scholarly journals Does the Depth of Gastric Ulceration Influence a Modified Dual Therapy with Amoxicilin and Lansoprazole forHelicobacter pylori-Positive Gastric Ulcer?

2000 ◽  
Vol 14 (9) ◽  
pp. 761-766 ◽  
Author(s):  
Takashi Okai ◽  
Koushiro Ohtsubo ◽  
Junta Sakai ◽  
Hiroyuki Watanabe ◽  
Yoshiharu Motoo ◽  
...  
Keyword(s):  
Gastric Ulcer ◽  
Eradication Therapy ◽  
Dual Therapy ◽  
Ulcer Recurrence ◽  
Ecabet Sodium ◽  
Antiulcer Agent ◽  
Superficial Ulcer ◽  
H Pylori ◽  
One Year ◽  
To Receive

PURPOSE: To clarify whether the depth of ulceration evaluated by endoscopic ultrasonography (EUS) influences a modified dual therapy with amoxicillin and lansoprazole for the treatment ofHelicobacter pylori-positive patients with gastric ulcer.PATIENTS AND METHODS: Twenty-two consecutive cases of gastric ulcer (nine superficial ulcers and 13 deep ulcers) inH pylori-positive patients were studied. Ten of 22 patients received a two-week eradication therapy with amoxicillin 1500 mg/day, lansoprazole 30 mg/day and a new antiulcer agent with features in common with sucralfate, ecabet sodium, 2.0 g/day. They continued to receive the same doses of lansoprazole and ecabet sodium for the next six weeks. The other 12 patients received the same therapy except for those who underwent the four-week amoxicillin treatment. All patients underwent EUS both at the start of the study and eight weeks later. They then received ecabet sodium alone for the next six months as a maintenance therapy, followed by a six-month interval with no treatment. The final endoscopy was done one year afterH pylorieradication therapy was completed to evaluateH pyloristatus and ulcer recurrence.RESULTS: The rates of endoscopic healing andH pylorieradication in the nine patients with superficial ulcer were 100%, irrespective of the period of amoxicillin treatment. In contrast, the rates of endoscopic evidence of healing andH pylorieradication in the 13 patients with deep ulcer were different for each period of amoxicillin treatment; that is, the rates of reduction in ulcer determined by echo andH pylorieradication in the four patients treated with the two-week amoxicillin course were significantly lower (P=0.03) than those in the nine patients treated with the four-week course.CONCLUSION: Ulcer depth is likely to influence the success of amoxicillin treatment forH pylori-positive patients with gastric ulcer.

scholarly journals Ranitidine bismuth citrate with clarithromycin for the treatment of duodenal ulcer

Gut ◽  
1997 ◽  
Vol 41 (2) ◽  
pp. 181-186 ◽  
Author(s):  
K D Bardhan ◽  
C Dallaire ◽  
H Eisold ◽  
A E Duggan
Keyword(s):  
Duodenal Ulcer ◽  
Ulcer Healing ◽  
Eradication Therapy ◽  
Dual Therapy ◽  
Ulcer Recurrence ◽  
Bismuth Citrate ◽  
Ulcer Relapse ◽  
Table Analysis ◽  
Duodenal Ulcer Healing ◽  
H Pylori

Background/Aims—To investigate the effect of the new Helicobacter pylori eradication regimen, ranitidine bismuth citrate (RBC) and clarithromycin (CLAR) dual therapy, on duodenal ulcer healing and absence of ulcer recurrence during 24 weeks follow up (overall success).Methods—Two hundred and thirty two H pylori positive patients with active duodenal ulcer received four weeks treatment with RBC 400 mg twice daily alone (RBC400) (n=82), or RBC 400 or 800 mg twice daily co-prescribed with clarithromycin 250 mg four times daily for 14 days, followed by 14 days of RBC 400 mg twice daily alone (RBC400+CLAR and RBC 800+CLAR, respectively, n=75 for each).Results—The co-prescription regimens gave highH pylori eradication rates determined using two tests (CLOtest and 13C-urea breath test) for the presence of the organism. These rates were 92% and 81% for RBC400+CLAR (n=62) and RBC800+CLAR (n=63) respectively, compared with 2% for RBC400 (n=66) (p<0.001). With respect to overall success as estimated by life table analysis, RBC400+CLAR (89%) and RBC800+ CLAR (87%) were significantly more effective than RBC400 alone (51%) (p<0.001). All regimens were safe and well tolerated. Trough plasma bismuth concentrations at week 4 were low (treatment medians less than 6.6 ng bismuth/ml).Conclusions—Ranitidine bismuth citrate is a well tolerated and efficacious ulcer healing drug which, when co-prescribed with clarithromycin, affords effective H pylorieradication therapy and prevents ulcer relapse in most patients with duodenal ulcer.

scholarly journals TWO YEARS FOLLOW UP AFTER ERADICATION THERAPY OF PEPTIC ULCER

2020 ◽  
pp. 28-31
Author(s):  
HASSAN KHUDER RAJAB ◽  
ALI ESMAIL AL-SNAFI
Keyword(s):  
Peptic Ulcer ◽  
Eradication Therapy ◽  
Endoscopic Examination ◽  
Urea Breath Test ◽  
Ulcer Recurrence ◽  
Follow Up Study ◽  
History Of ◽  
Second Year ◽  
H Pylori

Objective: This study was performed to detect the recurrence rate for two years after eradication therapy of peptic ulcer. Methods: Sixty-nine patients included in this study in Kirkuk city from January 2004 to January 2005 as 1st year follow up, and 49 patients from January 2005 to January 2006 as second year follow up study. A urea breath test and re-endoscopic examination were carried out to confirm peptic ulcer recurrence. A questionnaire was prepared to take the history of the disease and other relevant data of each patient. Results: The recurrence was occurred in 6 (8.7%) and 8 patients (16.33%) in the 1st and 2nd years after eradication therapy. Highly risk of recurrence was smoking, age below 50 y and stress in 1st year follow up, and stress was the highly risk in the 2nd year follow up. Conclusion: After triple and quadruple therapy of peptic ulcer, the recurrence is low, However, the possibility of H. pylori resistance should be considered.

Helicobacter pylori causes gastrointestinal hemorrhage in patients with congenital bleeding disorders

2003 ◽  
Vol 89 (04) ◽  
pp. 741-746 ◽  
Author(s):  
Ann-Sofie Rehnberg ◽  
Marju Hein ◽  
Olga Hegedus ◽  
Per Lindmarker ◽  
Per Hellström ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Gastrointestinal Hemorrhage ◽  
Breath Test ◽  
Eradication Therapy ◽  
Urea Breath Test ◽  
Von Willebrand Disease ◽  
Bleeding Disorders ◽  
Ulcer Disease ◽  
H Pylori ◽  
One Year

Summary Helicobacter pylori (H. pylori) infection is associated with peptic ulcer disease and gastric cancer. The eradication of H. pylori is of special interest in patients with congenital bleeding disorders, for whom treatment of gastrointestinal hemorrhage with factor concentrates is costly. The prevalence of H. pylori varies between different populations and identification of high-risk subgroups may allow for more targeted screening and eradication of the infection. We performed a 5-year retrospective study of gastrointestinal bleeding, combined with screening and treatment for H. pylori and a long-term prospective follow-up in 168 Swedish and 23 Estonian patients with hemophilia or von Willebrand disease. The prevalence of seropositivity was lower in Sweden than in Estonia (28 versus 48%, p = 0.03), lower in native Swedes than in non-Nordic immigrants to Sweden (20 versus 76%, p = 0.0001) and lower in patients less than 40 years of age than older patients (16 versus 38%, p = 0.002). The incidence of gastrointestinal hemorrhages among the 35 Swedish patients with active H. pylori infection, confirmed by a urea breath test, was 6.0 per 100 patient-years before eradication therapy versus 1.7 during the prospective followup. A negative urea breath test one month after therapy always remained negative after one year. Screening, followed by treatment of all infected patients, yielded a reduction of direct costs over a 5-year period of 130 US-$ per screened patient. We conclude that screening and eradication therapy for infection with H. pylori in patients with congenital bleeding disorders is an effective and economic strategy.

scholarly journals The Puzzle of Coccoid Forms of Helicobacter pylori: Beyond Basic Science

Antibiotics ◽  
2020 ◽  
Vol 9 (6) ◽  
pp. 293
Author(s):  
Enzo Ierardi ◽  
Giuseppe Losurdo ◽  
Alessia Mileti ◽  
Rosa Paolillo ◽  
Floriana Giorgio ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Dual Therapy ◽  
Current Evidence ◽  
High Dose ◽  
Coccoid Form ◽  
High Proton ◽  
Polymerase Chain ◽  
H Pylori ◽  
One Year ◽  
Inhibitor Dose

Helicobacter pylori (H. pylori) may enter a non-replicative, non-culturable, low metabolically active state, the so-called coccoid form, to survive in extreme environmental conditions. Since coccoid forms are not susceptible to antibiotics, they could represent a cause of therapy failure even in the absence of antibiotic resistance, i.e., relapse within one year. Furthermore, coccoid forms may colonize and infect the gastric mucosa in animal models and induce specific antibodies in animals and humans. Their detection is hard, since they are not culturable. Techniques, such as electron microscopy, polymerase chain reaction, loop-mediated isothermal amplification, flow cytometry and metagenomics, are promising even if current evidence is limited. Among the options for the treatment, some strategies have been suggested, such as a very high proton pump inhibitor dose, high-dose dual therapy, N-acetycysteine, linolenic acid and vonoprazan. These clinical, diagnostic and therapeutic uncertainties will represent fascinating challenges in the future.

scholarly journals GASTRIC ULCER AFTER SHORT-TERM NONSTEROIDAL ANTI-INFLAMMATORY DRUGS ADMINISTRATION IN A SMALL CHILD – CASE REPORT

2015 ◽  
Vol 64 (4) ◽  
pp. 403-405
Author(s):  
Ancuta Ignat ◽  
◽  
Gabriela Paduraru ◽  
Angelica Cristina Marin ◽  
Anamaria Ciubara ◽  
...  
Keyword(s):  
Gastric Ulcer ◽  
Eradication Therapy ◽  
Gastric Ulcers ◽  
Upper Gastrointestinal Endoscopy ◽  
Short Term ◽  
Upper Respiratory Infection ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
H Pylori ◽  
Associated Risk Factors

Nonsteroidal anti-inflammatory agents (NSAIDs) produce gastric lesions through two mechanisms: local irritation and systemic action. A 2 year and 10 months old female received NSAID for acute upper respiratory infection for 2 days and she developed coffee ground vomitus one day later. Upper gastrointestinal endoscopy revealed a gastric ulcer. She was negative for H. pylori infection, and she was diagnosed with NSAID – induced acute gastric ulcer in the absence of other causes of gastric ulcer. Gastric ulcers develop very rarely after a short-term administration of NSAIDs, which prompted us to report this case. Balancing the risk and the benefit of eradication therapy, it is indicated, for every patient who must follow a chronic treatment with anti-inflammatory drugs, to look for possible associated risk factors.

scholarly journals Evidence-based clinical practice guidelines for peptic ulcer disease 2020

2021 ◽  
Author(s):  
Tomoari Kamada ◽  
Kiichi Satoh ◽  
Toshiyuki Itoh ◽  
Masanori Ito ◽  
Junichi Iwamoto ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Clinical Practice ◽  
Practice Guidelines ◽  
Eradication Therapy ◽  
Ulcer Recurrence ◽  
Evidence Based ◽  
Peptic Ulcers ◽  
Ulcer Disease ◽  
History Of ◽  
H Pylori

AbstractThe Japanese Society of Gastroenterology (JSGE) revised the third edition of evidence-based clinical practice guidelines for peptic ulcer disease in 2020 and created an English version. The revised guidelines consist of nine items: epidemiology, hemorrhagic gastric and duodenal ulcers, Helicobacter pylori (H. pylori) eradication therapy, non-eradication therapy, drug-induced ulcers, non-H. pylori, and nonsteroidal anti-inflammatory drug (NSAID) ulcers, remnant gastric ulcers, surgical treatment, and conservative therapy for perforation and stenosis. Therapeutic algorithms for the treatment of peptic ulcers differ based on ulcer complications. In patients with NSAID-induced ulcers, NSAIDs are discontinued and anti-ulcer therapy is administered. If NSAIDs cannot be discontinued, the ulcer is treated with proton pump inhibitors (PPIs). Vonoprazan (VPZ) with antibiotics is recommended as the first-line treatment for H. pylori eradication, and PPIs or VPZ with antibiotics is recommended as a second-line therapy. Patients who do not use NSAIDs and are H. pylori negative are considered to have idiopathic peptic ulcers. Algorithms for the prevention of NSAID- and low-dose aspirin (LDA)-related ulcers are presented in this guideline. These algorithms differ based on the concomitant use of LDA or NSAIDs and ulcer history or hemorrhagic ulcer history. In patients with a history of ulcers receiving NSAID therapy, PPIs with or without celecoxib are recommended and the administration of VPZ is suggested for the prevention of ulcer recurrence. In patients with a history of ulcers receiving LDA therapy, PPIs or VPZ are recommended and the administration of a histamine 2-receptor antagonist is suggested for the prevention of ulcer recurrence.

Positive Effect of Helicobacter pylori Treatment on Outcome of Patients With Chronic Spontaneous Urticaria

2020 ◽  
Author(s):  
Mohammed Elhendawy ◽  
Maha M Hagras ◽  
Shaimaa S Soliman ◽  
Engi Seif E Shaker
Keyword(s):  
Helicobacter Pylori ◽  
Eradication Therapy ◽  
Hypochromic Anemia ◽  
Chronic Spontaneous Urticaria ◽  
Gastric Tissue ◽  
Stool Antigen ◽  
Helicobacter Pylori Treatment ◽  
H Pylori ◽  
To Receive ◽  
Positive Effect

Abstract Objectives The association between Helicobacter pylori and chronic spontaneous urticaria (CSU) is controversial. Therefore, we aimed to directly diagnose H pylori by polymerase chain reaction (PCR) in gastric tissue from patients with CSU and to investigate the association between H pylori eradication therapy and CSU remission. Methods Twenty-seven of 72 patients with CSU who were positive for H pylori stool antigen and PCR in gastric biopsy specimens were randomized to receive either anti–H pylori treatment or placebo. Results Patients with H pylori were found to have significantly lower hemoglobin concentrations with microcytic hypochromic anemia and a significantly higher occurrence of dyspepsia symptoms. All H pylori–treated patients (except two) showed significant improvement of the urticaria itching and red wheals after 2 weeks of therapy compared with the placebo group (P &lt; .001). The response rate to treatment was 85.7% (12 patients; 95% confidence interval, 64.3%-100.0%). The two patients who failed to eradicate H pylori had an H pylori strain resistant to amoxicillin. Conclusions An association was observed between CSU and presence of H pylori infection in the gastric tissue. Whether this is a causal relationship or not remains to be discovered, but treatment of H pylori can significantly improve the symptoms of CSU.

scholarly journals Helicobacter pylori Eradication Therapy - Recent Trend in Research

2020 ◽  
Vol 20 (3) ◽  
pp. 210-217
Author(s):  
Heung Up Kim
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Antibiotic Resistance ◽  
Gastric Mucosa ◽  
Drug Exposure ◽  
Eradication Therapy ◽  
Dual Therapy ◽  
Resistance Rate ◽  
H Pylori ◽  
Selection Of

It is well known that <i>Helicobacter pylori (H. pylori)</i> can cause peptic ulcer, mucosa-associated lymphoid tissue lymphoma, atrophic gastritis, intestinal metaplasia, and ultimately, gastric cancer. Various studies have proven that <i>H. pylori</i>, which attaches to the gastric mucosa, is the cause of gastric cancer and can be eradicated using appropriate antibiotics. Since 2013, Japan has been carrying out national-led eradication treatment of <i>H. pylori</i> for the whole population. However, as drug exposure increases, the resistance rate to some antibiotics increases, and the pattern of antibiotic resistance varies from region to region. Therefore, the development of individualized antimicrobial therapies has become important since antibiotic resistance to <i>H. pylori</i> eradication is a problem worldwide. To help overcome this, remedies such as selection of antibiotics through susceptibility testing, selection of empirical treatment combinations appropriate for the region, dual therapy with high doses of amoxicillin, and the use of rifabutin or sitafloxacin with low antibiotic resistance have been studied. Potassium-competitive acid blocker has been reported to be more potent in inhibiting acid secretion than proton pump inhibitor, and its role in <i>H. pylori</i> eradication is expected. Drug formulations and regimens that are easy to take are being developed to increase compliance. New treatments such as spraying antibiotics directly to the gastric mucosa are being developed and studied.

scholarly journals Helicobacter pylori and Gastric Metaplasia: Their Status after Eradication Therapy

1970 ◽  
Vol 15 (2) ◽  
pp. 59-63
Author(s):  
Maleeha Hussain ◽  
Mian Ahmad Mashud ◽  
Hazera Khatun ◽  
Tareak Al Nasir
Keyword(s):  
Duodenal Ulcer ◽  
Helicobacter Pylori ◽  
Eradication Therapy ◽  
Ulcer Recurrence ◽  
Ulcer Margin ◽  
Gastric Metaplasia ◽  
H Pylori ◽  
The Relationship

This study was carried out with an aim to investigate the relationship between gastricmetaplasia with H. pylori and the effect of eradication therapy. A total of 210 patients withhistory of dyspepsia were included in the study of which 50 were enrolled in the eradicationtherapy. After the eradication therapy 35 patients came for follow-up endoscopy. Pairedendoscopic biopsies were taken from antrum and duodenal ulcer margin and were examined forH. pylori and for duodenitis and gastric metaplasia. Gastric metaplasia was significantlyassociated with H. pylori. After eradication H. pylori showed further extension of gastricmetaplasia. It can be recommended that these patients can be further followed up to see thecourse of gastric metaplasia and what impact it has on ulcer recurrence and re-infection.doi: 10.3329/taj.v15i2.3908TAJ December 2002; Vol.15(2):59-63

Sign in / Sign up

Export Citation Format

Share Document