Document Detail

Hypersecretory duodenal ulcer and Helicobacter pylori infection: a four-year follow-up study.
MedLine Citation:
PMID:  10975785     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: About 10% of duodenal ulcer patients are characterized by gastric acid hypersecretion with normal gastrin values. Relapsing duodenal ulcer after Helicobacter pylori cure has been related to high acid output and maintenance antisecretory therapy has been suggested in hypersecretory duodenal ulcer patients. The role of Helicobacter pylori infection and the effects of Helicobacter pylori cure in hypersecretory duodenal ulcer patients still remain to be fully studied. AIM: To study: a) whether gastric acid hypersecretion "per se" is a risk factor for duodenal ulcer recurrence; b) whether maintenance antisecretory therapy is necessary after eradication in hypersecretory duodenal ulcer patients. PATIENTS: The study population comprised 8 hypersecretory duodenal ulcer patients, selected from a population of 79 Helicobacter pylori-positive duodenal ulcer patients. METHODS: Hypersecretory duodenal ulcer patients were followed-up for at least 4 years after eradication. Gastric acid secretion was measured again 12 months after Helicobacter pylori eradication. Gastroscopy with histology was performed 3, 6, 12 and 36 months after treatment, 13C-urea breath test after 42 months; clinical questionnaires were completed every 6 months. RESULTS: After eradication, despite a not significantly reduced high acid output (median value of basal acid output and pentagastrin-stimulated acid output, respectively, 23.1 mEq/h and 64.1 mEq/h before treatment vs 16 mEq/h and 49.7 mEq/h 12 months after treatment), all patients were free from symptoms, none of them had duodenal ulcer relapse or complications (7/8 before treatment), or needed antisecretory maintenance therapy, except for one patient taking non-steroidal anti-inflammatory drugs. CONCLUSIONS: These findings, obtained in a selected population of hypersecretory duodenal ulcer patients with long-term follow-up, suggest that after successful Helicobacter pylori eradication gastric acid hypersecretion "per se" is not able to determine the recurrence of duodenal ulcer.
G Capurso; G Martino; C Grossi; B Annibale; G Delle Fave
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver     Volume:  32     ISSN:  1590-8658     ISO Abbreviation:  Dig Liver Dis     Publication Date:  2000 Mar 
Date Detail:
Created Date:  2000-11-08     Completed Date:  2000-11-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100958385     Medline TA:  Dig Liver Dis     Country:  ITALY    
Other Details:
Languages:  eng     Pagination:  119-24     Citation Subset:  IM    
Dept of Gastroenterology, University La Sapienza, Rome, Italy.
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MeSH Terms
Anti-Bacterial Agents
Drug Therapy, Combination / therapeutic use
Duodenal Ulcer / drug therapy,  metabolism*,  microbiology
Follow-Up Studies
Gastric Acid / secretion*
Gastric Mucosa / secretion*
Helicobacter Infections / drug therapy,  metabolism*,  microbiology
Helicobacter pylori / isolation & purification*
Middle Aged
Pepsinogen A / secretion
Reg. No./Substance:
0/Anti-Bacterial Agents; 9001-10-9/Pepsinogen A
Comment In:
Dig Liver Dis. 2000 Mar;32(2):125-7   [PMID:  10975786 ]

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