Current Treatment Options in Gastroenterology

, Volume 3, Issue 2, pp 171–181

Duodenal ulcer

Authors

  • P. Malfertheiner
    • Department of Gastroenterology, Hepatology and Infectious DiseasesOtto-von-Guericke University Magdeburg, Universitätsplatz 2
  • U. Peitz
    • Department of Gastroenterology, Hepatology and Infectious DiseasesOtto-von-Guericke University Magdeburg, Universitätsplatz 2
Article

DOI: 10.1007/s11938-000-0010-2

Cite this article as:
Malfertheiner, P. & Peitz, U. Curr Treat Options Gastro (2000) 3: 171. doi:10.1007/s11938-000-0010-2

Opinion statement

  • 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.

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© Current Science Inc 2000