New study shows that peptic ulcers caused by H. pylori should be taken seriously and treated promptly

DOWNERS GROVE, Ill., Aug. 6, 2018 /PRNewswire/ -- A new study looks at delays in treatment for infection with Helicobacter pylori bacteria, and how delaying treatment for various lengths of time can influence the probability of developing recurrent ulcers or other serious complications. "Time latencies of Helicobacter pylori eradication after peptic ulcer and risk of recurrent ulcer, ulcer adverse events, and gastric cancer: a population-based cohort study" is published in the August issue of GIE: Gastrointestinal Endoscopy, the official peer-reviewed journal of American Society for Gastrointestinal Endoscopy.

Helicobacter pylori, often called H. pylori, is a type of bacteria that can enter the body and live in the digestive tract. Over time, it can cause ulcers in the stomach lining or small intestine that can lead to a range of diseases from peptic ulcer disease to cancer. Most peptic (digestive tract) ulcers are thought to be caused by H. pylori infection.

Patients with symptoms that suggest an ulcer may have an upper endoscopy, which allows a physician to examine the lining of the digestive tract. Once a patient is diagnosed with peptic ulcer disease due to H. pylori, the treatment often involves eradication therapy, which uses antibiotics and other medications to get rid of the bacteria. This helps to prevent formation of new sores or ulcers, and also promotes healing of existing ulcers, although some may need to be treated surgically.

It is understood that any delay in treatment can have undesired consequences. The researchers aimed to determine how the length of the delay in treatment correlated with increased probability for varying degrees of illness.

The study looked at more than 29,000 patients receiving H. pylori eradication therapy following a peptic ulcer disease diagnosis from 2005 to 2013.  The intervals of time that had passed from diagnosis to treatment were grouped as follows: within seven days; within eight to 30 days; 31 to 60 days; 61 to 365 days; and more than 365 days.

The group of patients who were treated with eradication therapy within a week of diagnosis fared significantly better than those with even a brief delay. The probability of developing a recurrent ulcer doubled in the 31- to 60- day group compared with the seven-day group, and it was three and a half times as great for recurrent ulcer in the group waiting more than a year.

The probability of developing a complicated ulcer was tripled in the group treated within 31 to 60 days, and more than six times as high for the group waiting more than a year compared with the group treated in seven days.

For gastric (stomach) cancer, the probability more than tripled in the 61- to 365-day group, and more than quadrupled for those waiting more than a year, compared with the group treated within seven days.

The authors concluded that delays in H. pylori eradication therapy after peptic ulcer diagnosis increase the probability of developing recurrent and complicated ulcers, as well as stomach cancer, starting from delays of 8 to 30 days. They also concluded that the risk is dependent on the length of the delay.

SOURCE American Society for Gastrointestinal Endoscopy

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