Topically active drugs in the treatment of peptic ulcers. Focus on colloidal bismuth subcitrate and sucralfate.

Topically active agents (i.e., colloidal bismuth subcitrate and sucralfate) have proved to be effective in promoting the healing of both gastric and duodenal ulcers and in relieving ulcer symptoms. Sucralfate alone has also been shown to maintain peptic ulcers in remission when taken continuously for a long period of time, whereas successful short-term therapy with bismuth subcitrate is associated with a more prolonged remission of duodenal ulcer disease when compared to H2 blockers. The antiulcer efficacy of these agents is partially counteracted by the need for multiple daily administrations, which requires greater patient compliance than with H2 antagonists. A specific subgroup of patients who might particularly benefit from these drugs are those with duodenal ulcer resistant to H2 blockers, whereas chronic nonsteroidal antiinflammatory drug users with peptic ulcer respond to therapy with site-protective agents as well as to antisecretory drugs.