Long-Term Follow-Up of 1,000 Patients Cured of Helicobacter pylori Infection Following an Episode of Peptic Ulcer Bleeding

Abstract

Peptic ulcer rebleeding virtually does not occur in patients with complicated ulcers after H. pylori eradication. Maintenance anti-ulcer (antisecretory) therapy is not necessary if eradication is achieved. However, NSAID intake or H. pylori reinfection may exceptionally cause rebleeding in H. pylori-eradicated patients.

III Conferencia Española de Consenso sobre la infección por Helicobacter pylori

“…Referencias posteriores constatan también la utilidad de la erradicación en la úlcera gástrica 10 y en la prevención de distintas complicaciones como, por ejemplo, la recidiva de la hemorragia por úlcera 11,12 , la estenosis pilórica 13 o la perforación 14 . Por tanto, se recomienda la erradicación de la infección por H. pylori en todos los pacientes tanto con úlcera activa como con antecedentes de esta.…”

Randomised clinical trial comparing sequential and concomitant therapies forHelicobacter pylorieradication in routine clinical practice

“…Although most H pylori -positive individuals will remain asymptomatic through life, its presence causes chronic gastritis in 100% of infected patients and is the major cause of relevant diseases, such as atrophic gastritis, peptic ulcer disease and gastric cancer 2 . H pylori eradication prevents peptic ulcer recurrence and its complications 3. WHO's International Agency for Research on Cancer classified H pylori as a group 1 (definite) carcinogen 4.…”

Diagnosis, Treatment, and Outcome in Patients with Bleeding Peptic Ulcers andHelicobacter pyloriInfections

“…While there has been concern over whether maintenance antisecretory treatment was necessary, the current position is that, as long as Hp is eradicated, peptic ulcer rebleeding is virtually eliminated. Therefore, antisecretory therapy is no longer required [101–104]. However, maintenance antisecretory therapy should be considered for Hp -eradicated patients who did not stop NSAID use.…”

“…Despite 4 months of different maintenance regimens among the four groups (antacid suspension, colloidal bismuth, famotidine, or a placebo treatment), all the patients remained ulcer free with no evidence of reinfection. In recent pooled data of 1000 patients from 10 Spanish university hospitals and a total of 3253 patient-years of long-term followup, maintenance antiulcer treatment was not indicated once Hp had been eradicated [104]. However, the recent Maastricht IV/Florence Consensus suggested that while maintenance antiulcer treatment is not needed for bleeding duodenal ulcers, it should be continued for gastric ulcers [13].…”