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Peptic Ulcer Disease

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Helicobacter pylori

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Abstract

Since the discovery of Helicobacter pylori (H. pylori), H. pylori eradication has dramatically lowered the recurrence rate of peptic ulcer disease (PUD). Combining H. pylori eradication with gastric acid inhibition accelerates ulcer healing compared to gastric acid inhibition alone. Moreover, H. pylori eradication prevents various PUD complications, such as bleeding, perforation, and obstruction. Therefore, for PUD patients with H. pylori infection, H. pylori eradication has become the standard care of treatment ensuring improved outcomes including ulcer healing and prevention of recurrence and complications.

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References

  1. Lanas A, Dumonceau JM, Hunt RH, Fujishiro M, Scheiman JM, Gralnek IM, et al. Non-variceal upper gastrointestinal bleeding. Nat Rev Dis Primers. 2018;4:18020.

    Article  PubMed  Google Scholar 

  2. Venerito M, Schneider C, Costanzo R, Breja R, Rohl F-W, Malfertheiner P. Contribution of Helicobacter pylori infection to the risk of peptic ulcer bleeding in patients on nonsteroidal anti-inflammatory drugs, antiplatelet agents, anticoagulants, corticosteroids and selective serotonin reuptake inhibitors. Aliment Pharmacol Ther. 2018;47:1464–71.

    Article  CAS  PubMed  Google Scholar 

  3. El-Omar EM, Panman ID, Ardill JE, Chittajallu RS, Howie C, McColl KE. Helicobacter pylori infection and abnormalities of acid secretion in patients with duodenal ulcer disease. Gastroenterology. 1995;109:681–91.

    Article  CAS  PubMed  Google Scholar 

  4. Moss SF, Legon S, Bishop AE, Polak JM, Calam J. Effect of Helicobacter pylori on gastric somatostatin in duodenal ulcer disease. Lancet. 1992;340:930–2.

    Article  CAS  PubMed  Google Scholar 

  5. Gillen D, El-Omar EM, Wirz AA, Ardill JE, McColl KE. The acid response to gastrin distinguish duodenal ulcer patients from Helicobacter pylori-infected healthy subjects. Gastroenterology. 1998;114:50–7.

    Article  CAS  PubMed  Google Scholar 

  6. Gisbert JP, Boixeda D, Martín De Argila C, Alvarez Baleriola I, Abraira V, García PA. Unhealed duodenal ulcers despite Helicobacter pylori eradication. Scand J Gastroenterol. 1997;32:643–50.

    Article  CAS  PubMed  Google Scholar 

  7. Graham DY, Lew GM, Evans DG, Evans DJ Jr, Klein PD. Effect of triple therapy (antibiotics plus bismuth) on duodenal ulcer healing. A randomized controlled trial. Ann Intern Med. 1991;115:266.

    Article  CAS  PubMed  Google Scholar 

  8. 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.

    Article  CAS  PubMed  Google Scholar 

  9. 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.

    Article  CAS  PubMed  Google Scholar 

  10. 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.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Rauws EA, Tytgat GN. Cure of duodenal ulcer associated with eradication of Helicobacter pylori. Lancet. 1990;335:1233–5.

    Article  CAS  PubMed  Google Scholar 

  12. 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.

    Article  CAS  PubMed  Google Scholar 

  13. 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.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. 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.

    Article  CAS  PubMed  Google Scholar 

  15. 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.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. 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.

    CAS  PubMed  Google Scholar 

  17. 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.

    Article  PubMed  Google Scholar 

  18. 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.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. 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.

    Article  CAS  PubMed  Google Scholar 

  20. 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.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. 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.

    Article  CAS  PubMed  Google Scholar 

  22. 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.

    Article  CAS  PubMed  Google Scholar 

  23. Labenz J, Börsch G. Evidence for the essential role of Helicobacter pylori in gastric ulcer disease. Gut. 1994;35:19–22.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. 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.

    Article  CAS  PubMed  Google Scholar 

  25. 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.

    CAS  PubMed  Google Scholar 

  26. Penston JG, McColl KE. Eradication of Helicobacter pylori: an objective assessment of current therapies. Br J Clin Pharmacol. 1997;43:223–43.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. 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.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. 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.

    PubMed  Google Scholar 

  29. 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.

    Article  CAS  PubMed  Google Scholar 

  30. 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.

    Article  PubMed  Google Scholar 

  31. 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.

    Article  CAS  PubMed  Google Scholar 

  32. 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.

    Article  CAS  PubMed  Google Scholar 

  33. 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. Hepato-Gastroenterology. 2003;50:1731–4.

    CAS  PubMed  Google Scholar 

  34. 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.

    Article  CAS  PubMed  Google Scholar 

  35. 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.

    Article  CAS  PubMed  Google Scholar 

  36. Tytgat GN. Review article: treatments that impact favourably upon the eradication of Helicobacter pylori and ulcer recurrence. Aliment Pharmacol Ther. 1994;8:359–68.

    Article  CAS  PubMed  Google Scholar 

  37. 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.

    Article  CAS  PubMed  Google Scholar 

  38. 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.

    Article  CAS  PubMed  Google Scholar 

  39. 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.

    Article  CAS  PubMed  Google Scholar 

  40. 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.

    Article  CAS  PubMed  Google Scholar 

  41. Misra SC, Dasarathy S, Sharma MP. Omeprazole versus famotidine in the healing and relapse of duodenal ulcer. Aliment Pharmacol Ther. 1993;7:443–9.

    Article  CAS  PubMed  Google Scholar 

  42. Dammann HG, Walter TA. Efficacy of continuous therapy for peptic ulcer in controlled clinical trials. Aliment Pharmacol Ther. 1993;7 Suppl 2:17–25.

    Article  PubMed  Google Scholar 

  43. Penston JG, Wormsley KG. Nine years of maintenance treatment with ranitidine for patients with duodenal ulcer disease. Aliment Pharmacol Ther. 1992;6:629–45.

    Article  CAS  PubMed  Google Scholar 

  44. 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.

    Article  CAS  PubMed  Google Scholar 

  45. 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.

    Article  CAS  PubMed  Google Scholar 

  46. 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.

    Article  CAS  PubMed  Google Scholar 

  47. Laine LA. Helicobacter pylori and complicated ulcer disease. Am J Med. 1996;100:52–9.

    Article  Google Scholar 

  48. 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.

    Article  CAS  PubMed  Google Scholar 

  49. 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.

    Article  CAS  PubMed  Google Scholar 

  50. 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.

    Article  PubMed  Google Scholar 

  51. 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.

    Google Scholar 

  52. 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.

    PubMed  Google Scholar 

  53. 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.

    Article  PubMed  Google Scholar 

  54. 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.

    Article  CAS  PubMed  Google Scholar 

  55. 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.

    Article  CAS  Google Scholar 

  56. 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.

    PubMed  Google Scholar 

  57. Reinbach DH, Cruickshank G, McColl KE. Acute perforated duodenal ulcer is not associated with Helicobacter pylori infection. Gut. 1993;34:1344–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  58. 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.

    Article  CAS  PubMed  Google Scholar 

  59. 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.

    CAS  PubMed  Google Scholar 

  60. Sebastian M, Chandran VP, Elashaal YI, Sim AJ. Helicobacter pylori infection in perforated peptic ulcer disease. Br J Surg. 1995;82:360–2.

    Article  CAS  PubMed  Google Scholar 

  61. 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.

    Article  CAS  PubMed  Google Scholar 

  62. 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.

    Article  PubMed  Google Scholar 

  63. 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.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  64. de Boer WA, Driessen WM. Resolution of gastric outlet obstruction after eradication of Helicobacter pylori. J Clin Gastroenterol. 1995;21:329–30.

    Article  PubMed  Google Scholar 

  65. 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.

    CAS  PubMed  Google Scholar 

  66. 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.

    Article  CAS  PubMed  Google Scholar 

  67. 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.

    Article  CAS  PubMed  Google Scholar 

  68. Gisbert JP, Pajares JM. Helicobacter pylori infection and gastric outlet obstruction – prevalence of the infection and role of antimicrobial treatment. Aliment Pharmacol Ther. 2002;16:1203–8.

    Article  CAS  PubMed  Google Scholar 

  69. 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.

    Article  PubMed  Google Scholar 

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    Jinjoo Kim

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  1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea (Republic of)

    Nayoung Kim

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Kim, J. (2023). Peptic Ulcer Disease. In: Kim, N. (eds) Helicobacter pylori. Springer, Singapore. https://doi.org/10.1007/978-981-97-0013-4_54

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  • DOI: https://doi.org/10.1007/978-981-97-0013-4_54

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