Treating Gastric Ulcers: Medications and Management Strategies

If you've been diagnosed with a gastric ulcer through endoscopy, it's highly recommended to test for Helicobacter pylori (H. pylori), a common bacterial infection linked to ulcers. If the test comes back negative, a combination of acid-suppressing medications and mucosal protectants is typically prescribed for 6–8 weeks.

The primary acid-reducing drugs include proton pump inhibitors (PPIs) such as Nexium (esomeprazole), Protonix (pantoprazole), and H2 receptor antagonists like Pepcid (famotidine) or Zantac (ranitidine). These medications help reduce stomach acid production, allowing the ulcer to heal.

In addition to acid suppression, mucosal protective agents play a crucial role in the healing process. Common options include Tuprint (teprenone), Rebamipide, and bismuth-based compounds such as Pepto-Bismol or Gastro-Plus (a colloidal bismuth formulation). Another widely used agent is aluminum magnesium carbonate, which also protects the stomach lining while neutralizing excess acid.

It's important to follow up with a repeat endoscopy after completing the 6–8 week treatment period to confirm that the ulcer has healed properly. In cases where the ulcer does not improve, a biopsy may be necessary to rule out other serious conditions, including gastric cancer.

If H. pylori is detected, a standardized quadruple therapy regimen should be followed to eradicate the bacteria effectively. This usually involves two antibiotics, a bismuth compound, and a PPI taken together for 10–14 days. After completing this course, patients are advised to continue with a PPI and mucosal protectant for another 6–8 weeks to ensure complete healing and prevent recurrence.

Always consult with a gastroenterologist to tailor the treatment plan based on your specific condition and medical history.