MEDICAL-MANAGEMENT OF PEPTIC-ULCER DISEASE

Strong advice to stop smoking and careful prescription of nonsteroidal anti-inflammatory drugs remain basic steps in peptic ulcer management . Long-term, low-dose treatment with an H-2-blocker provides effective prophylaxis against recurrent ulceration, but most patients with pept ic ulceration should now be offered treatment to eradicate infection w ith Helicobacter pylori. An H+, K+-APTase inhibitor is the treatment o f choice for a patient with the Zollinger-Ellison syndrome. Treatment of peptic ulceration is usually safe, but there are concerns about inc reased hazards of enteric infection due to decreased gastric acid, and the accelerated development of gastric atrophy during long-term treat ment with omeprazole. Finding an effective and convenient regimen for the eradication of H. pylori remains the major problem in the medical management of peptic ulceration.