The efficacy of triple therapy in the eradication of nelicobater-pylori in Sudanese patients with pepetic ulcer dise ase .


Research type: Research Paper

Authors: El Magrabi, Ahlam Babiker Ali .

Abstract: Since the discovery of helicobacter-pylori infection in 1983 by Marshall, it has been showen that it infect the gastric mucous layer of nearly almost all the patients with duodenal ulcer disease (greater than 90 percent in some centre 100 percent), as well as that most of the patient with gastric ulcer it is also contributing factor in some type of gastric carcinoma, recent studies have suggested that the eradication of H-pylori infection affected the natural history of duodenal ulcer disease, such as that the rate of relapse decrease compared with that after treatment with H2-blockers only, it decrease from about 50-70 percent or 4 percent or to zero in some studies, this after eradication by using triple therapy and follow for up to 7 years. In this study we detect the efficacy of triple therapy in eradication of H-pylori infection in Sudanese patients with duodenal ulcer disease, the study were carried out in Ibn Sina Hospital in a period from June 1996 - Feb. 1997, thirty three patients from gastroentrology unit were studied, it is a prospective, unblinded single center trial. Patients with endoscopicalloy proven duodenal ulcer are selected, antral biopsy were taken from all patients, evaluated for H-pylori infection by rapid urease test (CLO test), only positive patients were taken, symptoms and signs were documented and scored by standardized questionnaires in all patients. The study group were assigned for triple therapy treatment for one month, they were motivated to take the tablets in form of: Rantidine 300 mg per day for one month; Amoxocillin 500 mg three times per day for 12 days; Metronidazole 400 mg three times for 12 days; then the patients followed up, improvements in signs, symptoms and compliance were recorded after 2 weeks from the beginning of the the treatment, then another follow up one month after the completion of the treatment, another endoscopy was done, commentment about the ulcer state, the CLO test were repeated, 20 patients out of 33 patient were came for reendoscopy and follow up, that is to say 13 patients lost their follow up and they refused another endoscopy. Most of the study group have marked improvement regarding their. Clinical symptoms and signs, about 75 percent of followed patients had complete healing ulcer, 15 percent had partial healing ulcer, and 5 percent had no healing. The CLO test were negative in about 86 percent of patients those came for follow up, and it is positive in 14 percent. Most of the study group had good compliance, the side effects of triple therapy is present in the majorty of patients, usually it is not serious and dose not lead to cession of treatment, and it is self-limiting. From this study it is obvious that eradication of H-pylori infecton with triple therapy is essential in cures duodenal ulcer in most of patients and achived high healing rate.