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Recurrence of duodenal ulcer after Helicobacter pylori eradication is related to high acid output |
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| Authors: | A W HARRIS P A GUMMETT P S PHULL M R JACYNA J J MISIEWICZ & J H BARON |
| Institution: | Parkside Helicobacter Study Group, Central Middlesex and St Mary's Hospitals, London, UK; Gastroenterology Unit, Northwick Park Hospital, Harrow, UK |
| Abstract: | Background : Helicobacter pylori eradication reduces the recurrence of duodenal ulcers. It is unclear why duodenal ulcers rarely recur in the absence of reinfection with H. pylori or NSAID treatment. Methods : Basal, gastrin-releasing peptide- and pentagastrin-stimulated peak acid outputs in patients with ulcer relapse after H. pylori eradication were measured, and compared with patients without ulcer relapse after H. pylori eradication. Results : Pentagastrin-stimulated peak acid output was significantly higher in H. pylori -positive patients with duodenal ulcers than in H. pylori -negative controls, and fell significantly after H. pylori eradication. In H. pylori -negative patients with recurrent duodenal ulcers, pentagastrin-stimulated peak acid output was significantly higher than in controls and similar to H. pylori -positive patients with duodenal ulcers. Conclusions : These findings suggest that duodenal ulcer relapse after eradication of H. pylori may be related to high pentagastrin-stimulated peak acid output. In this subset of patients with duodenal ulcers, maintenance anti-secretory treatment may be necessary to prevent relapse. |
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