Eradicating Helicobacter pylori in patients with a past history of peptic ulcer: is the juice worth the squeeze?

The efficacy of Helicobacter pylori eradication for H. pylori associated duodenal ulcer disease is beyond dispute. However, little attention has been paid to how feasible it is in primary care to undertake H. pylori eradication for patients with a past history of peptic ulcer disease. Patients identified by computer search of three general practices with a documented history of peptic ulcer disease were invited to attend for H. pylori testing and eradication therapy if H. pylori positive. A total of 101 patients were identified from a combined practice size of 24,780 of whom 34 were eligible for testing. Twenty-one per cent (seven patients) declined testing, 3% (one patient) refused therapy and another 21% (seven patients) were H. pylori negative. Helicobacter pylori eradication was highly successful (95%) and had an effect on prescription and reconsultation rates at 12 months. Eradicating H. pylori in patients with a past history of peptic ulcer disease not associated with non-steroidal anti-inflammatory drug ingestion is a challenging goal in general practice.