MedicinesDoctors treat stomach and duodenal ulcers with several types of medicines including H2-blockers, acid pump inhibitors, and mucosal protective agents. When treating H. pylori, these medications are used in combination with antibiotics.
H2-blockers
Currently, most doctors treat ulcers with acid-suppressing drugs known as H2-blockers. These drugs reduce the amount of acid the stomach produces by blocking histamine, a powerful stimulant of acid secretion. H2-blockers reduce pain significantly after several weeks. For the first few days of treatment, doctors often recommend taking an antacid to relieve pain.
H2-blockers that are approved to treat both stomach and duodenal ulcers are:
Cimetidine (Tagamet®)
Ranitidine (Zantac®)
Famotidine (Pepcid®)
Nizatadine (Axid®)Proton Pump Inhibitors
Like H2-blockers, proton pump inhibitors modify the stomach's production of acid. However, proton pump inhibitors more completely block stomach acid production by stopping the stomach's acid pump—the final step of acid secretion. The FDA has approved proton pump inhibitors for short and long-term treatment of ulcer disease.
Proton pump inhibitors that are are approved to treat both stomach and duodenal ulcers are:
Esomeprazole (Nexium®)
Lansoprazole (Prevacid®)
Omeprazole (Prilosec®)
Pantoprazole (Protonix®)
Raberprazole (Aciphex®)Mucosal protective medications
Mucosal protective medications protect the stomach's mucous lining from acid. Unlike H2-blockers and acid pump inhibitors, protective agents do not inhibit the release of acid. These medications shield the stomach's mucous lining from the damage of acid. Two commonly prescribed protective agents are:
Sucralfate (Carafate®). This medication adheres to the ulcer, providing a protective barrier that allows the ulcer to heal and inhibits further damage by stomach acid. Sucralfate is approved for short-term treatment of duodenal ulcers and for maintenance treatment. Misoprostol (Cytotec®). This synthetic prostaglandin, a substance naturally produced by the body, protects the stomach lining by increasing mucus and bicarbonate production and by enhancing blood flow to the stomach. It is approved only for the prevention of NSAID-induced ulcers. Two common non-prescription protective medications are:
Antacids. Antacids can offer temporary relief from ulcer pain by neutralizing stomach acid. They may also have a mucosal protective role. Many brands of antacids are available without prescription.
Bismuth Subsalicylate. Bismuth subsalicylate has both a protective effect and an antibacterial effect against H. pylori. Antibiotics
The discovery of the link between ulcers and H. pylori has resulted in a new treatment option. Now, in addition to treatment aimed at decreasing the production of stomach acid, doctors may prescribe antibiotics for patients with H. pylori. This treatment is a dramatic medical advance because eliminating H. pylori means the ulcer may now heal and most likely will not come back.
