Ulcer Treatment–Regimens and Duration of Inhibition of Acid Secretion: How Long to Dose

Abstract

The healing rate of duodenal and gastric ulcer depends on the duration of treatment. When a single drug is examined, there are considerable variations from study to study. The healing rate also depends on the type of drug used. It increases with an increasing degree of acid inhibition. Thus, the strongest acid inhibitor presently known, omeprazole, leads in patients with duodenal ulcer to 2-week healing rates of 65%, similar to the 4-week healing rate observed with H2-antagonists. If the aim is, however, to heal almost all ulcers at risk, then treatment should last for 4 weeks with omeprazole and 6 weeks with H2-antagonists. It has been claimed that eradication of Campylobacter pylori accelerates ulcer healing, but this is at present controversial. The duration of treatment depends on whether an endoscopy is performed at the end of treatment and on the presence or absence or risk factors. Treatment of duodenal ulcer should last 6 weeks with H2-antagonists or 4 weeks with omeprazole when no endoscopy is pe...