Treatment of Helicobacter pylori-Positive Lesions: 13C-Urea Breath Test Monitoring and Morphology

  • F. E. Bauer
  • G. Lepsien
  • I. Meineke
  • J. V. Geletneky
  • A. Schauer
  • F. E. Lüdtke
Conference paper


Helicobacter pylori (HP) is now generally accepted as a major pathogenetic factor in antral gastritis and ulcer disease [1–5]. The evidence which links HP infection to peptic ulceration is strongest in duodenal ulcer (DU) and less powerful in gastric ulcer (GU). As far as DU is concerned, however, eradication of infection markedly alters the natural history of the disease [6, 7]. Therefore, very recently the Sidney Working Party on Gastroenterology recommended HP eradication in patients suffering from DU [4].


Duodenal Ulcer Triple Therapy Eradication Rate Antral Gastritis Colloidal Bismuth Subcitrate 
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  1. 1.
    Marshall BJ, Warren JR, Blincow ED, Phillips M, Goodwin CS, Murray R, Blackbourn SJ, Waters TE, Sanderson CR (1988) Prospective double-blind trial of duodenal ulcer relapse after eradication of Campylobacter pylori. Lancet II: 1437–1441CrossRefGoogle Scholar
  2. 2.
    Goodwin CS (1988) Duodenal ulcer, Campylobacter pylori, and the “leaking roof” concept. Lancet II: 1467–1469CrossRefGoogle Scholar
  3. 3.
    Graham DY (1989) Campylobacter pylori and peptic ulcer disease. Gastroenterology 96:615–625PubMedGoogle Scholar
  4. 4.
    Tytgat GNJ, Axon ATR, Dixon MF, Graham DY, Lee A, Marshall BJ (1990) Helicobacter pylori: causal agent in peptic ulcer disease? In : Falk H (ed) Helicobacter pylori. Literature Review no 9, 3rd quarter. Falk, Freiburg, pp 360–369Google Scholar
  5. 5.
    Drumm B (1990) Helicobacter pylori. Arch Dis Child 65:1278–1282PubMedCrossRefGoogle Scholar
  6. 6.
    Rauws EAJ, Tytgat GNJ (1990) Cure of duodenal ulcer associated with eradication of Helicobacter pylori. Lancet 1:1233–1235CrossRefGoogle Scholar
  7. 7.
    George LL, Borody TJ, Andrews P, Devine M, Moore-Jones D, Walton M, Brandi S (1990) Cure of duodenal ulcer after eradication of Helicobacter pylori. Med J Aust 153:145–149PubMedGoogle Scholar
  8. 8.
    Graham DY, Klein PD, Evans DJ, Evans DG, Alpert LC, Opekun AR, Boutton TW (1987) Campylobacter pylori detected noninvasively by the 13C-urea breath test. Lancet 1:1174–1178PubMedCrossRefGoogle Scholar
  9. 9.
    Eggers RH, Kulp A, Tegeler R, Lüdtke FE, Lepsien G, Meyer B, Bauer FE (1990) A methodological analysis of the 13C-urea breath test for detection of Helicobacter pylori infections: high sensitivity and specificity within 30 min using 75 mg of 13C-urea. Eur J Gastroenterol Hepatol 2:437–444Google Scholar
  10. 10.
    Colin-Jones DG (1988) Management of dyspepsia: report of a working party. Lancet 1:576–579Google Scholar
  11. 11.
    Rauws EAJ, Langenberg W, Houthoff HJ, Zanen HC, Tytgat GNJ (1988) Campylobacter pyloridis-associated chronic active antral gastritis. Gastroenterology 94:33–40PubMedGoogle Scholar
  12. 12.
    Cooreman M, Hengels KJ, Krausgrill P, Strohmeyer G (1990) 13 C-Harnstoff-Atemtest als nicht invasive Methode zum Nachweis von Helicobacter (Campylobacter) pylori. Dtsch Med Wochenschr 115:367–371PubMedCrossRefGoogle Scholar
  13. 13.
    Dill S, Payne-James JJ, Misiewicz JJ, Grimble GK, McSwiggan D, Pathak K, Wood AJ, Scrimgeour CM, Rennie MJ (1990) Evaluation of 13C-urea breath test in the detection of Helicobacter pylori and in monitoring the effect of tripotassium dicitratobismuthate in non-ulcer dyspepsia. Gut 31:1237–1241PubMedCrossRefGoogle Scholar
  14. 14.
    Mannes GA, Bayerdörffer E, Höchter W, Weingart J, Heldwein W. Müller-Lissner S, Oertel H, Blendinger Ch, Kuntzen O, Bornschein W, Malfertheiner P, Wilkening J, Ruckdeschel G, Pfaller P, van Wulffen H, Köpcke W, Stolte M (1990) Relapse rate of H. pylori (HP) positive duodenal ulcers (DU) following antibacterial therapy. In: Abstracts of the world congress of gastroenterology, Sydney, Australia. Medicine Group, Abingdon, P 955Google Scholar
  15. 15.
    Goodwin CS, Marshall BJ, Warren JR, Blackbourn S, Blincow ED (1987) Clearance of Campylobacter pyloridis and reduced duodenal ulcer relapse with bismuth and tinidazole compared to cimetidine. In: Kaijser B, Falsen E (eds) Campylobacter, vol 4. University of Göteborg, Göteborg, pp 368–369Google Scholar
  16. 16.
    Lambert JR, Borromeo M, Korman MG, Hansky J, Eaves ER (1987) Effect of colloidal bismuth (De-Nol) on healing and relapse of duodenal ulcers-role of Campylobacter pyloridis. In: Kaijser B, Falsen E (eds) Campylobacter, vol 4. University of Göteborg, Göteborg, p 383Google Scholar
  17. 17.
    Börsch G, Mai U, Müller KM (1988) Monotherapy or polychemotherapy in the treatment of Campylobacter pylori-related gastroduodenal disease. Scand J Gastroenterol 23 [Suppl 142]: 101–106CrossRefGoogle Scholar
  18. 18.
    Bayerdörffer E, Ottenjann R (1988) The role of antibiotics in Campylobacter pylori associated peptic ulcer disease. Scand J Gastroenterol 23 [Suppl 142]: 93–100CrossRefGoogle Scholar
  19. 19.
    Glupczynski Y, Burette A, Labbe M, Deprez C, De Reuck M, Deltenre M (1988) Campylobacter pylori-associated gastritis: a double-blind placebo-controlled trial with amoxycillin. Am J Gastroenterol 83:365–372PubMedGoogle Scholar
  20. 20.
    Glupczynski Y, Burette A, Nyst JF (1988) Campylobacter pylori-associated gastritis: attempts to eradicate the bacteria by various antibiotics and anti-ulcer regimens. Acta Gastroenterol Belg 5:329–337Google Scholar
  21. 21.
    Lamouliatte H, de Mascarel A, Megraud FM, Barberis C, Bernard PH, Cayla R, Quinton A (1990) Omeprazole improves amoxycillin therapy directed towards Helicobacter pylori associated chronic gastritis. Gastroenterology 98 : A75Google Scholar
  22. 22.
    Börsch G (1991) Treatment regimens to eradicate Helicobacter pylori. In: Menge H, Gregor M, Tytgat GNJ, Marshall BJ, McNulty CAM (eds) Helicobacter pylori 1990. Springer, Berlin Heidelberg New York, pp 209–215CrossRefGoogle Scholar
  23. 23.
    Hirschl AM, Hentschel E, Schütze K, Nemec H, Pötzi R, Gangl A, Weiss W, Pletschette M, Stanek G, Rotter ML (1988) The efficacy of antimicrobial treatment in Campylobacter pylori associated gastritis and duodenal ulcer. Scand J Gastroenterol 23 [Suppl 142]: 76–81CrossRefGoogle Scholar
  24. 24.
    O’Morain C (1990) How to eradicate Helicobacter pylori and prevent reinfection. In: Malfertheiner P, Ditschuneit H (eds) Helicobacter pylori, gastritis and peptic ulcer. Springer, Berlin Heidelberg New York, pp 388–394Google Scholar
  25. 25.
    O’Riordan T, Mathai E, Tobin E, McKenna D, Keane C, Swenney E, O’Morain C (1990) Adjuvant antibiotic therapy in duodenal ulcers treated with colloidal bismuth subcitrate. Gut 31:999–1002PubMedCrossRefGoogle Scholar
  26. 26.
    Graham DY, Lew GM, Opekun AR, Klein PD, Evans DG, Evans DJ Jr, Alpert LC, Michaletz PA (1990) Controlled evaluation of the effectiveness of triple therapy in eradication of Helicobacter pylori infection. Gastroenterology 98 : A 452Google Scholar
  27. 27.
    Lambert JR, Lin SK, Borromeo M, Nicholson L, Korman MG, Hansky J, Monash (1990) Eradication of Helicobacter pylori with colloidal bismuth subcitrate/antibiotic combinations. Gastroenterology 98 : A74Google Scholar
  28. 28.
    McNulty CAM, Eyre-Brook I A, Uff JS, Dent JC, Wilkinson SP (1989) Triple therapy is not always 95% effective. 5th international workshop on Campylobacter infections, Puerto Vallarata, MexicoGoogle Scholar
  29. 29.
    Borody TJ, Cole P, Noonan S, Morgan A, Lenne J, Hyland L, Brandi S, Borody EG, George LL (1989) Recurrence of duodenal ulcer and Campylobacter pylori infection after eradication. Med J Aust 151:431–435PubMedGoogle Scholar
  30. 30.
    Tytgat GNJ, Rauws EAJ, De Koster E (1988) Campylobacter pylori. Scand J Gastroenterol Suppl 155:68–79PubMedCrossRefGoogle Scholar
  31. 31.
    Eberhardt R, Kasper G (1990) Effect of oral bismuth subsalicylate on Campylobacter pylori and on healing and relapse rate of peptic ulcer. Rev Infect Dis 12:115–119CrossRefGoogle Scholar
  32. 32.
    Goodwin CS, Armstrong JA, Wilson DH (1988) Differences between in vitro and in vivo sensibility of Campylobacter pylori to antibacterials. In: Menge H, Gregor M, Tytgat GNJ, Marshall BJ (eds) Campylobacter pylori. Springer, Berlin Heidelberg New York, pp 29–36CrossRefGoogle Scholar
  33. 33.
    Hollingsworth JA, Goldie J, Silette LY, Richardson H, Hunt RH (1987) Gastric secretion of antibiotics used for Campylobacter pyloridis. Gut 28: A 1409Google Scholar
  34. 34.
    Glupczynski Y, Burette A, De Koster E, Nyst JF, Deltenre M, Cadranel S, Bourdeaux L, De Vos D (1990) Metronidazole resistance in Helicobacter pylori. Lancet 1:976–977CrossRefGoogle Scholar
  35. 35.
    Stolte M, Eidt S, Ohnsmann A (1990) Differences in Helicobacter pylori associated gastritis in the antrum and body of the stomach. Z Gastroenterol 28:229–233PubMedGoogle Scholar
  36. 36.
    Stolte M, Eidt S, Ritter M, Bethke B (1989) Campylobacter pylori und Gastritis. Pathologe 10:21–26PubMedGoogle Scholar
  37. 37.
    Gad A, Hradsky M, Furugard K, Malmodin B (1989) Campylobacter pylori and gastroduo-denal ulcer disease. Scand J Gastroenterol 24 [Suppl 167]: 81–85CrossRefGoogle Scholar
  38. 38.
    Rokkas T, Pursey C, Uzoechina E, Dorrington L, Simmons NA, Filipe MI, Sladen GE (1988) Non-ulcer dyspepsia and short term De-Nol therapy: a placebo controlled trial with particular reference to the role of Campylobacter pylori. Gut 29:1386–1391PubMedCrossRefGoogle Scholar
  39. 39.
    Drumm B, Sherman P, Chiasson D, Karmali M, Cutz E (1988) Treatment of Campylobacter pylori-associated antral gastritis in children with bismuth subsalicylate and ampicillin. J Pediatr 113:908–912PubMedCrossRefGoogle Scholar
  40. 40.
    Dooley CP, McKenna D, Humphreys H, Bourke S, Keane CT, Sweeney E, O’Morain C (1988) Histological gastritis in duodenal ulcer: relationship to Campylobacter pylori and effect of ulcer therapy. Am J Gastroenterol 83:278–282PubMedGoogle Scholar
  41. 41.
    Gad A, Hradsky M, Furugard K, Malmodin B, Ny berg O (1989) Campylobacter pylori and non-ulcer dyspepsia. Scand J Gastroenterol 24 [Suppl 167]: 44–48CrossRefGoogle Scholar
  42. 42.
    Hirschl AM, Hentschel E, Schütze K, Nemec H, Pötzi R, Gangl A, Weiss W, Pletschette M, Stanek G, Rotter ML (1988) The efficacy of antimicrobial treatment in Campylobacter pylori-associated gastritis and duodenal ulcer. Scand J Gastroenterol 23 [Suppl 142]: 76–81CrossRefGoogle Scholar
  43. 43.
    Cadranel S, Keppens E, Koslowski M, Verhas M, Glupczynski Y, De Prez C (1990) Detection of HP infection in children by means of a standardised 13C-urea-breath test. Rev Esp Enferm Dig 78 [Suppl 1]:A84Google Scholar
  44. 44.
    Bell GD, Weil J, Harrison G, Morden A, Johnes PH, Gant PW, Trowell JE, Yoong AK, Daneshmed TK, Logan RF (1987) 14C-Urea breath analysis as non-invasive test for Campylobacter pylori in the stomach. Lancet 1:1367–1368PubMedCrossRefGoogle Scholar
  45. 45.
    Rauws EAJ, Royen EAV, Langenberg W, Woensel JV, Vrij AA, Tytgat GN (1989) 14C-Urea breath test in Campylobacter pylori gastritis. Gut 30:798–803PubMedCrossRefGoogle Scholar
  46. 46.
    Marshall BJ, Surveyor I (1988) Carbon-14 urea breath test for the diagnosis of Campylobacter pylori associated gastritis. J Nucl Med 29:11–16PubMedGoogle Scholar
  47. 47.
    Henze E, Malfertheiner P, Clausen M, Glasbrenner B, Lietzenmayer R, Schoetensack C, Burkhardt H, Adam WE (1989) Der C-14 Urea Test-Ein neuer nuklearmedizinischer Test für die Campylobacter-pylori-Diagnostik. Nucl Med 28 : A34Google Scholar
  48. 48.
    Husebye E, O’Leary D, Skar V, Melby K (1990) How reliable are the 14C-urea breath test and specific serology for the detection of gastric Campylobacter? Scand J Gastroenterol 25:725–730PubMedCrossRefGoogle Scholar
  49. 49.
    Ormand JE, Talley NJ, Carpenter HA, Shorter RG, Conley CR, Wilson WR, DiMagno EP, Zinsmeister AR, Phillips SF (1990) 14C urea breath test for diagnosis of Helicobacter pylori. Dig Dis Sei 35:879–884CrossRefGoogle Scholar
  50. 50.
    Coelho LGV, Chausson Y, Passos MCF, Sadala RU, Costa EL, Sabino CVS, Queiroz DMM, Mendes EN, Rocha GA, Oliveira CA, Lima GF, Fernandes M LM, Castro LP (1990) Test respiratoire á l’urée marquée au carbone-14 pour le diagnostic de la colonisation gastrique par Helicobacter pylori. Gastroenterol Clin Biol 14:801–805PubMedGoogle Scholar
  51. 51.
    Bardhan K, Cole DS, Hawkins BW, Franks CR (1982) Does treatment with Cimetidine extended beyond initial healing of duodenal ulcer reduce the subsequent relapse rate? Br Med J 284:621–623CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1993

Authors and Affiliations

  • F. E. Bauer
    • 1
  • G. Lepsien
    • 2
  • I. Meineke
    • 1
  • J. V. Geletneky
    • 1
  • A. Schauer
    • 3
  • F. E. Lüdtke
    • 2
  1. 1.Department of Clinical PharmacologyGeorg August University of GöttingenGöttingenGermany
  2. 2.Department of SurgeryGeorg August University of GöttingenGöttingenGermany
  3. 3.Department of PathologyGeorg August University of GöttingenGöttingenGermany

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