Therapeutic approach to peptic ulcer relapse

Abstract

The ideal aim of ulcer treatment is to avoid relapse. However, to date it has only been possible to reduce the annual number of relapses following maintenance therapy using different drugs. All prolonged treatments using drugs at doses usually below those used in treating acute outbreaks have shown statistically significant differences in the number of resulting relapses when compared with placebo trials. Reports comparing the results obtained with the different drugs available are contradictory. However, at present the H2 antagonists agents constitute the treatment of choice in preventing relapse, in view of their easy administration and single nocturnal dose requirements. Moreover, there are monitored groups of patients with over five years administration of these drugs, with results being satisfactory and secondary effects very few. Elective surgery to counter relapse is currently less common in cases of uncomplicated ulcers, as the less aggressive and more functional forms of surgery lead to an important percentage of relapse that tends to increase with time. Because of discomfort to the patient, little experience has been accumulated on the administration of associated drugs. In the future, the ideal drug will not only exhibit antisecretory activity, but will also protect the gastric mucosa and prevent ulcer relapse once administration is discontinued.