Effect of Short-term Treatment with Regular or High Doses of Omeprazole on the Detection of Helicobacter pylori in Bleeding Peptic Ulcer Patients

Abstract

Background: It is unknown whether short-term regular or high-dose omeprazole has any influence on the colonization of Helicobacter pylori in the stomach. We therefore studied the effect of 3-day treatment of 2 different doses of omeprazole. Methods: H. pylori -positive patients with peptic ulcer bleeding ( n &#114 = &#114 101) were randomized to receive either a regular dose (20 &#114 mg/day for 3 days) ( n &#114 = &#114 51) or a high dose of omeprazole (80 &#114 mg bolus &#114 + &#114 8 &#114 mg/h infusion/day for 3 days) ( n &#114 = &#114 50). H. pylori status was assessed by histology and urease testing of gastric biopsies pre-entry and after 3-day therapy. Results: With the high dose of omeprazole, tests for the diagnosis of H. pylori became negative significantly more often than with the regular dose (60% versus 27.5%, P &#114 = &#114 0.001 (any test), 67.6% versus 31.7%, P &#114 = &#114 0.003 (histology) and 82.2% versus 43.6%, P &#114 = &#114 0.001 (urease test)). Conclusion: Conversion of the H. pylori tests negative after 3-day treatment of omeprazole is dose-dependent. The diagnosis of H. pylori infection depends on the timing of biopsies in relation to the beginning of proton-pump inhibitor treatment. If samples to find H. pylori are not taken before the treatment, the presence of the bacteria may be overlooked.

• Bleeding
• High-dose Omeprazole
• Histology
• H. Pylori Infection
• Peptic Ulcer
• Regular-dose Omeprazole
• Urease Test