Reply to Rácz et al.

We really appreciate the interest and comments of Dr. Rácz and his colleagues concerning our report.

With regard to the patients with known Helicobacter pylori status, diagnostic procedures had been performed in all cases after complete halting of bleeding by means of injection therapy alone or in combination with other methods. Endoscopic hemostatic procedures were carried out in all patients with a positive endoscopic Doppler sign; thus some patients with Forrest II and III gradings were also treated. None of the patients that we referred to surgery had bled by the time of the operation. However, the H. pylori status of those patients was determined in order to inform the surgeon about the etiology of the ulcer.

Injection therapy alone was successful in 150 patients, while other hemostatic methods were needed for the rest. Because only a small number of patients received combination therapy, we did not carry out a differentiated analysis of rebleeding with reference to the technique of combination therapy.

We agree with the authors that the most important time for assessment of the rebleebing rate is the first 72 hours after the initial attack. Actually, 95 % of the instances of rebleeding occurred within the first 72 hours. Therefore, our conclusion regarding the influence of H. pylori infection does not change if the timespan of the analysis is decreased. Rácz et al. have presented interesting data with results similar to ours.

We think that the real influence of H. pylori infection on the early rebleeding rate can only be answered by performing a prospective randomized placebo-controlled trial analyzing the effect of early eradication of H. pylori on the rebleeding rate within the first 72 hours.