Does smoking predispose to peptic ulcer relapse after eradication of Helicobacter pylori?

To investigate whether smoking would increase ulcer recurrence after eradication of Helicobacter pylori (H. pylori) without maintenance acid-suppression therapy.

A total of 287 patients, 256 patients with duodenal ulcers and 31 patients with gastric ulcers, were followed-up for up to 18 months after ulcer healing and successful eradication of H. pylori. There were 83 smokers (defined as smoking > or = 10 cigarettes/day) and 204 patients who never smoked or stopped smoking after the diagnosis of peptic ulcer disease. None were taking nonsteroidal anti-inflammatory drugs or receiving maintenance acid suppression therapy. Endoscopy was repeated either at the end of the follow-up period or when ulcer symptoms recurred.

Of the 83 smokers, 3 (3.6%) had ulcer recurrence, which included two duodenal ulcers and one gastric ulcer. Of the 204 nonsmokers, 4 (2.0%) had ulcer relapse, and all being recurrent duodenal ulcers. Four smokers (4.8%) and nine nonsmokers (4.4%) had recurrence of H. pylori infection after 10-18 months. There was no significant difference in ulcer relapse or recurrence of H. pylori infection between smokers and nonsmokers.

Cigarette smoking did not increase the recurrence of peptic ulcers after eradication of H. pylori.