Introduction to gastric ulcer therapy
The therapy of peptic ulcer is very important, because in addition to a life-threatening stomach bleeding, scarring, but also in chronic inflammation, there is an increased risk of stomach cancer.
Therapy stomach ulcer
Obtain the therapeutic options of a peptic ulcer:
- General measures
- Drug therapy
- Endoscopic measures (mirroring endoscopy)
- Surgical measures
1. general measures
First, the patient should change his or her lifestyle by temporarily abstaining from alcohol, smoking (stomach irritants) and harmful drugs. A special diet is not indicated for a peptic ulcer and according to many studies it is not relevant for peptic ulcer healing. However, it is still recommended to avoid very fatty, spicy and fried food.
- Acid reduction Nowadays, the stomach ulcer is treated with proton pump inhibitors (e.g. omeprazole, Pantoprazole/Pantozol® etc.). Duration of treatment approx. one week.
As the name suggests, the “proton pump” is inhibited in the acid-forming stomach cells (tumour cells) and thus the formation of stomach acid is actively reduced. With a stomach ulcer, which is caused by NSAIDs, one gives proton pump inhibitors even over 4-8 weeks, since the healing rate is worse with these. Other drugs such as H2 blockers and acid binders (antacids), as used in reflux disease (chronic heartburn), are not indicated.
The drug sucralfate can be administered as a supplement to proton pump inhibitor therapy. This drug forms a protective film over the stomach lining and thus over the ulcer.
- Eradication therapy This is a drug combination therapy consisting of a proton pump inhibitor (e.g. : omeprazole 2×20 mg/d) and two different antibiotics (clarithromycin 2x 250 – 500 mgd in combination with amoxicillin 2x 1g/d or metronidazole 2×400 mg/d) for 7-10 days. This kills the bacterium Helicobacter pylori and at the same time brings the ulcer to healing. The success of the therapy is monitored 8 weeks later by a control stomach mirror or a breath test (see above). The therapeutic success rate is 85%.
