Eradication of Helicobacter pylori does not decrease the long‐term use of acid‐suppressive medication

• Published in: Alimentary pharmacology & therapeutics Vol. 13; no. 11; pp. 1519 - 1522
• Main Authors: Tan, Hartog, G. Den, Mulder
• Format: Journal Article
• Language: English
• Published: Oxford UK Blackwell Science Ltd 01.11.1999; Blackwell
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Digestive system; Dyspepsia - drug therapy; Enzyme Inhibitors - administration & dosage; Enzyme Inhibitors - therapeutic use; Female; Helicobacter Infections - drug therapy; Helicobacter Infections - microbiology; Helicobacter pylori; Histamine H2 Antagonists - administration & dosage; Histamine H2 Antagonists - therapeutic use; Humans; Male; Medical sciences; Middle Aged; Peptic Ulcer - drug therapy; Peptic Ulcer - microbiology; Pharmacology. Drug treatments; Proton Pump Inhibitors; Surveys and Questionnaires; Human; Spirillales; Dyspepsia; Use; Spirillaceae; Eradication; Antihistaminic; Long term; Proton pump inhibitor; Infection; Chemotherapy; Treatment; Helicobacter pylori; Antisecretory agent; Bacteriosis; Digestive diseases; Bacteria; Antagonist; Anastomotic ulcer; H2 Histamine receptor; Gastric disease
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1046/j.1365-2036.1999.00626.x

Background : Many patients are not symptom‐free after eradication therapy for Helicobacter pylori and continue to use proton pump inhibitors or H2‐receptor antagonists (H2‐RAs). Aim : To ascertain whether a cohort of patients treated for H. pylori were still taking either proton pump inhibitors or H2‐RAs more than 4 years after H. pylori eradication therapy. Methods : In 1993–94, a cohort of 167 patients were given eradication therapy for their H. pylori infection. By means of questionnaires to the patient, general practitioner and pharmacist we were able to retrieve data from 151 patients. The use (at the time of questionnaire) of proton pump inhibitors or H2‐RAs was noted. Results : Indications for eradication therapy were peptic ulcer disease: 28 patients (19%) or functional dyspepsia: 123 patients (82%). Mean time of follow‐up was 1466 ± 21 days. In this group, 77 patients (51%) still used acid‐suppressive medication (proton pump inhibitors 44% and H2‐RAs 7%) at the time of the survey (mean follow‐up more than 4 years after eradication). In the group treated for peptic ulcer disease (n=28), only nine patients still used proton pump inhibitors or H2‐RAs. In contrast, 68 patients who were treated for functional dyspepsia (total number 123) still used proton pump inhibitors or H2‐RAs (55%) (P < 0.05). Conclusion : Even after successful H. pylori eradication, < 50% of patients stop acid‐suppressive therapy. This contributes significantly to economic cost and raises doubts about the practice of routinely eradicating H. pylori in patients with functional dyspepsia. In contrast, the majority of peptic ulcer patients are able to stop acid‐suppressive medication.