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Peptic Ulcer Disease

  • Jinjoo KimEmail author
Chapter

Abstract

Peptic ulcer disease (PUD) used to recur frequently, cause various complications, and show high mortality rate. However, after the discovery of Helicobacter pylori (H. pylori), H. pylori eradication has dramatically reduced the recurrence rate of PUD. H. pylori eradication combined with gastric acid inhibition promotes ulcer healing more rapidly than gastric acid inhibition only. H. pylori eradication also prevents various PUD complications, such as bleeding, perforation, and obstruction, to occur. Therefore, PUD patients with H. pylori infection should get H. pylori eradication for better ulcer healing and prevention of its recurrence and complications.

Keywords

Helicobacter pylori Peptic ulcer disease Gastric acid 

References

  1. 1.
    Gisbert JP, Boixeda D, Martín De Argila C, Alvarez Baleriola I, Abraira V, García Plaza A. Unhealed duodenal ulcers despite Helicobacter pylori eradication. Scand J Gastroenterol. 1997;32:643–50.CrossRefPubMedGoogle Scholar
  2. 2.
    Graham DY, Lew GM, Evans DG, Evans Jr DJ, Klein PD. Effect of triple therapy (antibiotics plus bismuth) on duodenal ulcer healing. A randomized controlled trial. Ann Intern Med. 1991;115:266–9.CrossRefPubMedGoogle Scholar
  3. 3.
    Marshall BJ, Goodwin CS, Warren JR, Murray R, Blincow ED, Blackbourn SJ, et al. Prospective double-blind trial of duodenal ulcer relapse after eradication of Campylobacter pylori. Lancet. 1988;2:1437–42.CrossRefPubMedGoogle Scholar
  4. 4.
    Hentschel E, Brandstätter G, Dragosics B, Hirschl AM, Nemec H, Schütze K, et al. Effect of ranitidine and amoxicillin plus metronidazole on the eradication of Helicobacter pylori and the recurrence of duodenal ulcer. N Engl J Med. 1993;328:308–12.CrossRefPubMedGoogle Scholar
  5. 5.
    Hosking SW, Ling TK, Yung MY, Cheng A, Chung SC, Leung JW, et al. Randomised controlled trial of short term treatment to eradicate Helicobacter pylori in patients with duodenal ulcer. BMJ. 1992;305:502–4.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Rauws EA, Tytgat GN. Cure of duodenal ulcer associated with eradication of Helicobacter pylori. Lancet. 1990;335:1233–5.CrossRefPubMedGoogle Scholar
  7. 7.
    George LL, Borody TJ, Andrews P, Devine M, Moore-Jones D, Walton M, et al. Cure of duodenal ulcer after eradication of Helicobacter pylori. Med J Aust. 1990;153:145–9.PubMedGoogle Scholar
  8. 8.
    Bianchi Porro G, Parente F, Lazzaroni M. Short and long term outcome of Helicobacter pylori positive resistant duodenal ulcers treated with colloidal bismuth subcitrate plus antibiotics or sucralfate alone. Gut. 1993;34:466–9.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Mantzaris GJ, Hatzis A, Tamvakologos G, Petraki K, Spiliades C, Triadaphyllou G. Prospective, randomized, investigator-blind trial of Helicobacter pylori infection treatment in patients with refractory duodenal ulcers. Healing and long-term relapse rates. Dig Dis Sci. 1993;38:1132–6.CrossRefPubMedGoogle Scholar
  10. 10.
    Wagner S, Gebel M, Haruma K, Bär W, Lange P, Freise J, et al. Bismuth subsalicylate in the treatment of H2 blocker resistant duodenal ulcers: role of Helicobacter pylori. Gut. 1992;33:179–83.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Labenz J, Börsch G. Highly significant change of the clinical course of relapsing and complicated peptic ulcer disease after cure of Helicobacter pylori infection. Am J Gastroenterol. 1994;89:1785–8.PubMedGoogle Scholar
  12. 12.
    Arkkila PE, Seppälä K, Kosunen TU, Sipponen P, Mäkinen J, Rautelin H, et al. Helicobacter pylori eradication as the sole treatment for gastric and duodenal ulcers. Eur J Gastroenterol Hepatol. 2005;17:93–101.CrossRefPubMedGoogle Scholar
  13. 13.
    Lam SK, Ching CK, Lai KC, Wong BC, Lai CL, Chan CK, et al. Does treatment of Helicobacter pylori with antibiotics alone heal duodenal ulcer? A randomised double blind placebo controlled study. Gut. 1997;41:43–8.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Hosking SW, Ling TK, Chung SC, Yung MY, Cheng AF, Sung JJ, et al. Duodenal ulcer healing by eradication of Helicobacter pylori without antiacid treatment: randomised controlled trial. Lancet. 1994;343:508–10.CrossRefPubMedGoogle Scholar
  15. 15.
    Logan RP, Gummett PA, Misiewicz JJ, Karim QN, Walker MM, Baron JH. One week’s anti-Helicobacter pylori treatment for duodenal ulcer. Gut. 1994;35:15–8.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Laine L, Suchower L, Frantz J, Connors A, Neil G. Twice-daily, 10-day triple therapy with omeprazole, amoxicillin, and clarithromycin for Helicobacter pylori eradication in duodenal ulcer disease: results of three multicenter, double-blind. US Trials Am J Gastroenterol. 1998;93:2106–12.CrossRefGoogle Scholar
  17. 17.
    Wheeldon TU, Hoang TT, Phung DC, Björkman A, Granström M, Sörberg M. Helicobacter pylori eradication and peptic ulcer healing: the impact of deleting the proton pump inhibitor and using a once-daily treatment. Aliment Pharmacol Ther. 2003;18:93–100.CrossRefPubMedGoogle Scholar
  18. 18.
    Labenz J, Börsch G. Evidence for the essential role of Helicobacter pylori in gastric ulcer disease. Gut. 1994;35:19–22.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Malfertheiner P, Kirchner T, Kist M, Leodolter A, Peitz U, Strobel S, et al. Helicobacter pylori eradication and gastric ulcer healing – comparison of three pantoprazole-based triple therapies. Aliment Pharmacol Ther. 2003;17:1125–35.CrossRefPubMedGoogle Scholar
  20. 20.
    Borody TJ, George LL, Brandl S, Andrews P, Ostapowicz N, Hyland L, et al. Helicobacter pylori-negative duodenal ulcer. Am J Gastroenterol. 1991;86:1154–7.PubMedGoogle Scholar
  21. 21.
    Penston JG, McColl KE. Eradication of Helicobacter pylori: an objective assessment of current therapies. Br J Clin Pharmacol. 1997;43:223–43.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Tatsuta M, Ishikawa H, Iishi H, Okuda S, Yokota Y. Reduction of gastric ulcer recurrence after suppression of Helicobacter pylori by cefixime. Gut. 1990;31:973–6.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Asaka M, Ohtaki T, Kato M, Kudo M, Kimura T, Meguro T, et al. Causal role of Helicobacter pylori in peptic ulcer relapse. J Gastroenterol. 1994;29 Suppl 7:134–8.PubMedGoogle Scholar
  24. 24.
    Sung JJ, Chung SC, Ling TK, Yung MY, Leung VK, Ng EK, et al. Antibacterial treatment of gastric ulcers associated with Helicobacter pylori. N Engl J Med. 1995;332:139–42.CrossRefPubMedGoogle Scholar
  25. 25.
    Bayerdörffer E, Miehlke S, Lehn N, Mannes GA, Höchter W, Weingart J, et al. Cure of gastric ulcer disease after cure of Helicobacter pylori infection – German Gastric Ulcer Study. Eur J Gastroenterol Hepatol. 1996;8:343–9.CrossRefPubMedGoogle Scholar
  26. 26.
    Malfertheiner P, Bayerdörffer E, Diete U, Gil J, Lind T, Misiuna P, et al. The GU-MACH study: the effect of 1-week omeprazole triple therapy on Helicobacter pylori infection in patients with gastric ulcer. Aliment Pharmacol Ther. 1999;13:703–12.CrossRefPubMedGoogle Scholar
  27. 27.
    Higuchi K, Fujiwara Y, Tominaga K, Watanabe T, Shiba M, Nakamura S, et al. Is eradication sufficient to heal gastric ulcers in patients infected with Helicobacter pylori? A randomized, controlled, prospective study. Aliment Pharmacol Ther. 2003;17:111–7.CrossRefPubMedGoogle Scholar
  28. 28.
    Hsu CC, Lu SN, Changchien CS. One-week low-dose triple therapy without anti-acid treatment has sufficient efficacy on Helicobacter pylori eradication and ulcer healing. Hepatogastroenterology. 2003;50:1731–4.PubMedGoogle Scholar
  29. 29.
    Gisbert JP, Pajares JM. Systematic review and meta-analysis: is 1-week proton pump inhibitor-based triple therapy sufficient to heal peptic ulcer? Aliment Pharmacol Ther. 2005;21:795–804.CrossRefPubMedGoogle Scholar
  30. 30.
    Tulassay Z, Stolte M, Sjölund M, Engstrand L, Butruk E, Malfertheiner P, et al. Effect of esomeprazole triple therapy on eradication rates of Helicobacter pylori, gastric ulcer healing and prevention of relapse in gastric ulcer patients. Eur J Gastroenterol Hepatol. 2008;20:526–36.CrossRefPubMedGoogle Scholar
  31. 31.
    Tytgat GN. Review article: treatments that impact favourably upon the eradication of Helicobacter pylori and ulcer recurrence. Aliment Pharmacol Ther. 1994;8:359–68.CrossRefPubMedGoogle Scholar
  32. 32.
    Leodolter A, Kulig M, Brasch H, Meyer-Sabellek W, Willich SN, Malfertheiner P. A meta-analysis comparing eradication, healing and relapse rates in patients with Helicobacter pylori-associated gastric or duodenal ulcer. Aliment Pharmacol Ther. 2001;15:1949–58.CrossRefPubMedGoogle Scholar
  33. 33.
    Befrits R, Sjöstedt S, Tour R, Leijonmarck CE, Hedenborg L, Backman M, Stockholm United Study Group for Helicobacter Pylori. Long-term effects of eradication of Helicobacter pylori on relapse and histology in gastric ulcer patients: a two-year follow-up study. Scand J Gastroenterol. 2004;39:1066–72.CrossRefPubMedGoogle Scholar
  34. 34.
    Londong W, Barth H, Dammann HG, Hengels KJ, Kleinert R, Müller P, et al. Dose-related healing of duodenal ulcer with the proton pump inhibitor lansoprazole. Aliment Pharmacol Ther. 1991;5:245–54.CrossRefPubMedGoogle Scholar
  35. 35.
    Bardhan KD, Bianchi Porro G, Bose K, Daly M, Hinchliffe RF, Jonsson E, et al. A comparison of two different doses of omeprazole versus ranitidine in treatment of duodenal ulcers. J Clin Gastroenterol. 1986;8:408–13.CrossRefPubMedGoogle Scholar
  36. 36.
    Misra SC, Dasarathy S, Sharma MP. Omeprazole versus famotidine in the healing and relapse of duodenal ulcer. Aliment Pharmacol Ther. 1993;7:443–9.CrossRefPubMedGoogle Scholar
  37. 37.
    Dammann HG, Walter TA. Efficacy of continuous therapy for peptic ulcer in controlled clinical trials. Aliment Pharmacol Ther. 1993;7 Suppl 2:17–25.PubMedGoogle Scholar
  38. 38.
    Penston JG, Wormsley KG. Nine years of maintenance treatment with ranitidine for patients with duodenal ulcer disease. Aliment Pharmacol Ther. 1992;6:629–45.CrossRefPubMedGoogle Scholar
  39. 39.
    Zanten SJ, Bradette M, Farley A, Leddin D, Lind T, Unge P, et al. The DU-MACH study: eradication of Helicobacter pylori and ulcer healing in patients with acute duodenal ulcer using omeprazole based triple therapy. Aliment Pharmacol Ther. 1999;13:289–95.CrossRefPubMedGoogle Scholar
  40. 40.
    Coghlan JG, Gilligan D, Humphries H, McKenna D, Dooley C, Sweeney E, et al. Campylobacter pylori and recurrence of duodenal ulcers-a 12- month follow-up study. Lancet. 1987;2:1109–11.CrossRefPubMedGoogle Scholar
  41. 41.
    Hopkins RJ, Girardi LS, Turney EA. Relationship between Helicobacter pylori eradication and reduced duodenal and gastric ulcer recurrence: a review. Gastroenterology. 1996;110:1244–52.CrossRefPubMedGoogle Scholar
  42. 42.
    Gillen D, el Omar EM, Wirz AA, Ardill JE, McColl KE. The acid response to gastrin distinguishes duodenal ulcer patients from Helicobacter pylori-infected healthy subjects. Gastroenterology. 1998;114:50–7.CrossRefPubMedGoogle Scholar
  43. 43.
    Laine LA. Helicobacter pylori and complicated ulcer disease. Am J Med. 1996;100:52–9.CrossRefGoogle Scholar
  44. 44.
    Murray WR, Cooper G, Laferla G, Rogers P, Archibald M. Maintenance ranitidine treatment after haemorrhage from a duodenal ulcer. A 3-year study. Scand J Gastroenterol. 1988;23:183–7.CrossRefPubMedGoogle Scholar
  45. 45.
    Jensen DM, Cheng S, Kovacs TO, Randall G, Jensen ME, Reedy T, et al. A controlled study of ranitidine for the prevention of recurrent hemorrhage from duodenal ulcer. N Engl J Med. 1994;330:382–6.CrossRefPubMedGoogle Scholar
  46. 46.
    Kikkawa A, Iwakiri R, Ootani H, Ootani A, Fujise T, Sakata Y, et al. Prevention of the rehaemorrhage of bleeding peptic ulcers: effects of Helicobacter pylori eradication and acid suppression. Aliment Pharmacol Ther. 2005;21 Suppl 2:79–84.CrossRefPubMedGoogle Scholar
  47. 47.
    Gisbert JP, Khorrami S, Carballo F, Calvet X, Gené E, Dominguez-Muñoz JE. H. pylori eradication therapy vs. antisecretory non-eradication therapy (with or without long-term maintenance antisecretory therapy) for the prevention of recurrent bleeding from peptic ulcer. Cochrane Database Syst Rev. 2004;2:CD004062.PubMedGoogle Scholar
  48. 48.
    Horvat D, Vcev A, Soldo I, Timarac J, Dmitrović B, Misević T, et al. The results of Helicobacter pylori eradication on repeated bleeding in patients with stomach ulcer. Coll Antropol. 2005;29:139–42.PubMedGoogle Scholar
  49. 49.
    Gisbert JP, Calvet X, Feu F, Bory F, Cosme A, Almela P, et al. Eradication of Helicobacter pylori for the prevention of peptic ulcer rebleeding. Helicobacter. 2007;12:279–86.CrossRefPubMedGoogle Scholar
  50. 50.
    Simpson CJ, Lamont G, Macdonald I, Smith IS. Effect of cimetidine on prognosis after simple closure of perforated duodenal ulcer. Br J Surg. 1987;74:104–5.CrossRefPubMedGoogle Scholar
  51. 51.
    Svanes C, Ovrebø K, Søreide O. Ulcer bleeding and perforation: non-steroidal anti-inflammatory drugs or Helicobacter pylori. Scand J Gastroenterol. 1996;220:128–31.CrossRefGoogle Scholar
  52. 52.
    Kumar S, Mittal GS, Gupta S, Kaur I, Aggarwal S. Prevalence of Helicobacter pylori in patients with perforated duodenal ulcer. Trop Gastroenterol. 2004;25:121–4.PubMedGoogle Scholar
  53. 53.
    Reinbach DH, Cruickshank G, McColl KE. Acute perforated duodenal ulcer is not associated with Helicobacter pylori infection. Gut. 1993;34:1344–7.CrossRefPubMedPubMedCentralGoogle Scholar
  54. 54.
    Kate V, Ananthakrishnan N, Badrinath S. Effect of Helicobacter pylori eradication on the ulcer recurrence rate after simple closure of perforated duodenal ulcer: retrospective and prospective randomized controlled studies. Br J Surg. 2001;88:1054–8.CrossRefPubMedGoogle Scholar
  55. 55.
    Metzger J, Styger S, Sieber C, von Flüe M, Vogelbach P, Harder F. Prevalence of Helicobacter pylori infection in peptic ulcer perforations. Swiss Med Wkly. 2001;131:99–103.PubMedGoogle Scholar
  56. 56.
    Sebastian M, Chandran VP, Elashaal YI, Sim AJ. Helicobacter pylori infection in perforated peptic ulcer disease. Br J Surg. 1995;82:360–2.CrossRefPubMedGoogle Scholar
  57. 57.
    Ng EK, Chung SC, Sung JJ, Lam YH, Lee DW, Lau JY, et al. High prevalence of Helicobacter pylori infection in duodenal ulcer perforations not caused by non-steroidal anti-inflammatory drugs. Br J Surg. 1996;83:1779–81.CrossRefPubMedGoogle Scholar
  58. 58.
    Matsukura N, Onda M, Tokunaga A, Kato S, Yoshiyuki T, Hasegawa H, et al. Role of Helicobacter pylori infection in perforation of peptic ulcer: an age- and gender-matched case-control study. J Clin Gastroenterol. 1997;25:S235–9.CrossRefPubMedGoogle Scholar
  59. 59.
    Ng EK, Lam YH, Sung JJ, Yung MY, To KF, Chan AC, et al. Eradication of Helicobacter pylori prevents recurrence of ulcer after simple closure of duodenal ulcer perforation: randomized controlled trial. Ann Surg. 2000;231:153–8.CrossRefPubMedPubMedCentralGoogle Scholar
  60. 60.
    de Boer WA, Driessen WM. Resolution of gastric outlet obstruction after eradication of Helicobacter pylori. J Clin Gastroenterol. 1995;21:329–30.CrossRefPubMedGoogle Scholar
  61. 61.
    Annibale B, Marignani M, Luzzi I, Delle Fave GF. Peptic ulcer and duodenal stenosis: role of Helicobacter pylori infection. Ital J Gastroenterol. 1995;27:26–8.PubMedGoogle Scholar
  62. 62.
    Lam Y, Lau JY, Law KB, Sung JJ, Chung SS. Endoscopic balloon dilation and Helicobacter pylori eradication in the treatment of gastric outlet obstruction. Gastrointest Endosc. 1997;46:379–80.CrossRefPubMedGoogle Scholar
  63. 63.
    Taskin V, Gurer I, Ozyilkan E, Sare M, Hilmioglu F. Effect of Helicobacter pylori eradication on peptic ulcer disease complicated with outlet obstruction. Helicobacter. 2000;5:38–40.CrossRefPubMedGoogle Scholar
  64. 64.
    Gisbert JP, Pajares JM. Review article: Helicobacter pylori infection and gastric outlet obstruction – prevalence of the infection and role of antimicrobial treatment. Aliment Pharmacol Ther. 2002;16:1203–8.CrossRefPubMedGoogle Scholar
  65. 65.
    Cherian PT, Cherian S, Singh P. Long-term follow-up of patients with gastric outlet obstruction related to peptic ulcer disease treated with endoscopic balloon dilatation and drug therapy. Gastrointest Endosc. 2007;66:491–7.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media Singapore 2016

Authors and Affiliations

  1. 1.Department of Internal MedicineGyeongsang National University HospitalJinju-siSouth Korea

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