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Management of peptic ulcer
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Management of peptic ulcer
The goals of management are to control any active bleeding, to heal the ulcer and prevent its recurrence. Initial management strategies are guided by the patient’s clinical condition and endoscopic findings. Thus, treatment may consist of endoscopic and medical therapy and at times, surgery.1

In order to facilitate healing and to decrease the risk for recurrence of PUD, H. pylori should be eradicated. Patients should receive antisecretory therapy, preferably with a proton pump inhibitor (PPI) for 4 weeks. Endoscopy should be performed in patients with persistent symptoms. Surgery is recommended in the presence of complications or when the ulcer is refractory to pharmacotherapy. The most common indication for surgery is bleeding. Rarely, complications such as perforation and gastric outlet obstruction may occur.

Patients negative for H. pylori infection should receive an empiric trial of acid suppression for 4–8 weeks and if beneficial it can be continued. Along with medications, lifestyle modifications are an important subset of management. Elimination or modification of PUD risk factors reduces the risk of ulcer recurrence.


Written by: Healthplus24 team
Date: Dec30th,08

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References 
  1. Holtmann G, Howden CW. Review article: Management of peptic ulcer bleeding-the roles of proton pump inhibitors and Helicobacter pylori eradication. Aliment Pharmacol Ther. 2004; 19(Suppl 1): 66–70.
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