What medicine to take for gastric ulcer, common drug treatment

Some patients with gastric ulcer have no symptoms, while others will have repeated attacks and experience stomach pain and weight loss, especially the pain is more obvious after eating. The most common treatment for gastric ulcer is drug therapy. It is necessary to take the medicine on time and lead a regular life.

(1) Drugs that enhance mucosal resistance : It has been shown that carbenoxolone can accelerate the healing of ulcers in outpatient gastric ulcer patients, but its application is limited because it has the side effects of licorice similar to aldosterone (sodium retention, hypertension, hypokalemia). Its mode of action may be related to increasing the production, secretion and viscosity of gastric mucus, inhibiting the activity of pepsin and prolonging the life of gastric mucosal cells. Animal experiments on dogs have shown that carbenoxolone can also greatly reduce the damage of bile to the gastric mucosa. Similar results were obtained in animal experiments with deglycyrrhizinated licorice preparations. Although clinical trials have shown that this preparation is not as effective as carbenoxolone, it has the advantage of fewer side effects. Colloidal bismuth subcitrate, sucralfate, and zinc acetamol are three other drugs that enhance mucosal resistance and have been shown to be as effective as histamine H2 receptor antagonists in healing gastric ulcers. The combination of teprenone and histamine H2 receptor antagonists can not only accelerate the healing of gastric ulcers, but also improve the quality of ulcer healing.

(2) Cholestyramine: Cholestyramine can bind to bile acids, so in theory it can reduce the damage of bile acids to the gastric mucosa and accelerate the healing of gastric ulcers. A controlled trial study showed that it did not affect the rate of ulcer healing, but the average ulcer shrinkage rate was higher in patients using cholestyramine. This preparation is also used in patients with bile reflux gastritis and esophagitis after gastric surgery and has a certain effect. Theoretically, the reason why this preparation is not effective may be that bile remains in the stomach for most of the day and night, while the drug stays in the stomach for a very short time. In addition, at around pH 2, the ability of cholestyramine to bind bile acids is also significantly reduced.

(3) Histamine receptor antagonists : Histamine H2 receptor antagonists synthesized in recent years can inhibit acid secretion and play an increasingly important role in the treatment of peptic ulcer disease. However, it is not as effective in treating gastric ulcer disease as it is in treating duodenal ulcer disease. Therefore, when treating gastric ulcer, the medication time should be slightly longer than that of treating duodenal ulcer. Rees et al. demonstrated that the combined use of histamine H1 receptor and H2 receptor antagonists can protect the dog's gastric mucosa from bile damage. This result suggests that mucosal damage accompanied by increased ion permeability is mediated by histamine. The findings also suggest that histamine H1 receptor blockers may have therapeutic effects in humans. However, the side effects of current histamine H1 receptor blockers limit their high-dose application.