Treatment for Acid Peptic Disease
Acid Peptic Disease is treated with drugs that reduce acidity and sometimes in addition, with certain antibiotics to eliminate the H pylori causing the infection. Surgery may be needed in cases of complication.(8✔)
A) Diet: Dietary therapy relates to avoidance of spicy and oily foods which increase acid production and are difficult to digest. Avoid tea and coffee, alcohol, aspirin and other NSAIDs, chocolate, tobacco and cigarettes. Meals should preferably be light and at small intervals.
B) Eradication of H.pylori: The three way approach to eradicate H.pylori involves diagnosis, treatment and confirmation of the cure of H.pylori infection. The standard protocol to eradicate H.pylori involves the use of two or three antibiotics (e.g., amoxicillin, tetracycline, clarithromycin, metronidazole) and the use of a proton pump inhibitor (e.g., esomeprazole, omeprazole, lansoprazole, rabeprazole, pantoprazole) with or without a bismuth compound for around 2-3 weeks and repeated if there is recurrence.
C) Avoid NSAIDs or the concurrent use of a prostaglandin analogue (misoprostol) may be prescribed to prevent peptic ulceration due to NSAIDs.
D) The use of antacids or H2 receptor antagonist (H2RAs) such as cimetidine, ranitidine, famotidine, and nizatidine which help in the reduction of gastric acid secretion and in turn increase the gastric pH and reduce the secretion of pepsin.
E) The treatment of peptic ulcer complications includes a blood transfusion for hematemesis and melena, the use of antacids and H2 receptor antagonists for pain, the treatment of peritonitis in case of perforation of peptic ulcer disease.
Maintenance with H2 receptor antagonists is usually effective and relatively safe.
Surgical treatment of ulcer may be indicated for patients with failure to respond to medical line of treatment or with complications such as increased pain, bleeding, obstruction and perforation.
- Kunmam (Acid Peptic Disease) - (https://www.nhp.gov.in/Kunmam-(Acid-Peptic-Disease)_mtl)
- American College of Gastroenterology guideline on the management of Helicobacter pylori infection. - (https://www.ncbi.nlm.nih.gov/pubmed/17608775)
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- Malagelada JR, Kuipers EJ, Blaser MJ. Acid peptic disease: clinical manifestations, diagnosis, treatment, and prognosis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 142.
- Kim YH, Lee JH, Lee SS, et al. (2002). "Long-term stress and Helicobacter pylori infection independently induce gastric mucosal lesions in C57BL/6 mice". Scand. J. Gastroenterol. 37 (11): 1259–64. doi:10.1080/003655202761020515. PMID 12465722.