Treatment

Treatment of peptic ulcers with modern drugs is highly successful in the majority of people. The person takes a short course of two antibiotics, usually in combination with a proton pump inhibitor (a drug that reduces the amount of acid the stomach produces). This medication eliminates the bacterial infection.

The antibiotics prescribed include amoxicillin, clarithromycin or metronidazole. Omeprazole, lansoprazole, pantoprazole and esomeprazole are examples of proton pump inhibitors. Treatment lasts between 7 to 14 days depending on the combinations chosen. The course of tablets may be repeated for recurrent symptoms.

Antacids provide symptomatic relief. Older established drugs including ranitidine, famotidine, bismuth, misoprostol and sucralfate are also prescribed in some cases.

NSAIDS or other drugs precipitating the ulcer are discontinued and avoided in future. It is not usually necessary to modify the diet, since drug therapy is so effective. People are advised to stop smoking and moderate alcohol use if excessive.

Treatment of complications

People with bleeding peptic ulcers are admitted to hospital to identify the source of the bleeding by endoscopy, stabilise their condition, and receive blood transfusion if haemorrhage is severe and initiate medication. A minority of cases will need surgery to over sew the ulcer if bleeding cannot be stopped or recurs.

Laparoscopy (surgery to open the abdomen) is undertaken in the event of an ulcer perforating.

In rare cases of recurrent peptic ulceration surgery to cut the nerve supply to the stomach/ duodenum may be carried out. This operation is called vagotomy.

Amended April 2008