Treatment Options for Duodenal Ulcers

One of the most common gastrointestinal conditions, duodenal ulcers can be effectively managed with a combination of medications and lifestyle adjustments. The primary treatment strategies include acid-suppressing drugs, mucosal protective agents, and, in many cases, eradication of Helicobacter pylori (H. pylori), a bacterium commonly linked to ulcer development.

Acid-Suppressing Medications

Two major types of acid-reducing drugs are widely prescribed for duodenal ulcer treatment: proton pump inhibitors (PPIs) and H2 receptor antagonists. PPIs such as rabeprazole, omeprazole, pantoprazole, and lansoprazole are highly effective in reducing gastric acid secretion, thereby promoting faster healing of the ulcerated tissue. These medications are often preferred for their potency and long-lasting effects.

H2 receptor blockers like famotidine and ranitidine also help reduce stomach acid production, although they are generally less powerful than PPIs. These drugs can provide symptom relief and support the healing process, especially in mild or intermittent cases.

Mucosal Protective Agents

In addition to acid suppression, protecting the lining of the digestive tract is essential for healing. Antacids containing aluminum and magnesium, such as alginate or hydrotalcite, help neutralize stomach acid and bile, reducing irritation and supporting mucosal repair. Other protective agents include bismuth compounds, gefarnate, and rebamipide, which form a protective barrier over the ulcer site and stimulate tissue regeneration.

H. Pylori Eradication Therapy

Testing for H. pylori infection is strongly recommended for all patients diagnosed with duodenal ulcers. Research indicates that the majority of these ulcers are caused by this bacterial infection. If the test comes back positive, a targeted eradication regimen is typically initiated.

Standard Treatment Protocol

The most commonly used approach for H. pylori eradication is quadruple therapy, which combines a proton pump inhibitor, a bismuth compound, and two different antibiotics. The choice of antibiotics may vary based on regional resistance patterns, patient allergy history, and prior antibiotic use. Tailoring the treatment to each individual's medical profile increases the likelihood of successful eradication and long-term healing.

Adherence to the prescribed regimen and follow-up testing after treatment are crucial to ensure complete elimination of the bacteria and prevent recurrence of ulcers.