Peptic ulcer disease

With proton-pump inhibitor (PPI) therapy, duodenal ulcers typically heal within 4 weeks and gastric ulcers within 8 weeks. EMC: Omeprazole 20 mg gastro-resistant tablets Opens in new window

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.[80]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 nonsteroidal anti-inflammatory drug (NSAID) use, discontinuing the NSAID (and eradicating H pylori if present) will lead to a low rate of ulcer recurrence. In patients who continue using NSAIDs, risk of future upper gastrointestinal bleeding is high, and thus coprescription of a PPI is advisable.[85]Targownik LE, Fisher DA, Saini SD. AGA Clinical practice update on de-prescribing of proton pump inhibitors: expert review. Gastroenterology. 2022 Apr;162(4):1334-42. https://www.gastrojournal.org/article/S0016-5085(21)04083-X/fulltext http://www.ncbi.nlm.nih.gov/pubmed/35183361?tool=bestpractice.com