This kind of medication neutralises the acid present in the stomach. Frequent dosages are needed, because the neutralising action of the medication is short-lived. Peptic ulcers often return when the use of antacids is discontinued. Antacids that contain magnesium may cause diarrhoea and those containing aluminium may cause constipation.
H2 blockers
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tudies have shown that a protein in the stomach, histamine, stimulates the secretion of gastric acid. Histamine antagonists (H2 blockers such as ranitidine, cimetidine and famotidine) can block this action of histamine on gastric cells and thereby reduce the amount of acid produced. This kind of medication is quite effective in healing peptic ulcers, but unless antibiotics are administered simultaneously, H2 blockers have limited success with eradicating the H. pylori bacteria. Although H2 blockers have few side effects and are well tolerated even when used continuously for a long time, ulcers often return when people stop taking this medication.
Proton pump inhibitors
These drugs are the most potent suppressors of gastric acid secretion. There are five main drugs available – omeprazole, lansoprazole, pantoprazole esomeprazole and rabeprazole. All five are used as part of a regime to eliminate H. pylori and are highly effective. The most frequent side effects are nausea, headaches diarrhoea, flatulance and constipation.
Antibiotics for H. pylori infection
H. pylori bacteria can infect the stomach lining, but this may or may not cause a peptic ulcer. Although H. pylori can be difficult to eradicate completely, treatment with several antibiotics, sometimes in combination with other medications such as H2 blockers or proton pump inhibitors, can be effective. Commonly used antibiotics are amoxycillin clarithromycin or metromedazole. If the bacteria are eliminated completely, this can prevent ulcers from recurring; it may also decrease the risk of developing stomach cancer. It is important for patients to note that treatment with antibiotics does have a risk of causing allergic reactions, diarrhoea and sometimes inflammation of the colon. It can take two to three weeks for infection with H. pylori to clear and may require two to three antibiotics in combination. Some patients find that this regime is difficult to adhere to.
For gastric ulcers a follow-up gastroscope is needed six to eight weeks later to ensure that the ulcer has healed. Further biopsies are needed if healing is not occuring as fast as expected.
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