Korean J Gastroenterol.  2010 Oct;56(4):229-235. 10.4166/kjg.2010.56.4.229.

Antibiotics-associated Diarrhea and Other Gastrointestinal Abnormal Responses Regarding Helicobacter pylori Eradication

• Kwon SB
• Lee KL
• Kim JS
• Lee JK
• Kim W
• Jung YJ
• Jeong JB
• Kim JW
• Kim BG

• KMID: 1718358
• DOI: http://doi.org/10.4166/kjg.2010.56.4.229

Abstract

BACKGROUND/AIMS
Helicobacter pylori (H. pylori) is closely related with a wide range of gastrointestinal disease. One-week triple therapy is currently considered as the golden standard for the treatment of H. pylori infection. However, gastrointestinal abnormal responses are major pitfalls in such regimen. The aim of this study was to identify symptoms, frequency and severity of antibiotics-associated gastrointestinal abnormal responses during H. pylori eradication therapy.
METHODS
Sixty-seven patients with H. pylori infection between September 2005 and March 2006 were included. After 1 week of H. pylori eradication triple therapy (rabeprazol 10 mg, clarithromycin 500 mg, amoxicillin 1 g bid), we evaluated gastrointestinal abnormal responses (diarrhea, bloating, constipation, abdominal pain, borborygmus, flatulence, stool frequency, belching, and nausea) and severities every week for 4 weeks.
RESULTS
The incidence of diarrhea was the highest in week 1, which was 41.28% (n=28) and the lowest in week 4, which was 9.52% (n=6) and decreased from week 1 to week 4 with statistical significance (p<0.0001). The most common gastrointestinal abnormal responses were associated with flatulence in week 1 (n=21, 31.34%), week 2 (n=21, 33.33%) and abdominal distention in week 3 (n=16, 25.40%), week 4 (n=15, 23.81%). Most of gastrointestinal abnormal responses were mild, and the most common symptom with higher than moderate grade was abdominal pain (n=4, 40.00%) in week 1. Alcohol consumption and coexisting medical illness were not associated with diarrhea (p=0.0852, 0.9009 respectively).
CONCLUSIONS
H. pylori eradication therapy is commonly associated with antibiotics-associated gastrointestinal abnormal responses, which may result in antibiotics intolerance and H. pylori eradication failure. Even though those symptoms are not so severe, we have to consider the gastrointestinal abnormal responses associated with H. pylori eradication, especially diarrhea.

Keyword

H. pylori eradication therapy; Antibiotics; Adverse effects

MeSH Terms

Abdominal Pain/chemically induced
Adult
Alcohol Drinking
Anti-Bacterial Agents/*adverse effects/therapeutic use
Diarrhea/*chemically induced
Female
Flatulence/chemically induced/etiology
Gastrointestinal Diseases/*chemically induced
Helicobacter Infections/*drug therapy
*Helicobacter pylori
Humans
Male
Middle Aged
Young Adult

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