Recurrent Peptic Ulcers in Patients Following Successful Helicobacter pylori Eradication: A Multicenter Study of 4940 Patients

Hiroto Miwa, Nobuhiro Sakaki, Kentaro Sugano, Hitoshi Sekine, Kazuhide Higuchi, Naomi Uemura, Mototsugu Kato, Kazunari Murakami, Chieko Kato, Akiko Shiotani, Toshifumi Ohkusa, Atsushi Takagi, Nobuo Aoyama, Ken Haruma, Kazuichi Okazaki, Kazuo Kusugami, Masayuki Suzuki, Takashi Joh, Takeshi Azuma, Akinori YanakaHidekazu Suzuki, Hiroshi Hashimoto, Takashi Kawai, Toshiro Sugiyama

Research output: Contribution to journalArticlepeer-review

80 Citations (Scopus)


Objective. Although curative treatment of Helicobacter pylori infection markedly reduces the relapse of peptic ulcers, the details of the ulcers that do recur is not well characterized. The aim of this study is to describe the recurrence rate and specific features of peptic ulcers after cure of H. pylori infection. Methods. This was a multicenter study involving 4940 peptic ulcer patients who were H. pylori negative after successful eradication treatment and were followed for up to 48 months. The annual incidence of ulcer relapse in H. pylori-cured patients, background of patients with relapsed ulcers, time to relapse, ulcer size, and site of relapsed ulcers were investigated. Results. Crude peptic ulcer recurrence rate was 3.02% (149/4940). The annual recurrence rates of gastric, duodenal and gastroduodenal ulcer were 2.3%, 1.6%, and 1.6%, respectively. Exclusion of patients who took NSAIDs led annual recurrence rates to 1.9%, 1.5% and 1.3%, respectively. The recurrence rate was significantly higher in gastric ulcer. Recurrence rates of patients who smoked, consumed alcohol, and used NSAIDs were significantly higher in those with gastric ulcer recurrence compared to duodenal ulcer recurrence (e.g. 125 of 149 [83.9%] relapsed ulcers recurred at the same or adjacent sites as the previous ulcers). Conclusions. Curative treatment of H. pylori infection is useful in preventing ulcer recurrence. Gastric ulcer is more likely to relapse than duodenal ulcer. Recurrent ulcer tended to recur at the site of the original ulcers.

Original languageEnglish
Pages (from-to)9-16
Number of pages8
Issue number1
Publication statusPublished - 2004
Externally publishedYes

ASJC Scopus subject areas

  • Gastroenterology
  • Infectious Diseases


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