Objective: To evaluate the dynamics of histological changes in the mucosa of the stomach and duodenal bulb during and after completion of a 14-day course of Hp-eradication dual treatment with high-dose omeprazole and amoxicillin.
Patients: 12 patients (mean age 53 +/- 16 years SD, 9 male, 3 female) with an acute Hp-positive duodenal ulcer were included in this open, prospective, single-centre study.
Method: Patients were given omeprazole 40 mg b.i.d. and amoxicillin 1,500 mg b.i.d. for a period of 14 days. Endoscopic biopsies were obtained on days 3, 7, 14, 28, 42 as well as at following endoscopies performed a mean of 17 months after treatment.
Results: The Hp-eradication rate achieved 4 weeks after treatment was 82%. On day 14, 88% of the ulcers were healed. Already on day 7 Hp had almost completely disappeared from the antrum, corpus and duodenal bulb, and the activity of gastritis in the antrum and corpus and the activity of bulbitis in the duodenal bulb was almost nonexistent. The decrease in the grade of gastritis was much lower by day 42.
Conclusions: Our study shows for the first time that in all patients signs of primarily successful Hp-eradication treatment during the first days of treatment are consistently demonstrable and complete already after one week of therapy, irrespective of the subsequent cure or persistence of Hp-infection. In the patients with persistence of Hp-infection Hp-colonization and activity of gastritis quickly increased within 2-4 weeks after cessation of treatment. Checks to evaluate complete eradication or recrudescence of Hp-infection should be carried out not earlier than 28 days after cessation of treatment.