Amount of Helicobacter pyloriin gastric mucus during anti‐H. pyloritreatment

Helicobacter pyloriis present in infected patients not only on the gastric epithelial cell surface but also in gastric mucus. We developed a competitive polymerase chain reaction (cPCR) method for quantitative measurement of H. pyloriin gastric mucus. The aim of this study was to determine the number of H. pyloriin gastric mucus before and after anti‐H. pyloritreatment. Patients with duodenal ulcer were treated with lansoprazole alone (n=11) or lansoprazole and amoxycillin (n=12). The amount of H, pyloriin gastric mucus was measured over time by a cPCR assay. Helicobacter pyloriinfection was also tested for using histology, culture, and the rapid urease test (RUT). Although most patients treated with lansoprazole alone had become H. pylori‐negative by the end of treatment when tested by histology, RUT, and culture, a large number of H. pyloriorganisms were found in the gastric mucus at that time by cPCR. These patients returned to being H. pyloripositive 1 to 12 months later on the basis of histology, RUT, and culture. However, cPCR results indicated eradication of H. pyloriby the end of treatment in eight of the 12 patients treated with lansoprazole and amoxicillin, and these patients remained H. pylorinegative on histology, RUT, culture, and cPCR 1 to 12 months later. Testing for H. pyloriin gastric mucus is thus useful for precise determination of the success or failure of H. pylorieradication therapy.