| Theme | Controversies in the Drug Therapy of Upper Gastrointestinal Tract Disorders | |
|---|---|---|
| Title | Should H2-RA be the Drug of Choice for Patients with Peptic Ulcers ? | |
| Publish Date | 1999/11 | |
| Author | Takeaki Kobayashi | Department of Internal Medicine, Teine St.Luke's Hospital |
| Author | Tsuyoshi Yahana | Department of Internal Medicine, Doto Hospital |
| [ Summary ] | Recently, a therapeutic strategy for treatment of peptic ulcer disease (PUD) appears to have been established on the following two essential bases. One is acid suppression, the another is eradication therapy for H.pylori (Hp) infection. Thus, in this review article, we examined whether H2 receptor antagonists (H2-RA) were sufficiently useful for PUD in clinical practice. Recently, in addition, therapy for eradication of Hp along with H2-RA instead of proton pump inhibitor (PPI) has been extensively used in many institutions. The high eradication rate for Hp infections treated with a triple therapy, including H2-RA but not PPI, is considered to indicate that PPI alone is not necessarily indispensable to Hp eradication. Although we have no objections at this time to therapies using PPI for patients with PUD, it is thought to be suitable in clinical practice that H2-RA should be chosen first from the many anti-secretory drugs for gastric ulcer treatment, because the majority of gastric ulcers, in particular those located proximally to the stomach do not indicate high acid secretion. |
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