Effect of Colloidal Bismuth Subcitrate on Chinese Patients with Duodenal Ulcer: Role of Campylobacter Pylori

Abstract

Common presence of Campylobacter Pylori in patients with duodenal ulcer usually manifests itself as the etiology of the disease and treatment of duodenal ulcer with colloidal bismuth subcitrate (CBS) may result in ulcer healing and eradication of C. pylori. This study attempted to evaluate the relations among ulcer healing, C. pylori eradication in patients with active duodenal ulcer receiving (CBS) treatment and the remissions of healed ulcer and C. pylori in a short- term follow-up . A total of 59 patients with active duodenal uicer on endoscopy entered this study, they received (CBS)(120mg×4/day) treatment for one month. Ulcer healing was endoscopically evaluated, and unhealed subjects received another one-month (CBS) treatment. Healed patients were follewed endoscopically at 1, 3 and 6 months, after cessation of medication without maintaining therapy. Unhealed or relapsed subjects were excluded. Antral mucosa were obtained to assess C. pylori status using both culture and urease tests by an independent observer. The prevalence of C. pylori in patients with duodenal ulcer was 74.6%. Ulcer healing rate of 79.7% and C .pylori eradicative rate of 79.6% were achieved by CBS treatment. Initial C. pylori status influenced neither with ulcer healing nor with duration of CBS Treatment. However, once C. pylori infection occurred, eradication was essential to ulcer healing when try to heal active DU with CBS. During follow-up, ulcer healing was found in two-thirds of the patients at the 6th month. Neither initial and final C. pylori status nor (CBS) treated course was found to be associated with afterward ulcer relapses. In most cases, the originally eradicated C. pylori reappeared at the 6th month on follow-up (68.1%), whereas, the duration of CBS treatment was not found to be related to the reappearance of C. pylori. These data suggest That C. pylori may be an etiologic factor of duodenal ulcer, however, CBS treatment for duodenal ulcer involves many mechanisms, and C. pylori is not the solely decisive factor for CBS to heal ulcer.