A variety of options are available for the medical treatment of peptic ulcer disease, including antacids, histamine2 receptor antagonists, omeprazole, prostaglandin analogues, and sucralfate and bismuth formulations. Seventy percent to 90% of peptic duodenal and gastric ulcers will heal after 4 to 8 weeks of therapy. Combination regimens using these agents have not been demonstated to be superior to singleagent therapy. Aggressive acid suppression with "highdose" histamine2 receptor antagonists or omeprazole accelerates healing of ordinary ulcers and promotes healing of previously refractory ulcers. Although ulcer recurrence is diminished by continuous "maintenance" therapy with the aforementioned agents, recurrence seems to be dramatically suppressed after eradication of Helicobacter pylori from the gastroduodenal mucosa.
(Arch Intern Med. 1992;152:726-732)