Beat the ulcer bug--for good!

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Antibiotics plus standard drugs wipe out disease

If you really want to banish a duodenal ulcer, first you've got to squash the bug. Antibiotics, plus standard therapy, are doing just that.

Standard drugs alone heal ulcers by reducing stomach acid, though in some cases that doesn't keep the ulcer from coming back. That's because the pesky cause of duodenal ulcers--the Helicobacter pylori bacterium--is immune to that type of treatment.

And that's why researchers look toantibiotics to nail this bug, which is also the underlying pest in chronic active gastritis. In a recent study of 105 patients, ulcers healed much faster in patients who received the standard therapy of ranitidine plus a two-week run of two antibiotics and the common home remedy bismuth.

After 16 weeks, 98 percent of the combined-treatment group had healed ulcers, compared with 84 percent in a ranitidine-only group (Annals of Internal Medicine, August 15, 1991).

"This therapy may help people with recurring or serious duodenal-ulcer disease--who end up facing surgery because conventional treatments just aren't working," says Howard Mertz, M.D., clinical instructor of medicine at the UCLA School of Medicine Division of Gastroenterology. "It's too early to say, though we expect that once you eradicate the bacteria, it's a long-lasting cure."

Because the study researchers also used bismuth (the main ingredient in over-the-counter stomach soothers) on top of antibiotics, the real effectiveness of the antibiotics is still a bit cloudy. And there is some worry that patients may develop bacteria that are resistant to antibiotics. "Future studies will help answer these questions," says Dr. Mertz.

Antimicrobial treatment isn't for everyone--or for every ulcer, either. "It's only been shown to work successfully on duodenal ulcers, though right now it's being tested against gastric-ulcer disease," says Dr. Mertz.

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By Greg Gutfeld

With Linda Rao and Maureen Sangiorgio

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