Medicinal Therapy for Gastric Ulcer

Antacids

The main function of antacids is to neutralize gastric acid, which is used to lift aches in patients and are mostly made from compounds containing aluminum, magnesium or aluminum magnesium.

The disadvantages of antacids are low effect and short-period of effect, which needs to be taken frequently. Additionally, excess magnesium ions could cause diarrhea while excess aluminum ions could cause constipation. Hence the aluminum magnesium compounding preparation can offset the side effects of each other.

Mucosal Protective Agent

The agents include colloidal bismuth or organic aluminum chloride compound preparation.

• Colloidal Bismuth)
• The agent can cover the ulcer surface to form gel-type protective layer to prevent the invasion of gastric acid.
• The agent has good sterilizing effect on helicobacter pylori and can significant lower the recurrence rate after the ulcer is healed, if the helicobacter pylori can be eradicated concurrently.
• Sucralfate
• Carafate, also known as sucralfate and BENACTYZINE, is one organic aluminum chloride compound containing fructose, which can connect with the proteins from the necrotic debris of the ulcer and selectively cover the ulcer surface. It is generally advised to take the sucralfate one hour before meal or sleep, so the ulcer may recover without the stimulation of gastric acid and digestive fluid.

Medicine for Parietal Cells

• H2-receptor antagonists (known as H2-blocker) include Zantac (ranitidine), Tagamet (cimetidine), and Gaster (famotidine).
• This medicine works for the H2 receptors on parietal cells, which comes with strong and more-lasting effect in inhibiting the secretion of gastric acid. The medicine has fast effect on the ache and healing of ulcer as well as can eradicate helicobacter pylori early.
• The patients can r each healing rate between 85%~90% through 8-week consecutive therapy. The disadvantage is that the ulcer recurrence rate is very high and 70%~80% of patients may likely to recur in one year if patients have not been given continuous therapy.

Proton-pump inhibitor (PPI)

• PPI includes Losec (omeprazole ), Takepron ( lansoprazole ), Nexium ( esomeprazole ), Pantoprazole, and Dexilant (deslansoprazole).
• PPI inhibits the secretion of gastric acid caused by any stimulating message, which effect is stronger and more lasting than H2 antagonists, with a accomplish rate of ulcer healing by taking medicines for 4 weeks, is nearly 90%.
• PPI also has good effect on the ulcer difficult to be healed by H2 antagonists.

Prostaglandin-Synthesis Agent

• Cytotec (Misoprostol) inhibits the synthesis of cyclic AMP to accomplish the effect of lowering secretion of gastric acid. Particularly patients using non-steroid anti-inflammatory analgesics over the long run can take prostaglandin-synthesis agent to protect the stomach gastric mucosa.

Potent Potassium-competitive Acid Blockers(P-CAB)

• Recently, there is a new type of therapeutic weapon, the potassium ion-competitive gastric acid inhibitor (P-CAB), which is less affected by meal time (not metabolized by CYP2C19) than the proton pump inhibitor (PPI), and can faster to achieve the function of inhibiting gastric acid secretion.

Triple Therapy or Quadruple Therapy for Helicobacter Pylori

• Triple Therapy: Apply ulcer treatment medicine-Proton-pump inhibitor (PPI) plus two or more antibodies (e.g. Amoxicillin, Clarithromycin or Metronidazole) to a therapy period of 1~2 weeks to effectively eradicate helicobacter pylori.
• Quadruple Therapy: Apply ulcer treatment medicine (e.g. Colloidal bismuth, Proton-pump inhibitor) plus two or more antibodies (e.g. Amoxicillin, Clarithromycin or Metronidazole) to a therapy period of 1~2 weeks to effectively eradicate helicobacter pylori.
• Also, there are Sequential Therapy, Hybrid therapy and Reverse hydrid therapy with different prescription of high-dose dual therapy. The doctors will prescribe according to the different conditions.
• Patients should avoid food likely to increase gastric acid such as coffee, sweet food or acid food during therapy, in order to enhance the eradication of helicobacter pylori.