Treatment of peptic ulcers

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• Avoid food that worsens symptoms

• Stop smoking (slows healing in Gastric, and increases relapse rates in Duodenal)

H. pylori Eradication:

• Triple therapy

Drugs to reduce acid:

• PPI (e.g. lansoprazole 30 mg / 24 hr PO for 4/52 (Duodenal) or 8/52 (Gastric)

• Alternative = H2 Receptor antagonists (H2RA):

• Ranitidine 300 mg PO nocte for 8/52 or

• Cimetidine 800 mg PO nocte for 8/52

NSAID associated ulcers:

• Stop NSAID if possible (if not, use H2RA, PPI or misoprostol for prevention)

• If symptoms persist re-endoscope, re-check for H. pylori and reconsider the differential