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Table of Contents
Vol. 52, No. 2, 2006
Issue release date: February 2006
Section title: Clinical Section
Gerontology 2006;52:99–106
(DOI:10.1159/000090955)

Effect of Helicobacter pylori Eradication on the Outcome of Reflux Esophagitis and Chronic Gastritis in the Elderly

A Randomized, Multicenter, Eight-Month Study

Pilotto A.a · Perri F.b · Leandro G.c · Franceschi M.a
aGeriatric Unit and bGastroenterology Unit, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, and cGastroenterology Unit, IRCCS, Castellana Grotte, Bari, Italy

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Article / Publication Details

First-Page Preview
Abstract of Clinical Section

Received: May 23, 2005
Accepted: September 09, 2005
Published online: February 28, 2006
Issue release date: February 2006

Number of Print Pages: 8
Number of Figures: 3
Number of Tables: 4

ISSN: 0304-324X (Print)
eISSN: 1423-0003 (Online)

For additional information: http://www.karger.com/GER

Abstract

Background: The effect of Helicobacter pylori eradication on the clinical outcome of esophagitis in elderly patients is controversial. Aim: To evaluate the effect of H. pylori eradication on clinical outcome of esophagitis and on chronic gastritis and its activity. Materials and Methods: Sixty-one symptomatic elderly patients with esophagitis and H. pylori infection were randomized into two groups. Group 1 (PPI-only, 30 patients) was treated with pantoprazole 40 mg daily for 2 months followed by pantoprazole 20 mg daily for a further 6 months; group 2 (PPI + eradication, 31 patients) was treated as group 1 plus a 1-week course of amoxicillin 1 g twice daily and clarithromycin 250 mg twice daily. Endoscopy with gastric biopsies, 13C-UBT and clinical visits were repeated after 2 and 8 months. Results: After 8 months, the intention-to-treat H. pylori eradication rates were 19.2% in group 1 vs. 80.7% in group 2 (p < 0.0001). No differences between group 1 and group 2 were observed in symptoms improvement (77 vs. 77%, p = n.s.) and healing rates of esophagitis (92.3 vs. 88.5%, p = n.s.). A significant decrease in the prevalence of moderate/severe chronic gastritis (from 52.2 to 4.7%, p = 0.002) and its activity (from 38 to 4.7%, p = 0.02) was observed in the antrum of patients of group 2, and not in patients of group 1. While a nonsignificant reduction in the chronic gastritis activity (from 28.6 to 4.7%, p = 0.09) was observed in the corpus of the eradicated patients of group 2, conversely a significant worsening of the chronic gastritis activity was found in the corpus of group 1 patients (from 25 to 60%, p = 0.05). Conclusion: The eradication of H. pylori infection does not affect the clinical outcome of esophagitis, while it improves chronic gastritis and its activity in elderly patients on short- and long-term treatment with PPIs. These findings suggest that H. pylori infection should be eradicated in elderly patients with esophagitis who need maintenance treatment with PPI.

© 2006 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Clinical Section

Received: May 23, 2005
Accepted: September 09, 2005
Published online: February 28, 2006
Issue release date: February 2006

Number of Print Pages: 8
Number of Figures: 3
Number of Tables: 4

ISSN: 0304-324X (Print)
eISSN: 1423-0003 (Online)

For additional information: http://www.karger.com/GER


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