Skip to main content
SpringerLink
Log in

The problem ulcer: bleeding, perforation, Helicobacter pylori-negativity and intractability

  • Chapter
Helicobacter pylori

Abstract

Since the discovery of Helicobacter pylori in 1982, this Gram-negative bacterium has been associated with a variety of clinical conditions. The bacterium was initially reported to be present in 80–100% of duodenal ulcer patients. In recent larger studies, with improved diagnostic techniques, the prevalence of H. pylori in uncomplicated duodenal ulcers is reported to be approximately 95%1. Duodenal ulcer disease is usually a chronic recurrent condition in untreated individuals. In excess of 50% of patients have dyspeptic symptoms for more than 2 years before presentation. In the pre-H. pylori era, of patients who were followed for 1 year after ulcer healing, 57% had one or two recurrences, 7% had more than three recurrences and 36% remained symptom-free2. Overall 50–80% of duodenal ulcer patients will have a recurrence during a 12-month follow-up after healing. Eradication of H. pylori alters the natural history of peptic ulcer disease and virtually abolishes ulcer relapse rates during 1 year follow-up3.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Kuipers EJ, Thijs JC, Festen HMP. The prevalence of Helicobacter pylori in peptic ulcer disease. Aliment Pharmacol Ther. 1995;9(Suppl. 2):59–69.

    PubMed  Google Scholar 

  2. Malmros H, Hiertonn T. A post-investigation of 687 medically treated cases of peptic ulcer. Acta Med Scand. 1949; 133:229.

    Article  PubMed  CAS  Google Scholar 

  3. Coghlan JD, Gilligan D, Humphries H et al. Campylobacter pylori and recurrence of duodenal ulcers. Lancet. 1987;2:1109–11.

    Article  PubMed  CAS  Google Scholar 

  4. Goh KL, Parasakthi N, Peh SC et al. Helicobacter pylori eradication with short-term therapy leads to duodenal ulcer healing without the need for continued acid suppressing therapy. Eur J Gastroenterol Hepatol. 1996;8:421–3.

    Article  PubMed  CAS  Google Scholar 

  5. Buckley M, O’Morain C. Helicobacter pylori eradication — a surrogate marker for duodenal ulcer healing. Eur J Gastroenterol Hepatol. 1996;8:415–16.

    PubMed  CAS  Google Scholar 

  6. Fry J. Peptic ulcer: a profile. Br Med J. 1964;2:809.

    Article  PubMed  CAS  Google Scholar 

  7. Kurath JH, Corboy ED. Current peptic ulcer time trends: an epidemiological profile. J Clin Gastroenterol. 1988;10:259–68.

    Article  Google Scholar 

  8. Makela J, Laitien S, Kairaluoma MI. Complications of peptic ulcer disease before and after the introduction of H2 receptor antagonist. Hepatogastroenterology. 1992;39:144–8.

    PubMed  CAS  Google Scholar 

  9. Hoskings W, Young MY, Chung SC, Li AKC. Differing prevalence of Helicobacter pylori in bleeding and non bleeding ulcers. Gastroenterology. 1992; 102: A85.

    Google Scholar 

  10. Hodgkin SW, Ling TKW, Young MY et al. Randomised control trial of short term treatment eradicating Helicobacter pylori in patients with duodenal ulcer. Br Med J. 1992;305:502.

    Article  Google Scholar 

  11. Jensen DM, You S, Pelayo E, Jensen ME. The prevalence of Helicobacter pylori and NSAID use in patients with severe UGI haemorrhage and their potential role in recurrence of ulcer bleeding. Gastroenterology. 1992; 102: A85.

    Google Scholar 

  12. Kaufman DW, Kelly JP, Sheehan JE et al. Nonsteroidal anti-inflammatory drug use in relation to major upper gastrointestinal bleeding. Clin Pharmacol Ther. 1983;53:485–94.

    Article  Google Scholar 

  13. Somerville K, Faulkner G, Langman M. Non-steroidal anti-inflammatory drugs and bleeding peptic ulcer. Lancet. 1986;1:462–4.

    Article  PubMed  CAS  Google Scholar 

  14. Hovoet J, Terriere L, van Hee W, Verbist L, Fierens E, Hauteteete ML. Relation of upper gastrointestinal bleeding to non-steroidal anti-inflammatory drugs and aspirin: a case control study. Gut. 1991;32:730–4.

    Article  Google Scholar 

  15. Lai KC, Hui WM, Lam SK. Bleeding ulcers have high false negative rates for antral Helicobacter pylori when tested with urease test. Gastroenterology. 1996; 110: A167.

    Article  Google Scholar 

  16. Jensen DM, Cheng S, Kovacs TOG et al. A control study of ranitidine for the prevention of recurrent haemorrhage from duodenal ulcer. N Engl J Med. 1994;303:382–6.

    Article  Google Scholar 

  17. Laine L, Peterson WL. Bleeding peptic ulcer. N Engl J Med. 1994;331:717–27.

    Article  PubMed  CAS  Google Scholar 

  18. Murray WR, Cooper G, Laferla G, Rogers P, Archibald M. Maintenance ranitidine treatment after haemorrhage from a duodenal ulcer: A 3 year study. Scand J Gastroenterol. 1988;23:183–7.

    Article  CAS  Google Scholar 

  19. Rokkas T, Karameris A, Mavrogeorgis A, Rallis E. Eradication of Helicobacter pylori reduces the possibility of rebleeding in peptic ulcer disease. Gastrointest Endosc. 1995;41:1–4.

    Article  PubMed  CAS  Google Scholar 

  20. Labenz J, Borsch G. The role of Helicobacter pylori by eradication and the prevention of peptic ulcer bleeding relapse. Indigestion. 1994;55:19–23.

    Article  CAS  Google Scholar 

  21. Graham DY, Hepps KS, Ramirez FC, Lew GM, Saeed ZA. Treatment of Helicobacter pylori reduces the rate of rebleeding in peptic ulcer disease. Scand J Gastroenterol. 1993;28:939–42.

    Article  PubMed  CAS  Google Scholar 

  22. Jaspersen D, Korner T, Schorr W, Brennensthul M, Raschka C, Hammar CH. Helicobacter pylori eradication reduces the rate of rebleeding of an ulcer haemorrhage. Gastrointest Endosc. 1995;41:5–7.

    Article  PubMed  CAS  Google Scholar 

  23. Jaspersen P, Korner T, Schorr W, Brennersthul M, Raschka C, Hammar CH. Omeprazole, amoxicillin therapy for eradication of Helicobacter pylori in duodenal ulcer bleeding: preliminary results of a pilot study. J Gastroenterol. 1995;30:319–21.

    Article  PubMed  CAS  Google Scholar 

  24. Debongnie JC, Legross G. Gastric perforation: an acute disease unrelated to H. pylori? Rev Esp Enferm Dig. 1990;78(Suppl. 1):71–2.

    Google Scholar 

  25. Turner FP. Acute perforations of the stomach, duodenum and jejunum. Surg Gynaecol Obstet. 1951;92:281.

    CAS  Google Scholar 

  26. Reinbach DH, Cruickshank G, McColl KEL. Acute perforated duodenal ulcer is not associated with Helicobacter pylori infection. Gut. 1993;34:1344–7.

    Article  PubMed  CAS  Google Scholar 

  27. Armstrong CP, Blower AL. Non-steroidal anti-inflammatory drugs in life threatening complications of peptic ulceration. Gut. 1987;28:527–32.

    Article  PubMed  CAS  Google Scholar 

  28. Horowitz J, Kukuora JS, Ritchie WP. All perforated ulcers are not alike. Ann Surg. 1989;209: 693–7.

    Article  PubMed  CAS  Google Scholar 

  29. Collier D, Sant J, Pain JA. Non-steroidal anti-inflammatory drugs in peptic ulcer perforation. Gut. 1985;26:359–62.

    Article  PubMed  CAS  Google Scholar 

  30. Oberhuber G, Puspok A, Oesterreicher C et al. Crohn’s disease of the stomach is histologically characterized by focal active gastritis. Gastroenterology. 1996;110:A982.

    Google Scholar 

  31. Borody TJ, George LL, Brandl S, Andrews P, Ostapowicz N, Hyland M, Devine M. Helicobacter pylori negative duodenal ulceration. Am J Gastroenterol. 1991;86:1154–7.

    PubMed  CAS  Google Scholar 

  32. Nensey YW, Schubert TT, Bolonga SD, Ma CK. Helicobacter pylori negative duodenal ulceration. Am J Med. 1991;91:15–18.

    Article  PubMed  CAS  Google Scholar 

  33. McColl KEL, El-Nujumi AM, Chittajallu RS et al. A study of the pathogenesis of Helicobacter pylori negative chronic duodenal ulceration. Gut. 1993;34:762–8.

    Article  PubMed  CAS  Google Scholar 

  34. Black JW, Duncan WAM, Durant CJ, Ganellin CR, Parsons ME. Definition and antagonism of histamine H2 receptors. Nature. 1972,236:385.

    Article  PubMed  CAS  Google Scholar 

  35. Tytgat GNJ. Treatments that impact favourably upon the eradication of Helicobacter pylori and ulcer recurrence (review). Aliment Pharmacol Ther. 1994;8:359–68.

    Article  PubMed  CAS  Google Scholar 

  36. Miehlke S, Bayerdorrfer E, Lehn N et al. Recurrence of duodenal ulcers during five years of follow-up after cure of Helicobacter pylori. Eur J Gastroenterol. 1995;7:975–8.

    Article  CAS  Google Scholar 

  37. Lanas AI, Remacha B, Esteva F, Sainz R. Risk factors associated with refractory peptic ulcers. Gastroenterology. 1995;109:1124–33.

    Article  PubMed  CAS  Google Scholar 

  38. Veldhuyzen van Zanten SOJ. H. pylori and NSAIDs: a meta-analysis on interactions of acute gastroduodenal injury, gastric and duodenal ulcers and upper gastrointestinal symptoms. In: Hunt RH, Tytgat GNJ, editors. Helicobacter pylori: basic mechanism to clinical cure. Dordrecht: Kluwer; 1994:449–57.

    Google Scholar 

Download references

Authors
  1. M. Buckley
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. O’Morain
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Division of Gastroenterology, McMaster University Medical Centre, 1200 Main Street West, Room 4W8, Hamilton, Ontario, L8N 3Z5, Canada

    Richard H. Hunt (Professor of Medicine, Director) (Professor of Medicine, Director)

  2. Department of Gastroenterology and Hepatology, Academic Medical Centre, 9 Meibergdreef, 1105 AZ, Amsterdam, The Netherlands

    Guido N. J. Tytgat (Professor) (Professor)

Rights and permissions

Reprints and permissions

Copyright information

© 1996 Kluwer Academic Publishers and Axcan Pharma

About this chapter

Cite this chapter

Buckley, M., Lee, J., O’Morain, C. (1996). The problem ulcer: bleeding, perforation, Helicobacter pylori-negativity and intractability. In: Hunt, R.H., Tytgat, G.N.J. (eds) Helicobacter pylori. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-1792-7_30

Download citation

  • DOI: https://doi.org/10.1007/978-94-009-1792-7_30

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-7299-1

  • Online ISBN: 978-94-009-1792-7

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation