A Possible Role For H. Pylori Eradication Therapy As Adjuvant Therapeutic Modality For Non-Herpetic Recurrent Aphthous Stomatitis

Objectives : To evaluate coincidence between Helicobacter pylori (Hp) infection and non-herpetic recurrent aphthous stomatitis (NH-RAS), and the effect of its eradication on ulcer severity as guided by the Ulcer Severity Score (USS). Patients & methods : 115 NH-RAS patients free of dyspeptic manifestations were clinically evaluated, and then underwent Hp stool antigen test (Hp-SAT). The patients who gave negative Hp-SAT result were prescribed the conventional oral ulcer therapy for 1-m duration, and then were re-examined for clinical status and USS (Control group), and the patients who gave positive Hp-SAT result were prescribed the Hp triple therapy for 14-days and conventional oral ulcer therapy for 1-m duration, and then were re-examined for clinical status and USS. Hp-SAT was repeated 1-m after the end of the triple therapy course.Results : Hp-SAT test was negative in 81, and positive in 34 patients. Repeated Hp-SAT was negative in 25 patients (Responders), and still positive (Non-responders) in 9 patients. Baseline USS was significantly (p=0.032) higher in Hp positive than negative patients. The 1-m USS of control patients was non-significantly lower than their baseline USS, while it was significantly lower (p=0.001) in study patients compared to both their baseline score and 1-m USS of controls (p=0.005). The 1-m USS of responders was significantly (p=0.001) lower compared both to their baseline USS and 1-m USS of non-responders and Hp negative patients. In non-responders, 1-m USS was significantly (p=0.044) lower compared to their baseline USS with non-significant difference versus Hp negative patients. Conclusion : Hp infection may predispose to recurrence of NH-RAS and induce aggravation of clinical manifestations. Hp eradication therapy in conjunction with conventional RAS therapy helps significant reduction of manifestations. Hp-SAT may be incorporated with investigations underwent by RAS patients as it is a safe, easy and reliable test.