Triple Therapy for Gastric Ulcers Explained

Gastric ulcers can be effectively treated with a medical approach known as triple therapy. This treatment regimen typically consists of one proton pump inhibitor (PPI) and two different antibiotics. The PPI helps reduce stomach acid production, allowing the ulcer to heal, while the antibiotics target and eliminate harmful bacteria that may be contributing to the ulcer's development.

Commonly prescribed proton pump inhibitors include esomeprazole enteric-coated tablets, rabeprazole enteric-coated capsules, and lansoprazole orally disintegrating tablets. These medications are essential in creating an environment conducive to healing by significantly lowering gastric acid levels.

When it comes to antibiotic choices, several options are available depending on patient factors and regional resistance patterns. Frequently used antibiotics include amoxicillin, clarithromycin, metronidazole, and furazolidone, though alternatives like tetracycline or levofloxacin might be considered when necessary. It's important to note that certain antibiotics such as amoxicillin, furazolidone, and tetracycline tend to have lower resistance rates in many regions.

The primary purpose of triple therapy is the eradication of Helicobacter pylori (H. pylori), a bacterium commonly associated with peptic ulcer disease. When a gastric ulcer is accompanied by an H. pylori infection, implementing this three-drug combination can successfully eliminate the bacteria and promote ulcer healing.

This standard triple therapy includes one proton pump inhibitor paired with two antibiotics, taken together over a specific treatment period as directed by a healthcare provider. While triple therapy remains effective in many cases, quadruple therapy has become increasingly popular both internationally and within China for H. pylori eradication. This enhanced regimen builds upon the triple therapy foundation by adding a gastroprotective agent such as bismuth subsalicylate (often referred to as Pepto-Bismol) or potassium citrate bismuth, which helps protect the stomach lining while the ulcer heals.