A Long-Term Follow-up after Treatment with Colloidal Bismuth Subcitrate and Tinidazole

Abstract

Ashorn M, Ruuska T, Karikoski R, Miettinen A, Maki M. Helicobacter pylori gastritis in dyspeptic children. A long-term follow-up after treatment with colloidal bismuth subcitrate and tinidazole. Scand J Gastroenterol 1994;29:203-208.

The connection between dyspeptic symptoms and Helicobacter pylori infection was studied prospectively in 21 children treated for verified H. pylori infection with bismuth subcitrate and tinidazole. Gastroscopy with biopsy was performed before and a mean of 4 months after discontinuation of the treatment. A second post-treatment check with determination of H. pylori antibodies and serum pepsinogen 1 level was made a mean of 1.5 years after cessation of treatment. The therapy given cleared the bacteria in 67% of the patients. No significant difference in symptoms was observed between treatment successes and failures. The histopathologic diagnosis of H. pylori infection was accompanied by positive IgG serology in 15 (75%) of the 20 patients tested, and a decrease in antibody levels was observed in children with successful eradication. Serum pepsinogen 1 seemed to be even a better marker in the follow-up. The healing of acute and also to some extent of chronic gastritis took place closely after successful eradication. Our results suggest that healing of H. py/ori-induced gastritis should be confirmed at re-endoscopy only, independent of the symptoms.

Key Words:

• Dyspepsia
• gastritis
• Helicobacter pylori
• IgG antibody
• serum pepsinogen 1