Aim of this study was to evaluate the monitorization of Helicobacter pylori (Hp) by HpSA (Helicobacter pylori stool antigen test) in upper GI bleeding after eradication therapy and to find the optimum time for testing HpSA.

Totally 42 patients (mean age 45.4±15.2 years; 22 male, 20 female) hospitalized with upper GI bleeding due to peptic ulcer were included to the study. All patients underwent endoscopic evaluation after admission. The presence of Hp was determined with rapid urease test and histologic analyses of biopsies from the corpus and antrum. A stool specimen was collected from all patients and stored at –20ºC. Hp positive patients were treated for 7 days with proton pump inhibitors bid + claritromicine 500 mg bid+ amoxicillin 1 gr bid or ranitidine bismuth citrate 500 mg bid+ claritromicine 500 mg bid+ amoxicillin 1 gr bid according to the Maastricht Consensus Report. Stool specimens were collected for HpSA; 3, 7, 14, 28 days after the treatment. Histological evaluation was considered as gold standard in diagnostic methods.

Twenty-eight patients (66.7%) had duodenal ulcer and 14 (33.3%) had gastric ulcer in the initial endoscopic examinations. Hp was positive in 30 patients (71.4%) by histology. Of the 25 patients included in the eradication therapy, 18 patients (72 %) had successful eradication. A fast decline of HpSA values in all of the patients was seen in the 3th day.

The ratio of HpSA values below the cut-off level in successfully eradicated patients, at day three, seven, and 14 was as follows respectively: 61.1%, 94.5%, 100%. On the other hand, the HpSA ratio values in non-eradicated patients was above the cut-off level and the values at day three, seven, and 14 were as follows respectively: 71.4%, 85.7%, 85.7%.

HpSA can be used as a useful test for Hp eradication as early as two weeks after the treatment in upper GI bleeding