Medicines to treat ulcers of the stomach and esophagus

Drugs to treat peptic ulcers are increasingly effective, helping patients limit the risk of having to be treated with surgery (surgery). Special drugs against gastric and esophageal ulcers can be classified into the following groups.

These drugs have the effect of neutralizing the H ion of HCl, helping the pH to rise to 3, changing the acidity (potential to cause ulcers) while the pH does not change much (also known as buffering capacity). There are 2 types of commonly used antacids:
Anionic (-) anionic antacids: They have a fast, strong neutralizing effect but have no buffering capacity. Currently, this group of drugs is rarely used in cases of acute inflammation or stomach dysfunction, only used for 1-2 days; Cationic (+) ionic antacids: These drugs all have good buffering capacity. Some drugs are: Maalox, Polisilane gel, Phosphalugel, Gastevin, Barudon,... This drug needs to be taken several times a day to be able to maintain the pH level always above 3 - 3.5, taken after eating (no Take before eating because it will have the opposite effect). These drugs work by preventing the body from absorbing other drugs. So, if you need to take another medicine, you need to take it at least 2 hours after taking the antacid.

Cimetidine (Cimet or Tagamet) was put into use in 1978. Up to now, there have been many generations of drugs in this group with gradually stronger effects, fewer side effects over the next generations, so the dose is also less. .
How to use drugs to treat stomach ulcers of this group as follows:
Cimetidine: The dose range is 400 - 800mg, the drug form is 200mg - 300mg - 400mg tablets or 300mg/2ml injection. The way to use the drug is to take it once a day in the afternoon, it is better to take it several times; Ranitidine: The dose range is 150 - 300mg, the drug form is 150mg - 300mg tablet or 50mg/2ml injection. The way to use the drug is to take it once a day in the afternoon; Nizatidine : The dose range is 20 - 40mg, the drug form is 10mg - 20mg - 30mg tablets or 50mg/2ml injection. The way to use the drug is to take it once a day in the afternoon; Famotidine (Servipep, Quamatel): The dose range is 30-40mg, the drug form is 20mg - 40mg tablets. The way to use the drug is to take it once a day in the afternoon; Note: The above drugs, in addition to the treatment of peptic ulcers, are also used to treat reflux, increase acid or prevent recurrent ulcers.

This group of drugs for the treatment of esophageal and gastric ulcers has the ability to adhere to gastric mucus into a membrane that covers the gastric mucosa and the bottom of the ulcer. It also has a neutralizing effect on stomach acid but is weaker than antacids.
The drugs in this group are:
Silicate Al (Kaolin, Smecta), Silicate Mg (Gastropulgite), Bismuth (Subcitrate Bismuth or CBS): Has the effect of creating a coating and killing Helicobacter Pylori bacteria. Dosage is: 120mg/time x 4 times/day, used for 30 days and then stopped; Sucralfate (Ulcer, Sucrate gel, Keal, Sucrabest,...): Able to bind to proteins of gastric mucus very firmly, not destroyed by bile, preventing the risk of reabsorption of H+ ions and gastric irritation prostaglandin production. Dosage is 1g/time x 3-4 times/day, used before meals; Prostaglandins: Use only prostaglandins E1 and E2. Their effects are: Preventing gastric acid secretion, stimulating gastric mucus and bicarbonate secretion, improving blood flow to the stomach. This drug is less used to treat peptic ulcers, but mainly used to prevent peptic ulcers when using non-steroidal anti-inflammatory drugs or aspirin. The brand names are Enprostol and Misoprostol. Dosage is 200mg/time x 4 times/day or 400mg/time x 2 times/day, taken with food and before sleeping.

These drugs have the effect of inhibiting the enzyme H + / K + ATPase, causing cells not to pump H + out (ie, not secrete HCl). This group has many different brand names with the following usage:
Lansoprazole: The dose range is 15mg - 30mg, the drug form is 15mg - 30mg capsules. How to use is to drink 1 time / day, use 4-6 weeks; Omeprazole: The dose range is 20mg - 40mg, the drug form is 20mg - 40mg capsule or 40mg injection/tube. How to use is 1 time / day, use 4-6 weeks (children over 1 year old use 1mg/kg, not more than 20mg/day). With injection drugs, slow injection 5 minutes, not more than 4ml/min; Pantoprazole : The dose range is 40mg, the drug form is 40mg / tube or 20mg - 40mg capsule. The way to use is slow IV injection: 2 - 3 minutes or take 1 time / day, used within 4 - 8 weeks; Rabeprazole: The dose range is 20mg, the drug form is 10mg - 20mg tablets. How to use is to drink 1 time / day, use within 4 - 8 weeks; Esomeprazole: The dose range is 20mg - 40mg, the drug form is 20mg - 40mg tablets. How to use is to take 1 time / day, use within 4 - 8 weeks. Note: In addition to anti-ulcer effect, the above drugs also work to treat gastroesophageal reflux disease, kill Helicobacter Pylori bacteria (when combined with some other drugs).

5.1 Mucosta or Rebamipide These drugs have the effect of stimulating the gastric mucosa to secrete Prostaglandin, improving the quality of gastric mucus (by increasing the Glycoprotein composition, inhibiting the adhesion of Helicobacter pylori bacteria to the mucosa). gastric mucosa, inhibiting Cytokine-producing neutrophils,...). As a result, it helps to heal ulcers, prevent recurrence of ulcers and reduce inflammatory symptoms of acute gastritis episodes, and prevent peptic ulcers caused by non-steroidal anti-inflammatory drugs.
These drugs can be used alone or in combination with H2 inhibitors or coating agents, antacids. Dosage is 100mg tablets x 3 times / day, almost no side effects.
5.2. Selbex drug Selbex drug (containing Teprenone) works to stimulate the stomach to secrete mucus. This drug is used in combination with other drugs, to help increase the rate of scar healing and help heal faster, reduce the rate of recurrence of peptic ulcer and reduce damage in case of acute gastritis.
Dosage: Tablets 50mg x 3 times/day after meals. The drug also has very few side effects. However, do not use the drug for children and pregnant women because there is not enough information on the effects of the drug on these subjects.
Above is basic information about drugs to treat peptic ulcers. However, patients should pay attention, if there are signs of stomach ulcer disease, oesophagitis, they need to see a doctor to be prescribed the exact dose and duration of treatment by a doctor. Patients absolutely do not use the drug without consulting a doctor to avoid encountering unwanted effects.