Treatment of duodenal ulcers: An update

Aim: To assess current practice in duodenal ulcer therapy. Method: Survey of recent studies. Inhibition of acid secretion: Profound and long-lasting inhibition of acid secretion can be obtained with proton pump-inhibiting drugs while a temporary suppression of gastric secretion can be obtained with the H₂-receptor antagonists. There are both advantages and disadvantages in pronounced acid inhibition in the short- and long-term treatment of duodenal ulcers, particularly with regard to long-term safety. Need to eradicate Helicobacter pylori: The contribution made by H. pylori to the etiology and pathogenesis of duodenal ulcers needs further clarification, but it seems clear that eradication of the organism dramatically reduces the ulcer relapse rate. There is no general agreement about the drugs required to eradicate this bacterium because a number of side effects have been reported and compliance may be low.