Acid Peptic Disease

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Treatment Of Uncomplicated Duodenal And Gastric Ulcers:

(See Table-2)

Conservative management:

Chronic gastric ulcer:

1. H2 Receptor blockers - Ranitidine See Algorithm.

2. Avoidance of aspirin, NSAIDS, alcohol and smoking.

3. Six weeks after starting the treatment - Healing should be obtained.

4. No evidence of Healing - Four quadrant endoscopic biopsy.

5. If ulcer persists - H.pylori positive - Treat for H.pylori (Table-3) 2 weeks.

6. Surgery is indicated if this treatment fails.

Chronic duodenal ulcer:

1. Antacids (Table -2).

2. H2 Receptor blockers.

3. Proton pump inhibitors.

4. Avoidance of irritants.

Surgery : Indications for operation:

1. Intractable pain / frequent loss of work / recurrence of pain.

2. Complications.

3. Ulcer present for 5 years are unlikely to heal.

4. Suspicion of malignancy.

Table-3: Regimens for H. pylori:

Bismuth Metro Tetra Omeprazole Clarithro Amoxi Duration Cure nidazole cycline mycin cillin

2 Tabs 250 mg 500 mg - - - 1-2 88% AC & AC & AC & weeks

HS HS HS.

2 Tabs 250 mg 500 mg 20 mg BID - - 1 week 94-

AC & AC & AC & 98% HS HS HS.

2 Tabs 250 mg - - - 500 mg 2 80- AC & AC & AC & HS weeks 86%.

HS HS.

- 500 mg bid - 20 mg BID 500 mg BID - 1 week 87- 91%.

- - - 20 mg BID 500 mg BID 1 g BID 1 week 86-

91%*.

- 500 mg bid - 20 mg BID - 1 g BID 2 weeks 77- 83%.

* Slightly higher with 2 weeks of therapy.

Operations for gastric ulcer:

Classic operation is Billroth I partial gastrectomy.

Other procedures are Billroth II gastrectomy / Vagotomy & Pyloroplasty but these two have a high chance of missing ulcer cancer.

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jungle 

I am suffering from acid peptic disease as the doctor told me and I want to try this lemon water drink in empty stomach in early morning before I have my breakfast. Does this drink worsen my disease as I read that lemon inside the body is alkaline not acid. Thank you.

sivakumar99 

useful information

nikkay_28 

i am suffering a stomach ache and the doctor told me that i have acid peptic deasease. what kind of food should i take? thank you so much nikki from philippines

LaltuSarkar 

i want to feel 1.5 years suffer burning in my stomuch but it is not right. i check endoscopy. answare is amtal gastritis/duodenal erosions. also biopsy that report is "Mild chronic antral gastritis, negative for H-pylori, gastric antral(endoscopic)biopsy." it is hapend 6 month ago. medicin doctor has been given nekfiune,zentel, nultivite gold. for 2 month but it is not work properly

jforkner_013 

hi i've just been diagnosed with acid peptic disease and i was wondering what we can and cannot eat

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