Uncomplicated peptic ulcer disease. An overview of formation and treatment principles.

The end point in peptic ulcer disease is a crater in the mucosa. The cause of gastric ulcers seems to be the breakdown of defensive factors, which then allows damage from endogenous and/or exogenous aggressive factors. Aggressive factors are more important in duodenal ulcer formation. Treatment options discussed herein have similar clinical effectiveness, and all have better results than placebo. Selection of a specific agent should be individualized. Helicobacter pylori infection has been implicated in both gastric and duodenal ulcer formation, and use of triple-drug therapy to eradicate or suppress the organism has decreased recurrence rates when maintenance therapy is not used. However, first-line treatment in acute peptic ulcer disease remains the use of antacids, sucralfate (Carafate), or histamine2 receptor antagonists. This approach to therapy is inexpensive, safe, and effective.