Recurrence of H. pylori infection and dyspeptic symptoms after successful eradication in patients cured of duodenal ulcer disease.

BACKGROUND/AIMS: To evaluate the recurrence of Helicobacter pylori (H. pylori) infection and dyspeptic symptoms in patients previously cured of active duodenal ulcers followed by successful eradication with bismuth-based triple therapy.

METHODOLOGY: Patients who remained H. pylori-negative by repeat endoscopy for 1 year were invited back and had their H. pylori status checked with a 13C-urea breath test. Those found positive for H. pylori underwent endoscopic confirmation by urease testing and histology.

RESULTS

Thirty-four (69%) patients, 30 males/4 females, with a mean age of 56.4 years and a mean follow-up period of 4.8 years, were eligible for study. Five patients were considered recurrent with H. pylori infection, giving us a recurrence rate of 3% per patient per year. Sixty percent (3/5) of the patients with recurrence experienced typical ulcer symptoms, whereas none of the H. pylori-negative patients experienced typical ulcer symptoms if non-steroidal antiinflammatory drug (NSAID) use is excluded.

CONCLUSIONS

Recurrence of H. pylori infection is low in Taiwan. Gender, age, smoking, alcohol consumption, and blood grouping do not appear to be significant risk factors for H. pylori recurrence. Reappearance of typical ulcer symptoms is suggestive of recurrence of H. pylori infection in patients cured of duodenal ulcer disease if the use of NSAID is excluded.