- Cite this article as:
- Malfertheiner, P. & Peitz, U. Curr Treat Options Gastro (2000) 3: 171. doi:10.1007/s11938-000-0010-2
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Every duodenal ulcer (DU) associated with H. pylori (HP) infection should be treated with HP eradication therapy. The recommended HP eradication therapy is a short-term triple therapy for 7 or 10 days’ duration, consisting of a protonpump-inhibitor (PPI), or ranitidine bismuth citrate (RBC) and two antibiotics selected among clarithromycin, metronidazole (or tinidazole), and amoxicillin.
If possible, any treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) should be discontinued. If continuation of NSAID treatment is necessary, concomitant therapy with a PPI is necessary.
HP-negative DUs are treated with one oral standard dose of PPI, although some patients will need higher doses to have the DU healed.
Whereas in uncomplicated DU the disappearance of symptoms is a good surrogate marker for DU healing, the healing of bleeding DU must be documented by endoscopy.
The role of surgery is to treat complications of DU, such as perforation or uncontrollable bleeding, not to reduce gastric acid secretion.