Effects of Helicobacter pylori infection on healing and recurrence of gastric ulcers.

OBJECTIVES The effects of Helicobacter pylori infection on the healing and recurrence of gastric ulcers were investigated. METHODS Eighty-five and 17 patients with endoscopically-proven gastric ulcer with and without H. pylori infection, respectively, received 800 mg of cimetidine daily. Healing of ulcer and H. pylori infection were assessed at wk 12. After the 12-wk-treatment period, 67 and 16 patients with healed ulcer positive and negative for H. pylori infection, respectively, received maintenance treatment (cimetidine 400 mg daily). Ulcer recurrence and H. pylori infection were assessed at or within 24 wk from the beginning of maintenance treatment. Variables influencing ulcer healing and recurrence were analyzed by multiple regression analysis. RESULTS Ulcer healing at wk 12 was similar in patients with and without H. pylori infection, occurring in 16 (89%) of 18 patients without H. pylori infection, compared with 67 (87%) of 77 patients with H. pylori infection. At or within 24 wk from the start of maintenance therapy, ulcer recurrence was significantly more frequent in patients with H. pylori infection than in those without: it occurred in three (20%) of 15 patients without H. pylori infection, but in 37 (58%) of 64 patients with infection. Multiple regression analysis showed that H. pylori infection was related most closely to ulcer recurrence independently. CONCLUSION H. pylori infection had a significant independent influence on gastric ulcer recurrence, but not initial ulcer healing.