Treating duodenal ulcer: antacids or cimetidine?

Patients with symptomatic duodenal ulcer can be effectively treated with antacids or cimetidine. Many patients with a first episode or an occasional flare-up of ulcer disease should be treated with antacids. Cimetidine should be added if the response is unsatisfactory. Cimetidine should be used initially in patients with severe ulcer diathesis and in those with conditions such as diarrheal disease or chronic renal failure that predispose to troublesome side effects from antacids. For most patients, chronic cimetidine therapy after healing of the ulcer is not warranted. Exceptions are those with severe and complicated disease.