Short- and long-term management of peptic ulcer disease: current role of H2-antagonists.

ABSTRACT

With numerous active agents available to treat peptic ulcer disease both acutely and long-term, this paper reviews various aspects of these agents and their effect on the disease process, reviewing efficacy, compliance, incidence of relapse, side-effect profile, drug interactions and the effect on the natural history of peptic ulcer disease. Helicobacter pylori is obviously a factor in the occurrence of peptic ulcer disease, but with the high prevalence of asymptomatic infection and evidence suggesting that duodenal ulcer disease may be self-limiting, widespread treatment with bismuth and antibiotics may do more harm than good. Maintenance therapy is recommended for the patient with previous bleeding or other complication, the patient with severe symptoms, and the patient with frequent recurrences. Maintenance therapy appears to reduce the complication rate in the patient with previous bleeding and possibly in the patient with uncomplicated disease, although the incidence of complications in this group is quite low.