An etiologic approach to management of duodenal and gastric ulcers

Douglas Rex

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

With rare exception, peptic ulcers can now be classified as either Helicobacter pylori-related, induced by nonsteroidal anti-inflammatory drugs (NSAIDs), or related to Zollinger-Ellison syndrome. Helicobacter pylori- related ulcers can be treated by eradication of H pylori or by traditional therapies, including antisecretory drugs or sucralfate. Successful eradication of H pylori requires compliance with a multidrug regimen. Therefore, candidates should demonstrate substantial motivation. In general, the greater the degree of ulcer recurrence or resistance, the stronger the indication for H pylori eradication. Sucralfate is effective in healing H pylori-related duodenal ulcers, and H2 receptor antagonists heal H pylori- related duodenal and gastric ulcers. Omeprazole provides faster healing of H pylori-related ulcers, and is particularly useful in treating large gastric ulcers. Dyspepsia induced by NSAIDs and NSAID-related endoscopic erosions are managed by stopping NSAID use or reducing the dosage; administering NSAIDs with meals; and administering H2 receptor antagonists in full split-doses. NSAID-induced duodenal ulcers and small gastric ulcers can be healed with full split-doses of H2 receptor antagonists, even while the NSAID is continued. Large (>5 mm) NSAID-induced gastric ulcers are most efficiently treated with omeprazole, particularly if the patient continues to take the NSAID.

Original languageEnglish
Pages (from-to)60-67
Number of pages8
JournalJournal of Family Practice
Volume38
Issue number1
StatePublished - 1994

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Stomach Ulcer
Duodenal Ulcer
Anti-Inflammatory Agents
Pylorus
Pharmaceutical Preparations
Histamine H2 Receptors
Sucralfate
Ulcer
Omeprazole
Helicobacter pylori
Zollinger-Ellison Syndrome
Dyspepsia
Peptic Ulcer
Meals
Recurrence

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

An etiologic approach to management of duodenal and gastric ulcers. / Rex, Douglas.

In: Journal of Family Practice, Vol. 38, No. 1, 1994, p. 60-67.

Research output: Contribution to journalArticle

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