Editor,—Apart from validating the reversibility of the pathogenic processes mediated by Helicobacter pylori in the causation of duodenal ulcer, the study by Lamet al (Gut1997;41:43–8) also served as a reminder that, even in H pylori associated ulcer disease, other mechanisms have a reversible aetiopathogenic role, exemplified by the spontaneous remission documented through the use of placebo. There is …