Introducción: Se ha sugerido que la intervención de médicos especialistas en formación en la CPRE (intento de canulación por residente: ICPR) podría asociarse con menor eficacia y más complicaciones.

Introducción: En estos últimos años hemos asistido al nacimiento y consolidación paulatina de técnicas híbridas de CPRE y ecoendoscopia (colangiopancreatografía-endosonográfica o "CPES"), que nos permiten tratar a pacientes con patología biliar/pancreática(tumores/litiasis/pancreatitis) en los que la CPRE ha sido fallida. Se desconoce cuáles son los requerimientos para realizar CPES con solvencia.

Introducción: La extracción de CGT mediante PCB tiene una eficacia considerable. Se desconoce si el grado de experiencia en la técnica influye en sus resultados y complicaciones.

La búsqueda de un agente causal de la colitis ulcerosa (CU) se ve dificultada, pues los métodos de cultivo de heces o tejido no son representativos de la microbiota intestinal real. Analizar los grupos bacterianos principales de la microbiota cólica en muestras de heces y de tejido de pacientes con CU, empleando métodos moleculares independientes de cultivo. 37 pacientes con CU (27 varones) y 33 voluntarios control (VC, 17 varones, colonoscopia como cribado de cáncer colorrectal, sin síntomas digestivos). Se recogieron heces y muestras de mucosa. Se extrajo ADN total con método manual con fenol-cloroformo. Se usó PCR cuantitativa (7300 Applied-Biosystem) para conocer el número de copias de 16SrADN de los grupos Fusobacterium, Bacteroides-Prevotella-Porphyromonas, y de las Bacterias Ácido Lácticas (BAL). En heces, no había diferencias significativas entre pacientes con CU y VC, aunque en los primeros hubo densidades más altas de Bacteroides y de Fusobacterium. Sin embargo, en mucosa, el número de copias del gen 16S rADN para Bacteroides y para Fusobacterium fue significativamente mayor en pacientes con CU que en VC (p=0,016 y p=0,025, respectivamente). No encontramos variaciones significativas en BAL, pero su densidad fue menor en la CU. La densidad bacteriana en heces y en mucosa no tuvo correlación, con valores generalmente más altos en la segunda. Los pacientes con CU presentaron en mucosa densidades más altas de los anaerobios Bacteroides y Fusobacterium, comparados con voluntarios control. Se detectan densidades mayores de bacterias en la mucosa que en las heces, con escasa correlación entre uno y otro tipo de muestra.

s of the 4th Congress of ECCO the European Crohn's and Colitis Organisation S137 identified with ESBL were symptomatic.Because of the limited number of oral antibiotics effective in ESBL pouchitis it may be associated with an increased risk of pouch failure in the long term.Treatment with maintenance antibiotics may be a particular risk factor and these patients should remain under follow-up.Patients with chronic pouchitis who relapse should be tested for ESBL and treated appropriately.

Aim: adherence to therapy is important to ensure success. We wanted to explore this feature in patients with inflammatory bowel disease. Patients and methods: we explored adherence to treatment and its modifiers in 40 patients with inflammatory bowel disease using a battery of tests. Results: a 67% of patients (95% CI: 51-81%) acknowledged a certain degree of involuntary nonadherence, and 35% (95% CI: 20-51%) of voluntary nonadherence. Overall, 72% (95% CI: 56-85%) of patients had some form of nonadherence. An objective correlation of these self-reported data was assessed by the determination of urine salicylate levels in the subset of patients treated with mesalazine or its derivatives (15 cases). Two of them (13%) had no detectable urinary drug levels, indicating complete nonadherence. Voluntary nonadherence was higher in patients with lower scores in the intestinal (p = 0.02) and social areas (p = 0.015) of IBDQ-32, as well as in those with less active Crohn's disease (p < 0.005), patients with high depression scores and high patient-physician discordance (p = 0.01), patients with long-standing disease (p = 0.057), patients who considered themselves not to be well informed about the treatment they were getting (p = 0.04) or who trusted their attending physicians less (p = 0.03). Conclusions: intentional nonadherence to therapy is prevalent among patients with inflammatory bowel disease. A correction of factors associated to poor adherence could lead to higher therapeutic success.Objetivo: la adhesión al tratamiento es importante para el éxito del mismo. Quisimos conocer este dato en pacientes con enfermedad inflamatoria intestinal. Pacientes y métodos: hemos explorado la adhesión al tratamiento y sus condicionantes en 40 pacientes con enfermedad inflamatoria intestinal, aplicando una batería de pruebas. Resultados: un 67% (IC 95%: 51-81%) de los pacientes presentaba algún grado de falta involuntaria de adhesión. A su vez, un 35% (20-51%) de los pacientes presentaba algún grado de falta voluntaria de adhesión. Globalmente, un 72% (56-85%) de los pacientes presentó uno u otro tipo de falta de adhesión. El correlato objetivo, se obtuvo mediante la determinación de salicilatos en orina en el subgrupo de pacientes bajo tratamiento con mesalazina o derivados (15 casos). Dos de ellos (13%), no tenían niveles detectables, traduciendo falta absoluta de adhesión al tratamiento. La adhesión intencionada era tanto más baja cuanto menores eran las puntuaciones en las áreas intestinal (p=0,02) y social (p=0,015) del IBDQ-32, así como en aquellos con enfermedad de Crohn menos activa (p < 0,005), pacientes con puntuaciones altas de depresión y alta discordancia con el médico (p = 0,01), pacientes con largo tiempo de evolución de su enfermedad (p = 0,057), los que no se consideraban bien informados acerca de sus medicaciones (p = 0,04) o con menos confianza en sus médicos (p = 0,03). Conclusiones: la falta de adhesión intencionada es prevalente en este grupo de pacientes. La corrección de los factores que la predicen puede mejorar los resultados terapéuticos.

Aim: adherence to therapy is important to ensure success.We wanted to explore this feature in patients with inflammatory bowel disease.Patients and methods: we explored adherence to treatment and its modifiers in 40 patients with inflammatory bowel disease using a battery of tests.Results: a 67% of patients (95% CI: 51-81%) acknowledged a certain degree of involuntary nonadherence, and 35% (95% CI: 20-51%) of voluntary nonadherence.Overall, 72% (95% CI: 56-85%) of patients had some form of nonadherence.An objective correlation of these self-reported data was assessed by the determination of urine salicylate levels in the subset of patients treated with mesalazine or its derivatives (15 cases).Two of them (13%) had no detectable urinary drug levels, indicating complete nonadherence.Voluntary nonadherence was higher in patients with lower scores in the intestinal (p = 0.02) and social areas (p = 0.015) of IBDQ-32, as well as in those with less active Crohn's disease (p < 0.005), patients with high depression scores and high patientphysician discordance (p = 0.01), patients with long-standing disease (p = 0.057), patients who considered themselves not to be well informed about the treatment they were getting (p = 0.04) or who trusted their attending physicians less (p = 0.03).Conclusions: intentional nonadherence to therapy is prevalent among patients with inflammatory bowel disease.A correction of factors associated to poor adherence could lead to higher therapeutic success.

Background: Localized low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphoma can regress after Helicobacter pylori eradication, but IgV(H) gene monoclonality may persist. We studied the long-term histological and molecular follow-up of 24 patients and the possible association of t(11;18) with the persistent monoclonality.Patients and methods: From January 1994, 24 untreated patients with stage I low-grade gastric MALT lymphoma associated with H. pylori were prospectively studied. They all received eradication treatment and were sequentially followed-up with endoscopies for histological and molecular studies. Rearrangement of the IgV(H) gene was studied by PCR analysis. MALT1 locus alterations were studied by FISH.Results: Twenty-two of the 24 patients (91%) achieved disappearance of the lymphoma. Eighteen (82%) of the 22 histologically cured patients and 16 of the 19 (84%) with long follow-up had monoclonality. Three patterns of development of IgV(H) gene rearrangements were observed: four patients (21%) had polyclonal rearrangements; eight (58%) had maintained/intermittent monoclonality and four (21%) had occasional monoclonality, mostly after H. pylori reinfection. Only one patient (6%) with persistent monoclonality relapsed. The remaining 18 patients maintained the remission, despite the persistent monoclonality in 15, for a median of 66 months (range 20-113). t(11;18) was not found in any of the patients with persistent monoclonality. Time and the number of endoscopies performed were not related with the occurrence of monoclonality.Conclusions: In stage I low-grade gastric MALT lymphoma eradication of H. pylori achieves prolonged histological remission in 90% of patients, but molecular remission is not accomplished in most cases. Molecular disease persists for years, but is not associated with t(11;18).

OBJECTIVE To study histologic gastric mucosa lesions in patients with gastric ulcer disease and to assess their evolution in the year after Helicobacter pylori eradication. METHODS Seventy-three patients with gastric ulcer were prospectively studied. On endoscopy, biopsy specimens were taken from the antrum and gastric body for hematoxylin and eosin staining and urease testing. Serology and 13C-urea breath test were carried out. Fifty-six patients treated for H. pylori infection were monitored with histologic study at months 1, 6 and 12 after therapy to eradicate H. pylori infection. RESULTS In patients with gastric ulcer, the prevalence of H. pylori was 86.3% (95% CI: 76-92%). Similar percentages in patients with chronic gastritis (CG) and in those with active chronic gastritis (ACG) were noted in the antrum and gastric body. However, severe active chronic gastritis was more prevalent in the antrum (p < 0.01). In patients with H. pylori infection who were not treated with non-steroidal anti-inflammatory drugs (NSAIDs), the percentages of both CG and ACG were higher than those observed in patients with both risk factors (p < 0.01) and in those treated with NSAIDs and with no infection (p < 0.0001). The prevalence of glandular atrophy (17.8%; 11-28%) and of intestinal metaplasia (68.5%; 57-78%) was higher in the antrum than in the gastric body (4.1%; 1-11% and 16.4%; 10-26%, respectively) (p < 0.01). In the antrum of patients with successful treatment, the percentages of CG:ACG before treatment and 1, 6, and 12 months after treatment completion were: 100%:97%, 74%:14%, 44%:11% and 11%:2%, respectively. In the gastric body these rates were: 88%:86%, 51%:14%, 23%:4% and 4%:0%. Improvement of CG was observed at month 1 after treatment completion, which was then confirmed at months 6 and 12 (p < 0.01) whereas improvement of ACG was most often achieved at month 1 after treatment completion (p > 0.001). No changes in atrophy and intestinal metaplasia were observed after H. pylori eradication. CONCLUSIONS Histologic gastritis associated with gastric ulcer disease involves both the antrum and gastric body, although prevalence of severe ACG, atrophy and intestinal metaplasia were higher in the antrum. Histologic gastritis were closely related to H. pylori infection but is unrelated to NSAIDs. H. pylori eradication results in progressive CG improvement over the first year, as well as in early ACG improvement (as soon as 1 month after treatment completion); however, atrophy and intestinal metaplasia remain unchanged.

Background: There is a paucity of data regarding the impact of EUS in therapy. Aim: To determine the therapeutic impact of EUS in an unselected cohort of patients (PT) referred for EUS. Methods: Design: Prospective. Time of inclusion: 08/2002-09/2003. Inclusion Criteria: 1.) PT > 18 years with clinical indication for EUS. Exclusion Criteria: 1.) PT refuses to participate in the study, 2.) Coagulation disorder. Assessment of therapeutic impact of EUS (overall, upper and lower GI): EUS provided additional information (yes/no), EUS findings have a potential (yes/no) and/or real impact on therapy (yes/no). Treatment decision pre-EUS vs post-EUS. Statistical analysis:Chi Square/Fisher, ANOVA, Wilcoxon. Multivariate: logistic regression. Results: 346 consecutive PT included: M/F (61%/39%), age (59.0+15.6; 61), smoker (56%; cigars/d: 13.7 + 15.2; 10), alcohol (68%; gr/d: 29.7 + 15.2; 20), diabetes mellitus (14%), COPD (9%), cardiac diseases (15%), BMI kg/m2 (27.0 + 4.1; 26.9), prior endoscopy (79%), prior EUS (5%). Indications for EUS: pancreas/bile duct tumor (82/346: 24%), subepithelial tumor (50/346: 14%), portal hypertension (22/346: 7%), esophageal/gastric carcinoma (56/346: 14%), idiopathic pancreatitis/lithiasis (55/346: 7%), perianal fistula (25/346: 7%), chronic pancreatitis (17/346: 5%), rectal carcinoma (15/346: 4%), MALT (15/346: 4%), lymphadenopathy (9/346: 3%). Treatment decision (pre vs post-EUS) was modified in 69% of PT. PT therapy changed to a more aggressive one in 115/346 (33%) of overall PT, 92/306 (30%) of upper GI and 23/40 (57%) of lower GI. PT therapy changed to a less aggressive one in 126/346 (36%) of overall PT, 120/306 (39%) of upper GI and 6/40 (15%) of lower GI PT. EUS findings, alcohol drinkers, and PT age > 61 years were statistically associated with changes in therapy (Uni/multivariate analysis, p<0.05) (Sex, smoker, diabetes, COPD, cardiopathy, p >0.05). Conclusions: 1.) EUS findings, advanced PT age and alcohol consumption have a significant impact on management and treatment decision in PT in whom EUS is clinically indicated. 2.) EUS findings modify treatment decision in 69% of PT evaluated (36% less aggressive therapy), which may have a significant economic impact.

Pyoderma gangrenosum is an extraintestinal manifestation of inflammatory bowel disease that can be therapeutically troublesome. We comment on the case of a patient with clinically inactive ulcerative colitis who progressively developed necrotic lesions on both tibial aspects of his legs, which corresponded both clinically and histologically to pyoderma gangrenosum. Treatment with steroids and azathioprine could not control this complication. A single dose of infliximab 5 mg/kg was given, achieving an impressive response of the skin lesions followed by complete healing 3 months later. Infliximab can be useful in the management of refractory extraintestinal manifestations of inflammatory bowel disease.

Background: The presence > 3 EUS diagnostic criteria for CP (EDCCP), allows one to establish a diagnosis of CP with a sensitivity > 90%. Unfortunately, specificity of EDCCP is low, as EDCCP may also be found in patients (PT) with no CP. Aims: 1.) To determine the pattern of pancreatic EUS normality and analyze which factors are associated with EUS changes suggestive of CP. 2.) To design new EDCCP that count on those factors associated with presence of EDCCP. Methods: 08/2002-05/2003. Prospective EUS exam in 155 asymptomatic patients (Inclusion Criteria: 1.) PT > 18 years candidate for EUS and no clinical suspicion for CP. Exclusion Criteria: 1.) History of pancreatobilliary disease, stones or colecystectomy, 2.) PT refuses to participate), in whom a prospective blinded assessment of EDCCP (Hyperechoic foci, linear strands, lobulation, calcifications, cysts, lithiasis, hyperechoic duct wall, irregular or dilated Wirsung) was performed. Factors associated with presence of EDCCP in this cohort of 155 PT was evaluated. In a different cohort of 75 PT (50 asymptomatic PT, 25 PT with CP), performance characteristics of conventional and modified EDCCP (accounting for confounding factors identified) were compared (Fisher, McNemar test. Logistic regression). Results: 155 consecutive PT included: : M/F (57%/43%), age (60.3 + 14.4 y.o. (61)), smoker (yes: 57%; cigs/d: 14 + 15.9 (10)), alcohol (yes: 64%; amount: 26.3 + 29.7 gr/d (30 gr/d), (BMI) (27.1 + 5.1 Kg/m2 (27.3)), diabetes mellitus (12%), EPOC (12%), cardiopathy (11%). Number of EDCCP +: 1.4 + 1.2 (median 1). Hyperechogenic foci (69% of PT), hyperechoic strands (32%), lobulation (21%). Uni and multivariate analysis of factors: alcohol intake > 30 gr/d and a PT age > 61 years were statistically associated with presence of EDCCP + (p=0.0001, p=0.0002) (BMI, sex, smoker p>0.05). In a different cohort of 75 PT, conventional EDCCP (CP = > 3 EDCCP +) and modified by age and alcohol EDCCP (CP = a.) 3 or more EDCCP + in PT < 60 y.o y < 30 grs/d alcohol; b.) 4 or more EDCCP + in PT > 60 y.o or > 30 grs/d alcohol; c.) 5 or more EDCCP + in PT > 60 y.o. and > 30 grs/d alcohol) were compared. EDCCP (conventional vs modified): sensitivity (100% vs 100%, p = 1), specificity (76% vs 88%, p = 0.04), diagnostic accuracy (84% vs 92%, p = 0.04). Conclusions: 1.) An alcohol intake > 30 gr/d and a PT age > 60 years are both associated with EUS changes suggestive of CP. 2.) Modified EDCCP provide a higher specificity and accuracy compared with conventional criteria, with no reduction in sensitivity.

AIMTo evaluate which factors influence eradication success with standard triple therapy for Helicobacter pylori.PATIENTS AND METHODSA prospective study was made of 891 patients infected by H. pylori and diagnosed with duodenal ulcer (n=422), gastric ulcer (n=221), or functional dyspepsia (n=248). Initially, an endoscopy with biopsies of antrum and body (haematoxylin-eosin stain), and a 13C-urea breath test were performed. All patients were treated for seven days with either omeprazole 20 mg twice daily in 442 patients (OCA) or pantoprazole 40 mg twice daily in 449 patients (PCA), associated to clarithromycin (500 mg twice a day) and amoxicillin (1 g twice a day). Two months after completing therapy urea breath test was repeated to confirm eradication.RESULTSMean age +/- SD was 51.6 +/- 15 years, 61% were male. Overall eradication rate was 73.7% (95% CI 69-77%) and 80.8% (77-84%) with OCA and PCA therapy, respectively, showing significant difference between treatment regimens (chi 2 =6.3; p= 0.01). As refers to underlying diseases, H. pylori eradication was achieved in 77.4% (74-80%) of peptic ulcers and 77% (71-82%) of functional dyspepsia (p=n.s.). With our two treatment regimens (OCA/PCA) eradication success was 74/81% in peptic ulcer (p=0.03), and 72/80% in functional dyspepsia (p=0.1). In the multivariate analysis, type of therapy was the only variable that correlated with eradication success (odds ratio 1.5; 95% CI: 1.1-2.1) (chi2 model: 6,4; p=0.01).CONCLUSIONSStandard triple therapy containing a proton pump inhibitor, clarithromycin and amoxicillin for seven days achieves in our community a moderate eradication success; this result could improve by using pantoprazole instead of omeprazole. This therapy is equally effective in patients with peptic ulcer and functional dyspepsia.

INTRODUCTION:some authors suggest that Helicobacter pylori eradication favors gastric ulcer healing.OBJECTIVE:to study which factors influence ulcer healing in patients suffering from gastric ulcer with H. pylori infection.SUBJECTS AND METHODS:a prospective study of 230 patients with gastric ulcer associated to H. pylori infection. Chronic ingestion of non-steroidal anti-inflammatory drugs was considered as an exclusion. In an initial endoscopy, malignancy was histologically excluded and two biopsies each of antrum and body were obtained. Also, ELISA IgG serology and a 13C-urea breath test were performed. Eradication therapy with omeprazole (20 mg twice a day), clarithromycin (500 mg twice a day) and amoxicillin (1 g twice a day) was administered for seven days, followed by omeprazole 20 mg once a day for five more weeks. Endoscopy was repeated after 6 weeks of treatment and breath test was repeated 2 month after completing therapy.RESULTS:overall gastric ulcer healing was achieved in 80.8% (95% CI: 75-85%) of cases by intention-to-treat, and in 82.6% (77-87%) per protocol. Ulcer healing was achieved in 94.3% (90-97%) of patients with eradication success, but only in 40.8% (28-54%) of patients with eradication failure (p<0.0001). In the multivariate analysis, H. pylori eradication was the only variable that correlated with ulcer healing (odds ratio 24; 95% CI: 10-56; p<0.0001) (x2 model: 64.4; p<0.0001). Additional variables (age, sex, sporadic ingestion of NSAIDs, smoking, previous ulcer disease, ulcer size and location) were not related to healing.CONCLUSION:H. pylori eradication favors ulcer healing in patients with gastric ulcer, which is an argument in favor of the etiological role of the microorganism in this disease. Other factors did not influence ulcer healing.

AIM:to evaluate etiological agents involved in acute pancreatitis in children, as well as clinical, laboratory and radiological findings and the illness clinical course.PATIENTS AND METHODS:we reviewed the cases of acute pancreatitis diagnosed over the last 15 years. The criteria used for cases to be included were acute abdominal pain, elevated serum amylase levels and/or ultrasound abnormalities in the pancreatic area in conscious patients, and the last two criteria in unconscious patients.RESULTS:thirty-one children were included (average age 7.9 years, range 2-15; 55% males). Infection and gallstones were the most common causes (19 and 16 %, respectively). In all, 9.7% of cases were drug-related (valproic acid, L-asparaginase, azathioprine combined with high doses of methylprednisolone); 6.5% were traumatic in origin and another 6.5% was due to systemic diseases. In 35.5 % no cause was found (idiopathic). The most frequent symptoms were abdominal pain (90%) and emesis (38%). Amylase serum levels were elevated in all patients. Abdominal ultrasound scans were abnormal in 64%, with an increase in the pancreatic area in 48% and hypoechogenicity in 51%. Seven cases required surgical treatment (22%). Seven children had acute pancreatitis, and three of them died as a result of shock unrelated to pancreatitis. Relapse of disease occurred in 19% of patients.CONCLUSIONS:acute pancreatitis should always be considered in children with abdominal pain. There are a wide variety of etiological factors and in a high percentage of patients no underlying cause is found. Prognosis is variable owing to the heterogeneity of the clinical course of this illness in children.

SummaryAim : To study the efficacy of a 7‐day quadruple regimen combining pantoprazole, bismuth, tetracycline and metronidazole as rescue treatment for Helicobacter pylori infection after failure of standard triple therapy.Methods : A prospective study was made of 140 patients infected with H. pylori and diagnosed with peptic ulcer or non‐ulcer dyspepsia in whom triple therapy with proton pump inhibitor, clarithromycin and amoxicillin had failed. The patients were treated with quadruple therapy including pantoprazole, 40 mg twice daily, colloidal bismuth subcitrate, 120 mg four times daily, tetracycline, 500 mg four times daily, and metronidazole, 500 mg three times daily, for 7 days. Two months after completion of therapy, a 13C‐urea breath test was performed to confirm eradication.Results : With quadruple therapy, the H. pylori eradication rates were 82% (95% confidence interval (CI), 75–88%) by ‘intention‐to‐treat’ and 85% (95% CI, 79–91%) by ‘per protocol’. No major side‐effects were observed. No differences in eradication success were observed in relation to underlying disease (peptic ulcer: 85% (95% CI, 76–91%) vs. non‐ulcer dyspepsia: 83% (95% CI, 68–93%)) or smoking habits (smokers: 86% (95% CI, 75–93%) vs. non‐smokers: 83% (95% CI, 71–91%)).Conclusion : Quadruple therapy with pantoprazole, bismuth, tetracycline and metronidazole for 7 days is an effective H. pylori eradication treatment for patients in whom standard triple therapy has failed.

Aim To evaluate whether the Helicobacter pylori status of the patient's spouse plays a role in reinfection after eradication success, and to assess the possibility of transmission of H. pylori among partners by using molecular methods. Methods We studied prospectively 120 patients in whom H. pylori had been eradicated. Endoscopy with biopsies and a 13C-urea breath test were performed 1 month after completing therapy. The breath test was repeated in all patients at 6 and 12 months. At the 1-year follow-up visit (or before if reinfection occurred), a breath test was also performed on the patient's partner. Samples for the molecular study included gastric biopsies from patients and gastric content obtained by the string test from partners. The heterogeneity of ureC was studied by enzymatic digestion with MseI and HhaI enzymes of a polymerase chain reaction (PCR) product of 1179 bp belonging to the ureC gene, and different band patterns were generated after electrophoresis. Results Four reinfections were diagnosed at 6 months, and four were diagnosed from 6 to 12 months (incidence 6.8% per patient-year). Seven of eight (87%) of the reinfected patients’ spouses were infected, but H. pylori infection of spouses was also frequent (76%) among non-reinfected patients. In the multivariate analysis, age of the patient (odds ratio [OR] 0.93, 95% confidence interval [CI] 0.87 to 0.99, P < 0.05), δ13CO2 value after therapy (OR 2.51, 95% CI 1.14 to 5, P < 0.05), and therapy regimen (OR 6.23, 95% CI 1.25 to 31, P < 0.05) were the only variables that correlated with H. pylori recurrence. However, family variables (H. pylori status of spouse, breath test value of spouse, length of time couple had lived together, number of children living at home, household density) did not correlate with recurrences. Thus, the OR for the H. pylori status of spouse (adjusted by age, δ13CO2 and therapy) was 2.93 (95% CI 0.29 to 29, P > 0.05). H. pylori recurrence occurred in seven of 92 (7.6%) patients when the spouse was infected (95% CI 3.7% to 15%), and in one of 28 (3.6%) patients when the spouse was H. pylori-negative (95% CI 0.6% to 18%) (P > 0.05; however, the power of this comparison was < 20%). Therefore, even if the spouse was infected, 92.4% of patients will remain uninfected 1 year after H. pylori eradication. Three reinfected patients (at 1 year) and their partners (also infected) agreed to have the endoscopy and string test performed, respectively. The molecular study revealed that H. pylori strains involved were different in all cases. Conclusion Recurrence of H. pylori infection seems to be relatively infrequent, even if the patient's spouse is H. pylori-positive. The molecular study demonstrated that the strains in reinfected patients and their partners are different, suggesting that the patient's partner does not act as a reservoir for H. pylori reinfection.