Reduced relapse rate in duodenal ulcer disease leads to normalization of psychological distress: Twelve-year follow-up

Background: The aim of this study was to elucidate the relationship between duodenal ulcer (DU) disease and psychological symptoms. Methods: Sixty-four Helicobacter pylori-positive patients with frequently relapsing DUs (patient group 1) were compared with 78 control subjects without dyspepsia, starting 2 years before and ending 10 years after eradication of H. pylori. Seven non-relapsing and untreated patients (patient group 2) were also followed-up. Results: The relapse rate was reduced from 100% per year in the two years before anti-H. pylori treatment to 0.3% per year after treatment in patient group 1. The reinfection rate was 0.7% per year. Anxiety and neuroticism were high at inclusion, but had normalized at the 10-year follow-up in relapse-free patients. There was no increase of gastro-oesophageal reflux symptoms during the 10 years after H. pylori eradication. Conclusions: Normalization of anxiety and neuroticism following cure of DU disease supports the view that the increased anxiety and neuroticism are consequences, and not causes, of the disease.