Persistence of Symptoms After Successful Eradication of Helicobacter Pylon in the Duodenal Ulcer Disease

Abstract

An Initial ulcer healing has never been a problem rather it is the relapse of the ulcer which is a clinical challenge, and if (Helicobacter Pylon) Hp eradication can be achieved, ulcer relapse is not expected. However it has been a common clinical experience that despite successful therapy these patients continue to suffer from upper GI symptoms. An audit was made to scrutinize the symptoms up to six months after the helicobacter pylori was successfully eradicated. 100 symptomatic endoscopically proven duodenal ulcer patients were included in the study and were given Lanzoprazole 30mg bid, Amoxicillin 1gm bid, Clarithromycin 250mg bid with and without Tinidazole 500mg bid for seven days. Ulcer healing and H pylon eradication was confirmed after three months by endoscopic assessment, mucosal rapid urease test and gastric antrum mucosal biopsy. 86 patients completed the seven day treatment and at the end of three months 72 patients were confirmed to be ulcer free and H. pylon negative. Only 51 patients could be followed upto six months after the eradication treatment and 20 patients were found to have upper GI type symptoms. The complaints were as follows: continuing abdominal pain (10 patients), water brash (9 patients), heart burn (5 patients), gas and flatulence (15 patients), and incomplete evacuation of bowels (4 patients). Majority of the patients had more than one symptom ( 16 patients ) and most common combination was of flatulence, gas, abdominal pain and water brash (8 patients).It appears that Hp eradication helps us in avoiding ulcer and its complications but a good percentage of people continue to complain of upper GI type symptoms afterwards as well.