The Impact of Helicobacter pylori Eradication on Peptic Ulcer Healing

Objective: Current literature was reviewed analyzing the outcome of peptic ulcer healing in relation to the results of the posttherapeuticHelicobacter pylori(HP) status. Methods: Literature was reviewed along with an analysis of 60 studies, comprising a total of 4329 patients. Results: SuccessfulHelicobacter pylorieradication was found to induce a better response in peptic ulcer healing, regardless of diagnosis: gastric ulcer 88%vs73% (odds ratio [OR] 2.7,p< 0.01), duodenal ulcer 95%vs76% (OR 5.6,p< 0.0001), and peptic ulcer 95%vs76% (OR 6.6,p< 0.0001), for patients having their HP infection successfully curedversusthose remaining HP-positive, respectively (Fisher's exact test). For all evaluated time points (≤ 6, 7–8, and 10–12 wk after beginning treatment), HP-negative patients had higher healing rates than HP-positive patients (95%vs82%, 94%vs69%, and 96%vs78% with corresponding OR of 4.2, 6.5, and 7.4, allp< 0.0001, Fisher's exact test). The use of concomitant acid suppression therapy during initial HP eradication provided a benefit on peptic ulcer healing only for patients with persistent HP infection (improved healing rates of 78%vs67%; otherwise rates were 94–96%). Likewise, prolonged acid inhibition in HP treatment failures after the initial HP treatment phase resulted in 7–20% improved healing rates, whereas patients becoming HP-negative did not profit. Conclusion: Successful HP eradication therapy accelerates peptic ulcer healing even without concomitant acid suppression.