Background and Study Aims: Eradication of Helicobacter pylori infection can reduce the rebleeding rate of peptic ulcer bleeding in the long term.
There are few data on the influence of H. pylori on the rebleeding rate in the acute phase of bleeding however. We therefore prospectively
investigated the influence of H. pylori infection on the early rebleeding rate in patients who had undergone successful endoscopic
hemostasis treatment for peptic ulcer bleeding.
Patients and Methods: Between January 1996 and November 2000 all patients with peptic ulcer bleeding were
evaluated consecutively. The diagnosis of H. pylori infection was made at index endoscopy, using histology and the rapid urease test.
Bleeding activity was assessed using the Forrest classification. After successful
endoscopic hemostasis all patients received omeprazole 40 mg or pantoprazole 40 mg,
intravenously, twice a day for 3 days. Rebleeding episodes were recorded over 21 days
following primary hemostasis.
Results: 344 patients were enrolled into the study. The prevalence of H. pylori infection was 62.9 %. A total of 51 patients showed rebleeding (14.8 %), of whom
31 were H. pylori -positive (60 %). There was no statistically significant difference between the H. pylori -positive and -negative patients, however. The rebleeding rate did not differ between
patients with H. pylori infection alone and patients also using nonsteroidal anti-inflammatory drugs. When
stratifying patients according to activity of bleeding at index endoscopy, we were
also unable to find any significant influence of H. pylori infection on the outcome of Forrest class I and IIa bleedings.
Conclusion: Based on our data, it can be concluded that H. pylori infection does not affect the early rebleeding rate in patients with peptic ulcer
bleeding after successful endoscopic hemostasis.
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D. Schilling, M.D.
Department of Internal Medicine C (Gastroenterology and Hepatology) · Klinikum der
Stadt Ludwigshafen · Academic Medical Hospital of the University of Mainz
Bremerstrasse 79 · 67063 Ludwigshafen/Rhine · Germany
Fax: + 49-621-503-4114
Email: MedCLu@t-online.de