ABSTRACT
Although dyspepsia frequently occurs in general population, its causes are poorly understood. This study is aimed at determining the role of Helicobacter pylori in non-ulcer dyspepsia (NUD) and evaluating the efficacy of dual therapies for H.pylori. Two groups totaling of 39 patients with endoscopically-proven NUD participated in the study. One group, comprising of 23 patients, received 300 mg of ranitidine daily for 4 weeks together with 500 mg of amoxicillin four time a day for two weeks. The second group, comprising of 16 patients, received GacidaTM 1 tablet for 4 weeks together with 500 mg of amoxicillin four time a day for 2 weeks respectively. H.pylori status was determined by histology and CLO testTM before and in the fourth and eighth week after treatment. Thirty-six patients completed the study, 21 in the ranitidine treatment group and 15 in the GacidaTM group H.pylori was successfully eradication in 47.3 percent (9/21) of ranitidine treatment group. Symptom relief at the second and sixth weeks was significantly higher under ranitidine regimen at 90.47 percent (19/21) and 100 percent (21/21) respectively, compared with the gacida regimen at 46.66 percent (7/15) and 53.33 percent (8/15) respectively. The number of patients who were symptom-free at the sixth week of treatment was significantly higher in the ranitidine group at 71.4 percent (15/21), compared with the gacida group at 20 percent (3/15). We concluded that the ranitidine regimen can relief the symptoms of NUD patients with H.pylori infection. However, the role of H.pylori needs further studies.
ABSTRACT
Eighty Thai patients aged 15 to 60 with endoscopic diagnosis of a single duodenal ulcer 5-20 mm. in diameter were randomized into two treatment groups. Group-A patients received hospital - made liquid aluminium – magnesium hydroxide antacid q.i.d. (30 ml. one hour after each meal and at bedtime acid neutralizing capacity 240 mEq/day). Group-B patients received a liquid placebo of similar appearance taken in the same manner. All patients were allowed additional antacid tablets as necessary for relief of ulcer symptoms. Repeat endoscopy was made after 4 weeks of treatment. Ten patients in group A and group B defaulted. The ulcer healing rates in those completing the study were 73.3 and 52.0 percent in group A and group B respectively. The study illustrates that low-dose liquid antacid taken four times daily for four weeks can be associated with duodenal ulcer healing in over two-thirds of cases, although the statistical significance over that of the placebo was not clearly demonstrated in this study with small numbers of cases. It also shows that the four-week placebo healing rate in Thai patients with duodenal ulcer can be as much as fifty percent or greater. Overall, however, patients’ compliance with a liquid medication is below expectation.