Duodenal ulcer. Who should have long-term maintenance therapy?

Duodenal ulcer frequently recurs in some high-risk patients, particularly those who smoke. Maintenance therapy with H2-receptor antagonists or sucralfate reduces the recurrence rate and appears to be safe over a one-year period. Not all patients with healed duodenal ulcer are candidates for maintenance therapy, however, and selection should be based on evaluation of such risk factors as smoking habits, previous recurrence, and history of complications. Intermittent treatment of acute episodes may be an alternative.