original) (raw)
Related papers
Langenbeck's Archives of Surgery, 2007
Background A marginal ulcer developing after an initial operation for gastroduodenal ulcer is a serious threat to the patient, and a challenge to surgeons. Helicobacter pylori is the primary cause of peptic ulcer disease. However, its role in ulcer recurrence, especially of marginal ulcer (MU), after peptic ulcer surgery is unclear. This study aimed to determine any association between H. pylori infection and perforated MU by comparing the prevalence of H. pylori and nonsteroidal anti-inflammatory drugs (NSAIDs) use in patients with perforated (PMU) and in those with nonperforated MU (NPMU). Study design The study retrospectively evaluated the records of 16 patients with PMU who underwent surgical treatment and 24 patients with NPMU who underwent medical treatment in Atatürk University, School of Medicine, Department of General Surgery and Gastroenterology, between January 1995 and December 2004. Results The rate of H. pylori in the PMU group was significantly higher than that of the NPMU group (P< 0.01). There was a significant relationship between NSAID consumption and PMU compared with NPMU patients (P< 0.01). There was also a significant relationship between NSAID consumption and H. pylori and PMU (P<0.01). Conclusion Eradication of H. pylori after the first PMU operation especially in cases with impaired hemodynamics, severe peritoneal contamination, and/or a diameter smaller than 1 cm and avoiding the use of NSAIDs will surely reduce the risk of relapsing ulcers.
Caspian Journal of Internal Medicine, 2010
Background: Helicobacter Pylori (H.P) and Non Steroidal Anti inflammatory Drugs (NSAID) are the most common cause of peptic ulcer Disease (PUD). This study was designed to identify endoscopic, clinical and demographic features of patients with H.P positive in comparison with NSAID related PUD. Methods: From December 2004 to March 2008, 5885 patients underwent upper GI Tract endoscopy in a large referral Teaching Hospital of Babol Medical University. All patients with endoscopic diagnosis of PUD were enrolled in the study. H.P positive patients were assigned as group A and NSAID user as group B. Then their clinical, demographic, endoscopic characteristics were compared. Results: A total of 749 (12.3%) patients diagnosed as Duodenal Ulcer (DU), among them 600 subjects were eligible for analysis. Three hundred thirty one (55.2%) were H.P positive, 80 (13.3%) were NSAID user and 189 (31.5%) had non H.P non NSAID related ulcer. Two hundred ninety seven patients diagnosed having Gastric Ulcer (G.U), 143 (48.2%) were H.P positive, 46 (15.5%) were NSAID user and 108 (36.3%) had non H.Pylori, non NSAID related ulcer. Mean age of patients with G.U was 54.2±17 and D.U was 46.9±17.5 years (p<0.04). Anterior wall of bulb and antrum were the most common site of patients with D.U and G.U respectively. Conclusion: This study shows non H.Pylori non NSAID related ulcers comprise a significant portion of peptic ulcer disease in north of Iran.
Helicobacter pylori and Early Duodenal Ulcer Status Post-Treatment: a Review
Helicobacter, 2001
Background. Data submitted to the FDA were reviewed to analyze the relationship between Helicobacter pylori infection and the incidence of early duodenal ulcers, within 6 weeks, following treatment. Materials and Methods. Retrospective analyzes were performed on data from three H. pylori development programs submitted to the FDA: ranitidine-bismuth-citrate (RBC), lansoprazole (L) and omeprazole (O). Efficacy assessments for the RBC, L and O programs were made at end of a 4-week treatment period, 4-6 weeks following the end of a 14-day treatment period, and 4 weeks following the end of a 4-week treatment period, respectively. Results. Overall, there was a 15%, 21% and 23% decrease in the number of patients in the RBC, L and O programs, respectively, with ulcers among H. pylori cleared/eradicated patients post-treatment compared with patients with persistent infection. Among patients who did not have cleared/eradicated H. pylori in the RBC and O programs, where antisecretory agents were continued beyond the antimicrobial treatment period, the number of ulcers was lower in the antisecretory plus antimicrobial subgroups compared with the antimicrobial alone subgroups (37% vs. 46% for RBC and 33% vs. 42% for O). Among patients with cleared/eradicated H. pylori , the number of patients with ulcers in the antimicrobial alone subgroups and antisecretory plus antimicrobial subgroups were similar within each program. Antimicrobials alone had significantly lower rates of ulcers among patients with cleared/ eradicated H. pylori as compared with patients without clearance/eradication. Conclusions. The early incidence of duodenal ulcers is significantly decreased in patients with H. pylori clearance/eradication.
Przeglad Gastroenterologiczny, 2015
Introduction: Helicobacter pylori (H. pylori) occurs throughout the world and causes gastroduodenal diseases. There is data indicating a change in the prevalence of H. pylori infection worldwide. The prevalence of H. pylori is 80% in Turkey, while it is higher in many developing countries, and the rate of infection varies throughout the world. In many developing countries, the prevalence of infection exceeds 90% by adulthood. Aim: To determine the change in the rate of H. pylori infection in gastric ulcers and duodenal ulcers for a 10-year period in a single centre. Material and methods: The study population included 550 patients (342 in 2004, 208 in 1994) with gastric and duodenal ulcers. Results: In 2004 there were 125 (36.5%) patients with gastric ulcer and 217 patients with duodenal ulcer (64.5%). CLO test positivity was 39.2% in patients with gastric ulcers and 60% in patients with duodenal ulcers. In 1994 there were 208 patients (159 duodenal ulcers, 49 gastric ulcers). Urease test was positive in 74.2% of patients with duodenal ulcer and in 65.2% of patients with gastric ulcer. The decrease in the rate of urease positivity in patients with gastric ulcer was statistically significant (p = 0.01) during this 10-year period. Conclusions: In the present study we found that the urease positivity decreased significantly in patients with gastric ulcer between 1994 and 2004.
Helicobacter, 2012
This review found significantly less recurrence of ulcers when patients were treated with Helicobacter pylori eradication therapy after surgery for perforated duodenal ulcers compared to treatment with antisecretory non-eradication therapy. The review was well conducted, but the small number and size of the included trials means the authors' conclusions should be interpreted with some caution. Authors' objectives To evaluate the effectiveness of Helicobacter pylori eradication therapy for the prevention of ulcer recurrence in patients with simple closures of perforated duodenal ulcers. Searching MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL) were searched from inception to December 2010 without language restrictions; search terms were reported. Study selection Eligible studies were randomised controlled trials (RCTs) that evaluated Helicobacter pylori eradication therapy compared with antisecretory non-eradication therapy in patients who underwent surgery for simple closures of duodenal ulcers. The primary outcome was ulcer recurrence at 12 months post-surgery. Healing of ulcers had to be confirmed by endoscopic examination early in the post-surgical period, with ulcer recurrence and Helicobacter pylori positivity determined by endoscopic examination at one year post-surgery. Studies were conducted in Hong Kong, Egypt and Thailand. Confirmation of ulcer healing was provided at two to four months of follow-up post-surgery. The proportion of patients positive for Helicobacter pylori ranged from 80.6 to 92.8%. All the trials enrolled at least one patient who was using non-steroidal anti-inflammatory drugs. The Helicobacter pylori eradication regimes included omeprazole with other drugs including bismuth subcitrate, metronidazole, tetracycline, amoxicillin or clarithromycin. The duration of eradication therapy ranged from two to five weeks. The comparator treatment was omeprazole administered in doses from 20 to 40mg for durations of two to four weeks. Two reviewers performed the study selection. Assessment of study quality Methodological quality was assessed using Downs and Black criteria and the Jadad five-point composite scale. Two reviewers assessed study quality; any discrepancies were resolved by consensus. Data extraction Data were extracted to calculate relative risks (RR) and 95% confidence intervals (CI) for the outcomes. Study authors were contacted for further information where necessary. Data were extracted by two independent reviewers; disagreements were resolved by consensus. Methods of synthesis Pooled relative risks and 95% confidence intervals were calculated using a DerSimonian and Laird random-effect model. Statistical heterogeneity was assessed using Ι². The reviewers evaluated the potential for publication bias using the Egger test and by visual appraisals of funnel plots. Numbers-needed-to-treat (NNT) for benefit was also calculated. Results of the review Three RCTs (183) were included in the review. The quality of the three studies using the Jadad scale scores were one
Gastroenterology, 1997
Short-term follow-up studies show lower relapse rates of duodenal and gastric ulcers after successful Helicobacter pylori eradication. The aim of this study was to determine the long-term outcome of ulcer disease after successful H. pylori eradication. We prospectively studied the long-term effect of H. pylori eradication on ulcer recurrence rates in patients after endoscopically proven healing of duodenal or gastric ulcers between 1984 and 1995. Patients using nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, or maintenance antisecretory therapy were excluded. H. pylori infection was assessed by culture and histopathology of gastric biopsy specimens. After endoscopically proven ulcer healing and successful H. pylori eradication, 186 patients with ulcers underwent elective endoscopy every 3 months during the first year of follow-up and were advised to contact us at symptom recurrence. Thereafter, 96 patients were available for elective half-yearly endoscopies. The 89 patients ...