GASTROENTEROLOGY 1997;113:1082–1086 Prevention of Ulcer Recurrence After Eradication of Helicobacter pylori: A Prospective Long-term Follow-up Study

Background & Aims: Short-term follow-up studies show matically reduces ulcer relapse rates.2–24 The few studies lower relapse rates of duodenal and gastric ulcers after in patients with gastric ulcers had similar findings.2,25–29 successful Helicobacter pylori eradication. The aim of Only a few studies have followed up on patients with this study was to determine the long-term outcome duodenal ulcers for more than 1 year.30,31 All these stud-of ulcer disease after successful H. pylori eradication. ies report ulcer relapses (3%–22%) despite successful H. Methods: We prospectively studied the long-term effect pylori eradication. Factors clarifying the variance in study of H. pylori eradication on ulcer recurrence rates in results include the varying end points: absence of docu-patients after endoscopically proven healing of duode-mented initial ulcer disease and ulcer healing; unknownnal or gastric ulcers between 1984 and 1995. Patients H. pylori status at the time of ulcer relapse or at theusing nonsteroidal anti-inflammatory drugs (NSAIDs), conclusion of the study14,17,18,25; and the assessment ofaspirin, or maintenance antisecretory therapy were ex-cure of the infection by H. pylori clearance instead of H.cluded. H. pylori infection was assessed by culture and pylori eradication, a difference leading to high rates ofhistopathology of gastric biopsy specimens. After endo-scopically proven ulcer healing and successful H. pylori H. pylori recrudescence and ulcer relapse rates.5,9,12,26 eradication, 186 patients with ulcers underwent elec- Moreover, the use of nonsteroidal anti-inflammator