Bacterial density of Helicobacter pylori predicts the success of triple therapy in bleeding duodenal ulcer☆,☆☆,★,★★
Section snippets
Patient selection criteria
From January 1994 to June 1995, 192 patients with duodenal ulcer bleeding proved by emergency endoscopy were studied. Only patients with H. pylori infection by positive results of rapid urease test (CLO test, Delta Ltd., Perth, Australia)17 and antral biopsy for histology were included. To avoid problems in evaluating H. pylori status, H. pylori-infected patients were excluded for the following conditions: severe medical illness (subject to increased risk of rebleeding and poor drug
Efficacy of early triple therapy
During the study period, 192 patients were proved to have duodenal ulcer bleeding. Our observed prevalence rate of H. pylori in cases of duodenal ulcer bleeding was 78.6% (151 of 192). Fifteen of the 151 H. pylori-infected patients were excluded prior to the study for reasons stated in the Methods section. Among the resulting 136 patients who began early triple therapy, only 6 patients (4.4%) with recurrent bleeding during the first 2 weeks of the study period and 3 patients (2.2%) with poor
DISCUSSION
Eradication of H. pylori changes the natural history of duodenal ulcer disease and is a standard therapy for duodenal ulcer patients, especially those with complications such as bleeding.11 In our study, the prevalence of H. pylori infection in patients with bleeding duodenal ulcer was 78.6% (somewhat lower than the 90% reported for patients with nonbleeding ulcers) determined by CLO test and histologic testing. Precisely because of the lower prevalence of H. pylori, coupled with the
ACKNOWLEDGEMENTS
The authors thank Miss Yen-Lin Wang, Miss Ruey-Jen Tsai, and Mr. T. Randall Gillespie.
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2013, Clinics and Research in Hepatology and GastroenterologyCitation Excerpt :Therapeutic attempts resulted in a reduction of the bacterial load leading to a rapid and significant reduction of gastritis activity [21,28]. It has also been proposed that intragastric bacterial load may affect the outcome of eradication treatment although the relevant data in the literature are scarce [17–19,29]. Sheu et al. tried to quantify bacterial load by serology and histology [17].
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From the Departments of Internal Medicine, Pathology, Medical Technology, and Emergency, National Cheng Kung University Hospital, Tainan, Taiwan.
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This manuscript is sponsored by a Research Grant of National Cheng Kung University Hospital (NCKUH 95003).
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Reprint requests: Xi-Zhang Lin, MD, Gastroenterology, National Cheng Kung University Hospital, 138, Sheng Li Road, 704 Tainan, Taiwan.
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