| Theme |
Comparison of PPIs and H2RAs in the Actions and Suitable Use for the Diseases |
| Title |
Effectiveness and Use of PPIs or H2RAs in Treatment of Peptic Ulcer Patients, Except for H. pylori Infection Eradication Therapy |
| Author |
Kiyoshi Ashida |
Gastroenterology and Hepatology, Saiseikai Nakatsu Hospital |
| Author |
Takumi Fukuchi |
Gastroenterology and Hepatology, Saiseikai Nakatsu Hospital |
| Author |
Hiroshi Yamashita |
Gastroenterology and Hepatology, Saiseikai Nakatsu Hospital |
| Author |
Masahiro Sakaguchi |
Internal Medicine, Moriguchi Keijinkai Hospital |
| [ Summary ] |
Helicobacter pylori (H. pylori) infections are found in about 95 % of patients with peptic ulcers. We considered the choice of histamin H2 receptor antagonists (H2RAs) or proton pump inhibitors (PPIs) in the treatment of peptic ulcer patients with a high prevalence of H. pylori infection by using twenty four hour intragastric pH monitoring. A good point concerning H2RA is strong acid suppression at night. PPIs are strong and provide lasting acid suppression both night and day. Since the correlation between acid suppression and healing rates for peptic ulcers was clear in many previous reports, PPIs are the drug of first choice from the standpoint of promoting ulcer healing. However, it is necessary to pay attention to the incidence of PPI-resistant ulcers. These represent a small percentage of PPI-resistant ulcers, which appear to result from insufficient inhibition of gastric acidity, with reduced gastric emptying interfering with the absorption of PPIs. Changing the formulation, to intravenous administration or changeing to H2RA absorbable agents are effective approaches in the treatment of patients with PPI-resistant ulcers. |