[The course of Helicobacter pylori-associated duodenal ulcer concurrent with chronic opisthorchiasis]

The purpose of the investigation was to study the specific features and the course of Helicobacter pylori-associated duodenal ulcer (DU) concurrent with chronic opisthorchiasis (CO) A hundred and twenty-seven patients with H. pylori-associated DU were examined. Of them 78 patients were found to have H. pylori-associated DU concurrent with CO. In mixed pathology, asthenovegetative disorders were observed in most patients, one third had eosinophilia. With an over 10-year history of CO, acid production and pepsin secretion substantially decreased in both phases of gastric secretion. Mucosal atrophic changes were found mainly in the antral portion of the stomach, which frequency correlated with the duration of Opisthorchis invasion. The incidence of atrophic duodenitis tripled. All the patients received eradication therapy by the classical first-line treatment regimen including omeprazole and the antibiotics clarithromycin and amoxicillin. In the mixed pathology group, the time of ulcerative defect scarring increased by an average of 5 days. Fifty-eight with pathology continuously receiving the antisecretoty agent underwent dehelminthization with the anthelminthic bilthricide in 33 patients and with the plant anthelminthic dry aspen bark extract in 25. Evaluation of the efficiency of eradication therapy indicated that the best results of H. pylori eradication had been achieved in the patients dehelminthized with bilthricide. Assessment of long-term results showed that after multimodality therapy (eradication followed by bilthricide dehelminthization), there were no relapses for 2 years and there was a drop in the number of patients resorting to on-request therapy in patients with H. pylori-associated DU concurrent with CO.