Peptic ulcer healing drugs

Preface

Peptic ulcers are open sores that develop on the inside lining of the esophagus (esophageal ulcer), stomach (gastric ulcer) and the upper portion of your intestine (duodenal ulcer). There is a mucous lining coating the digestive tract which protects against acid. An ulcer could develop if the amount of acid is increased or the amount of mucus is decreased, so that acid eats away at the inner surface of the digestive tract, creating painful open sore. Patient may develop complications such as bleeding, obstruction, or perforation.

The most common symptom of a peptic ulcer is abdominal pain. Typically, the pain may be felt anywhere from your navel up to your breastbone, and may be worse when your stomach is empty and flare at night. Other less common symptoms may include indigestion, heartburn, nausea, vomiting of blood, black-colored stools, loss of appetite and unexplained weight loss.

Peptic ulcers are usually caused by either infection by Helicobacter pylori (H. pylori) bacteria or regular use of non-steroidal anti-inflammatory drugs (NSAIDs), a kind of pain killers. Besides, there are many factors that may increase the risk of developing peptic ulcers, such as smoking, alcohol consumption, undesirable eating habits and uncontrolled stress.

Treatment

Lifestyle advice
Lifestyle factors such as diet and stress may worsen the symptoms of ulcers. On the contrary, healthy lifestyle and good dietary habits may help to accelerate ulcer healing, such as,:

1. Take small but frequent meals and eat at regular time;
2. Avoid spicy or excessively rich foods that are irritable to the gut;
3. Do not smoke and avoid drinking alcoholic and stimulating beverages, such as coffee and strong tea;
4. Drink milk and eat milk-based food that may help to relief the pain;
5. Avoid situations causing stress and anxiety; and
6. Do regular exercises to help you relax.

Peptic ulcer healing drugs

1. Antibiotics

For ulcers caused by H. pylori infection, you will be asked to take two or three antibiotics together with a PPI. There is good evidence that such eradication therapy has benefits both in healing ulcers and preventing recurrence, especially for duodenal ulcer. Commonly used antibiotics are amoxicillin, clarithromycin, metronidazole and tetracycline. They are prescription-only medicines and are available in many dosage forms such as tablets and capsules.

2. Proton pump inhibitors (PPIs)

PPIs directly suppress gastric acid production by blocking the proton pumps of the gastric parietal cell that is responsible for acid secretion, and thereby promoting the ulcer healing. Their effect on suppressing gastric acid production is stronger than that of Histamine-2 receptor antagonists. These include the pharmacy only medicine omeprazole, and the prescription only medicines lansoprazole, rabeprazole, and esomeprazole. They are available in various dosage forms such as tablets, capsules and injections.

3. Histamine-2 receptor antagonists

Histamine-2 receptor antagonists suppress the secretion of gastric acid by blocking the actions of histamine, a protein produced by the body that stimulates gastric acid secretion. Examples include cimetidine, famotidine and ranitidine. They are over-the-counter medicines and are available in forms of tablets, capsules, syrups or injections.

4. Antacids

Antacids cannot heal ulcer, but neutralise existing acid in the stomach, thereby relieving or eliminating the irritation and erosion to the stomach wall and the ulcer sites and provide rapid pain relief. Antacids are normally given between meals and at bedtime when symptoms of gastric hyperacidity usually occur. Common over-the-counter examples are aluminium hydroxide, magnesium trisilicate, calcium carbonate and sodium bicarbonate, and they are taken orally in forms of chewable pills and liquids.

5. Cytoprotective agents

Cytoprotective agents help protect the tissues that line your stomach and small intestine. They include the prescription-only medicines prostaglandin analogues, which inhibit gastric acid secretion by a direct action on the parietal cell and promoting healing of gastric and duodenal ulcers. Misoprostol is one of the examples and is taken orally in form of tablets. Besides, the over-the-counter medicines chelates and complexes also belong to this class. Chelates and complexes coat the ulcer surface by forming an adherent complex with proteins, thus protecting it from further damage by gastric acid and promoting healing. Sucralfate is one of the examples and is available in forms of tablets and suspensions.

Common Side Effects and Precautions of peptic ulcer healing drugs:

General advice on taking peptic ulcer healing drugs

• There are many factors that may affect ulcer healing. Healthy lifestyle and good dietary habits may accelerate ulcer healing.
  
  
• Peptic ulcer healing drugs should preferably be used according to medical directions and patient should adhere to the treatment regimen.
  
  
• For peptic ulcer disease caused by H. pylori infection, testing (preferably urea breath test) should be performed at least 4 weeks after treatment to confirm eradication.
  
  
• Be familiar with the name and dosage of the drugs you are taking. Taking the drugs in accordance with the using instruction on the label or package insert. Be cautious about their possible side effects and if persists, ask doctors for advices.
  
  
• If pain persists despite treatment, discuss with your doctor for other appropriate treatment.
  
  

Communication with your doctor

• Always seek your doctor’s advice on the best treatment option. Your doctor will use the most appropriate drugs after considering your condition and your response to the taken drugs.

• Inform your doctor of your medical history and the drugs you are taking because other drugs may interact with peptic ulcer drugs and some diseases may warrant special precautionary measures.

• Seek medical advice as soon as possible if you experience any serious side effects suspected to be related to your peptic ulcer drugs.

• Don’t manage peptic ulcer disease by self-medication with health products according to the product claims unless advised by healthcare professionals.