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Eradication of Helicobacter pylori (HP) has been widely performed, but subsequent upper gastrointestinal lesions associated with HP eradication have been reported. In this study, we investigated the frequency of upper intestinal lesions that developed after successful HP eradication and the course for five years after eradication. Subjects and methods: The subjects were 122 patients with HPpositive gastric ulcer or duodenal ulcer for whom successful eradication therapy with a proton pump inhibitor and antibiotics was performed. Patients did not receive medication after ulcer was healed, and the upper digestive tract was examined by endoscopy 3, 6, and 12 months after eradication and yearly for five years to investigate the development of lesions in the upper digestive tract. Results Duodenal erosion developed in the third month after eradication in 8.6% of the patients. Most of these patients had no subjective symptom and erosion resolved without treatment. Antral stomach erosion was observed in 12% in the third month after eradication. Antral stomach erosion was observed in 8.1% and 4.8% in the second and third year, but not in the fourth and fifth year. Most of these cases were not accompanied by symptoms. The frequency of gastroesophagial reflux disease was only 2.2% one year after eradication, but the frequency remained 2-4% even 2-5 years after eradication. Many cases were accompanied by symptoms. Despite successful eradication, stomach or duodenal ulcer recurred in 10 patients (8.2%) during the period from three months to five years after eradication. Two of 10 patients used NSAID, but the other 8 patients did not. Conclusion Long-term careful observation of ulcer patients is necessary to prevent recurrence of ulceration and development of duodenal erosion, antral gastritis, and gastroesophagial reflux disease, although HP eradication was successful. [ABSTRACT FROM AUTHOR]

: Several studies in Western countries showed that proton-pump inhibitors are superior to histamine2-receptor antagonists or placebo in the treatment of non-erosive gastro-oesophageal reflux disease. The efficacy of acid-suppressive drugs for non-erosive gastro-oesophageal reflux disease in Japan, in which the prevalence ofHelicobacter pyloriinfection is higher compared with Western countries, is unknown.: To compare the efficacy of famotidine and omeprazole in Japanese patients with non-erosive gastro-oesophageal reflux disease by a prospective randomized multicentre trial.: A total of 98 patients received either famotidine 20 mg b.d. (n = 48) or omeprazole once daily (n = 50). Frequency of gastro-oesophageal reflux disease symptoms and health-related quality of life were evaluated at baseline and after 4 weeks of treatment. Complete relief was defined as no gastro-oesophageal reflux disease symptoms during the 7-day interval in week 4.: Complete relief was achieved in 23 (48%) of patients receiving famotidine and 28 (56%) of patients treated with omeprazole. In the famotidine group, complete relief rate inH. pylori-negative patients was significantly lower thanH. pylori-positive patients (35% vs. 64%). Both famotidine and omeprazole improved most scales of health-related quality of life. Omeprazole significantly improved reflux score irrespective ofH. pyloriinfection while famotidine significantly improved reflux score inH. pylori-positive patients but not inH. pylori-negative patients.: Omeprazole is more effective than famotidine for the control of gastro-oesophageal reflux disease symptoms inH. pylori-negative patients, while similar efficacy is observed inH. pylori-positive patients with non-erosive gastro-oesophageal reflux disease. [ABSTRACT FROM AUTHOR]