Medical and surgical prophylaxis for duodenal ulcer, the role of sucralfate.

The risk of recurrent duodenal ulcer is high, 70-80% of duodenal ulcer patients having a recurrence during the first year after initial healing. Surgery has so far been the main method for preventing a relapse, but recent studies have shown that it is possible to reduce the risk and the need for surgery with medical maintenance therapy. Five controlled studies are available on the efficacy of sucralfate in prophylaxis for duodenal ulcer. 294 patients participated, 154 having received sucralfate treatment, usually 1 g twice daily. The summarized results indicate that initially healed duodenal ulcers recurred in six months in 60% of cases and in 12 months in 79% of cases in groups receiving placebo therapy or no treatment, the corresponding figures in the groups treated with sucralfate being 21% and 31%. The choice between surgical and medical prophylaxis is discussed, and more liberal use of medical prophylaxis is advocated.