Medicines and Drugs to Treat Peptic Ulcers

What is an ulcer?

An ulcer is damage to the inner lining (the mucosa) of the stomach or the upper part of the intestine (duodenum). A bacterium, Helicobacter pylori, is the main cause of ulcers in this area.

Antibiotics:- Several combinations of antibiotics kill H. pylori. Most of the medications are equally effective. However, for the treatment to work, it's essential that you follow your doctor's instructions precisely. Antibiotics most commonly prescribed for treatment of H. pylori include amoxicillin (Amoxil, Wymox), clarithromycin (Biaxin), metronidazole (Flagyl) or tetracycline (Achromycin V). Some pharmaceutical companies package a combination of two antibiotics together, with an acid suppre. Drugs for decreasing acidity are used for peptic ulcer, gastroesophageal reflux disease (GERD–see Esophageal and Swallowing Disorders: Gastroesophageal Reflux Disease (GERD)), and many forms of gastritis. Some drugs are used in regimens for treating H. pylori infection. Drugs include proton pump inhibitors, H2 blockers, antacids, and prostaglandins

Colloidal Bismuth or Tripotassium Dicitrato Bismuthate TDB (Trymo, Denol)

This is also used for the same purpose as sucralfate. The dose is 240 mg, twice daily, half an hour before meals. It causes blackening of the stools and tongue, dizzines diarrhoea and bismuth toxicity. It detaches H pylori and kills them. So it is used in eradication regime also.

Eradication of H. Pylori Infection in Peptic Ulcer

H-pylori is responsible for causing chronic gastritis, dyspepsia, peptic ulcer and stomach tumor in many cases 90% cases of gastric and duodenal ulcers have H. pylori in their stomachs. Eradication of this organism is difficult with single drug. Therefore a combination of two or three drugs is used.

Reflux, Esophagitis

It is a very common problem presenting as sour eructations, heartburn and water brash. The symptoms occur particularly after a large meal and increase on lying down. In this disorder the acid contents of stomach rise in the lower part of food pipe (esophagus). The lower end of food pipe has a valve like mechanism to prevent reguritation of acid contents. When this valve (sphincter) becomes lax or weak, the acid burns the lining of food pipe causing erosions, ulcers and heartburns. In many cases of night-time attacks of asthma, reflux is found to be a common problem. If untreated the food pipe is ultimately narrowed not allowing hard food to pass down (dysphagia). There is a risk of cancer development. Therefore, it should be treated vigorously.

Dosage: Omeprazole 20 mg, twice a day or lansoprazole 15 to 30 mg, daily for 4 to 8 week are better than H2 blockers (ranitidine or famotidine). These are often combined with prokinetic drugs. Common formulations are Omidom, Domstal-O (Omeprazole + Domperidone), Pentadom (Pantoprazole + Domperidone) and Zerocid (Lansoprazole + Domperidone).

Precautions: Persons suffering from reflux esophagitis should take light early dinner. The foot end of the bed should be raised to provide much relief. Weight reduction can also help.

Sodium alginate

It forms thick frothy layer on the gastric juice and thus prevents acid regurgitation. It is combined with antacids.

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