Peptic ulcer disease

With proton-pump inhibitor (PPI) therapy, duodenal ulcers typically heal within 4 weeks and gastric ulcers within 8 weeks.[126]​​​​​Dexcel Pharma Ltd. Summary of product characteristics: omeprazole 20 mg gastro-resistant tablets. March 2023 [internet publication]. https://www.medicines.org.uk/emc/product/663/smpc/print#gref

For patients with peptic ulcers caused by Helicobacter pylori, the prognosis post H pylori eradication is good: the rate of recurrence of a duodenal ulcer is reduced from approximately 64% without treatment to approximately 14% with eradication therapy, and the rate of recurrence of a gastric ulcer is reduced from approximately 52% without treatment to approximately 15% with eradication therapy.[84]Ford AC, Gurusamy KS, Delaney B, et al. Eradication therapy for peptic ulcer disease in Helicobacter pylori-positive people. Cochrane Database Syst Rev. 2016;(4):CD003840. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003840.pub5/full http://www.ncbi.nlm.nih.gov/pubmed/27092708?tool=bestpractice.com  H pylori eradication is also beneficial in those with complicated ulcer disease. 

For ulcers associated with use of non-steroidal anti-inflammatory drugs (NSAIDs), discontinuing the NSAID (and eradicating H pylori if present) will lead to a low rate of ulcer recurrence. In patients who continue using NSAIDs, ulcer recurrence is high, and thus coprescription of a PPI is advisable.