Treatment of Peptic Ulcer
1. The diet in peptic ulcer was strictly in the past, but now is more lax because of antisecretory products. There is evidence that smoking decreases the healing time of a peptic ulcer. However, avoid eating foods very spicy (acidic, spicy). If you have pain exclude the coffee. Important: do not use aspirin, NSAIDs and glucocorticoids.
2. Medical treatment for peptic ulcer. Antisecretory drugs should be administered (being products that protect the intestinal mucosa) and antibiotics for eradication of Helicobacter pylori.
2.1. Antisecretory treatment (two-drug types):
- H2 histamine receptor blockers: ranitidine, nizatidine, Famotidine;
- blockers of proton pump (H+): Omeprazole, Pantoprazole, Lanzoprazole, Rabeprazole, Esomeprazole.
Treatment duration is between one month and a half and two months. During this period ulcer lesion must heal.
2.2. Products that protects gastric mucosa: Sucralfate (4 grams per day).
2.3. Eradication of Helicobacter pylori (this bacteria is the cause in most cases of peptic ulcer). This treatment is administered when the presence of Helicobacter has been demonstrated by direct and indirect methods. If the bacteria is eradicated the risk of ulcer recurrence is less than 10%. It uses triple or quadruple therapy. Triple therapy: omeprazole + amoxicillin + clarithromycin. Quadruple therapy: Omeprazole + Bismuth subcitrate + tetracycline + metronidazole. Usually, it is used the triple therapy and the therapy with 4 drugs is administered in case of failure of the first therapy. Treatment duration is for 7-10 days.
- injection of adrenaline then using bipolar contact thermocoagulation;
- hemoclips placement;
- argon plasma coagulation.
These interventions save the patient’s life and help avoiding surgery.
4. Surgical treatment for peptic ulcer. This treatment is done more rarely due to the emergence treatments mentioned above. Surgery is done when an ulcer does not heal using the above therapies for 2 months, if the ulcer penetrates, if bleeding occurs that threatens the patient’s life (that can not be stopped by endoscopy), if the ulcer shows malignant cells. The conclusion is that surgical treatment will be chosen only in case of complications (penetration, hemorrhage, malignancy, stenosis of peptic ulcer).