Author(s): Rauws EA, Tytgat GN
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Abstract 50 patients with intractable duodenal ulcer were randomly assigned to 4 weeks of treatment with colloidal bismuth subcitrate (CBS) alone (26 patients) or with amoxicillin and metronidazole (24 patients). 5 patients (all on triple therapy) withdrew because of side-effects. In 17 of the 45 patients who completed the treatment, Helicobacter pylori was eradicated, and there was no ulcer relapse during the first 12 months of follow-up. The ulcer relapse rate was significantly higher (17 of 21 [89\%]) among patients who remained positive for H pylori. 9 patients who remained positive for H pylori and had ulcer relapses within 6 months of treatment with CBS alone, were subsequently given triple therapy. 7 of the 9 showed H pylori eradication and no relapses within the next 12 months. The 2 patients still H pylori-positive after triple therapy had further ulcer relapses. H pylori eradication, without altering acid output, will become the mainstay of duodenal ulcer treatment because it cures the disease.
This article was published in Lancet
and referenced in Journal of Bioequivalence & Bioavailability