Helicobacter pylori-negative idiopathic ulcers are increasingly recognized.
The secular trends and long-term outcomes of this condition are unknown.
|Recurrence at 12 months was 13% with H pylori-negative idiopathic ulcers vs 3% with H pyloriulcers|
Dr Francis Chan and colleagues prospectively studied consecutive patients with bleeding gastroduodenal ulcers in 2000.
The research team compared the incidence and etiology of ulcers during this period with that between 1997 and 1998.
The research team defined the H pylori-negative ulcers as negative tests for H pylori, no exposure to analgesics within 4 weeks, and absence of other risk factors for ulcers.
After the ulcers had healed, patients who received eradication therapy were followed up by the researchers for 12 months without anti-ulcer drugs.
The researchers found that 638 patients had bleeding ulcers, of which 213 had H pylori ulcers and 120 had H pylori-negative idiopathic ulcers.
The team reported that from 1997 to 1998, 480 patients had H pylori ulcers and 40 had H pylori-negative idiopathic ulcers.
The team observed that H pylori-negative idiopathic ulcers accounted for 16% admitted for bleeding and 42% of patients who bled while in the hospital.
The research team noted that 28% of patients with H pylori-negative idiopathic ulcers had histologic evidence of past H pylori infection.
The researchers observed that probability of recurrent ulcer complications at 12 months was 13% with H pylori-negative idiopathic ulcers.
In addition, the team showed that recurrent ulcer complications at 12 months was 3% with H pylori ulcers who received eradication therapy.
Dr Chan's team concludes, “The incidence of H pylori-negative idiopathic bleeding ulcers is rising.”
“These ulcers are prone to recurrent complications.”