Eradication of Helicobacter pylori Reduces the Rate of Duodenal Ulcer Rebleeding: A Long-Term Follow-Up Study

Objectives: The long-term efficacy ofHelicobacter pylorieradication to reduce the rate of recurrence of peptic ulcer bleeding is still uncertain. We evaluated the rate of duodenal ulcer rebleeding for 48 months afterH. pylorieradication. Methods: Thirty-two male patients withH. pyloriinfection and duodenal ulcer bleeding were treated with omeprazole (40 mg/day for 4 wk), colloidal bismuth (480 mg/day for 2 wk), amoxicillin (2 g/day for 1 wk), and metronidazole (750 mg/day for 1 wk), and followed up for 48 months. Endoscopy and tests forH. pyloriinfection were repeated every year. Results: Ulcer healed in all patients, butH. pyloriinfection persisted or recurred in 11 patients. Within 48 months, rebleeding occurred in nine (81.8%) of these patients, whereas the 21 patients who were persistently negative forH. pyloriinfection remained asymptomatic without rebleeding (0/21 = 0%,p< 0.002) during the whole follow-up. Conclusions: Eradication ofH. pylorican reduce the rate of duodenal ulcer rebleeding for at least 4 yr, thus potentially modifying the natural history of the disease.