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

A C Tan1, G D Hartog, C J Mulder

  • 1Department of Hepatogastroenterology, Rijnstate Hospital, Arnhem, The Netherlands.

Alimentary Pharmacology & Therapeutics
|November 26, 1999
PubMed
Summary
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Many patients continue acid-suppressive therapy long after Helicobacter pylori eradication. This practice, particularly in functional dyspepsia, warrants re-evaluation due to costs and efficacy concerns.

Area of Science:

  • Gastroenterology
  • Pharmacology
  • Public Health

Background:

  • Many patients remain symptomatic post-Helicobacter pylori eradication.
  • Continued use of proton pump inhibitors (PPIs) or H2-receptor antagonists (H2-RAs) is common.
  • Long-term acid suppression raises questions about treatment efficacy and cost.

Purpose of the Study:

  • To determine if patients continue PPIs or H2-RAs over 4 years post-H. pylori eradication.
  • To assess medication use patterns after successful H. pylori treatment.
  • To evaluate the long-term impact of H. pylori eradication therapy on acid-suppressive drug use.

Main Methods:

  • A cohort of 167 patients treated for H. pylori infection between 1993-94 was studied.
  • Data from 151 patients were collected via questionnaires sent to patients, general practitioners, and pharmacists.

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  • Use of PPIs or H2-RAs at the time of the survey was recorded.

    • Main Results:

    • Over 51% of patients continued acid-suppressive medication more than 4 years after H. pylori eradication.
    • 44% used PPIs and 7% used H2-RAs.
    • Patients treated for functional dyspepsia were significantly more likely to continue acid suppression (55%) compared to those treated for peptic ulcer disease (P < 0.05).

    Conclusions:

    • Less than 50% of patients discontinue acid-suppressive therapy even after successful H. pylori eradication.
    • Routine H. pylori eradication in functional dyspepsia patients may not be cost-effective.
    • Peptic ulcer patients are more likely to cease acid-suppressive medication post-eradication.