Several classes of drugs are commonly used in the treatment of peptic ulcers

Article written by Pharmacist Huynh Xuan Loc - Faculty of Pharmacy - Vinmec Central Park International General Hospital

Stomach ulcer is a disease manifested by erosions, ulcers on the stomach lining causing discomfort, hangover or stomach pain. In some cases, these sores will go away on their own, but the disease can come back again and again. Most people need treatment to reduce discomfort, heal ulcers, and prevent complications.
2. What causes stomach ulcers? Ulcers are caused by digestive acids eroding the lining of the stomach. This is due to an excess of stomach acid or damage to the protective lining of the stomach, making the lining of the stomach more vulnerable. Two main causes of stomach ulcers include:
Infection with Helicobacter pylori: This is a strain of bacteria that is able to grow in the acidic environment of the stomach. H. pylori increases the amount of acid secreted from the stomach, causing inflammation of the surface mucosa and destruction of the protective membrane of the stomach; These contribute in the formation of ulcers. H. pylori persists in the body if not treated effectively and increases the risk of serious complications on the gastrointestinal tract, even stomach cancer. Inappropriate use of non-steroidal anti-inflammatory drugs (NSAIDs): As a commonly used analgesic and anti-inflammatory drug, NSAIDs can cause stomach ulcers, especially when used in high doses for a long time. NSAIDs change the structure of the protective membrane of the gastrointestinal tract and lead to ulcers. Risk factors for stomach ulcers or aggravation of the disease are smoking habits, drinking alcohol, frequent consumption of indigestible foods and drinks (sour, hot, spicy, greasy)... , due to genetic factors or other stressors and psychological pressures.

Patients need to visit a medical facility to determine the cause and condition of the disease, thereby finding an effective treatment for stomach ulcers.
If H. pylori is diagnosed, your doctor may prescribe a course of antibiotics in combination with other drugs to eradicate the bacteria. In the case of ulcers without H. pylori, medications that help relieve symptoms and heal ulcers will be used. These drugs include gastric acid-blocking, acid-neutralizing, or ulcer-covering agents that are indicated depending on the condition.

Stomach acid antagonists include 2 main groups: Histamine-2 receptor antagonists (H2RA) and proton pump inhibitors (PPIs). Although the mechanism of action is different, both groups help reduce the production of stomach acid, reduce symptoms of pain, burning, discomfort and help heal ulcers.
Some common H2RA drugs such as cimetidine, ranitidine, famotidine ... are used in cases of simple stomach ulcers, few symptoms or help reduce acid secretion during sleep. The drug is well absorbed after oral administration and suppresses acid secretion through inhibition of H2 receptors at gastric parietal cells.
Proton pump inhibitors (PPIs) with common names such as omeprazole, esomeprazol, pantoprazol ... are the most used drugs and help effectively treat stomach ulcers. The drug is also combined with antibiotics in the eradication of H. pylori. PPIs inhibit gastric acid secretion through proton pump blocking at gastric parietal cells, which helps to quickly reduce uncomfortable symptoms and has a high healing effect on ulcers. PPIs are also used together with NSAIDs to prevent stomach ulcers.

As the name suggests, this group of drugs helps neutralize stomach acid and relieve symptoms of burning pain. Medicines often have ingredients such as magnesium trisilicate, aluminum hydroxide, calcium carbonate ... which help in the treatment of stomach ulcers as well as digestive disorders and gastroesophageal reflux disease. However, the drug does not help treat the underlying cause of the disease and therefore should not be used long-term without consulting a doctor. The abuse of drugs can cause the patient to ignore the symptoms, causing the disease to progress silently and uncontrollably. Depending on the type of drug will have different side effects such as diarrhea, constipation, bloating, or nausea, but in general, antacids are safe and do not cause serious side effects.
6. Drugs that cover the ulcer, protect the stomach Sucralfate is a drug that covers the ulcer often used in the treatment of stomach ulcers. When entering the body, the drug forms a complex that binds with positively charged (+) proteins in the secretions to form a mucus compound that covers and protects the gastric mucosa. As a result, the drug prevents mucosal damage and heals ulcers.
7. What do antibiotics do? Antibiotics in the treatment of peptic ulcers are used to eradicate Helicobacter pylori bacteria. Successful eradication of this bacteria helps to completely treat, prevent bad progression and prevent recurrence of stomach ulcers. Depending on the medical history and tolerability, the doctor may choose different antibiotics such as amoxicillin, clarithromycin, tetracycline, metronidazole .... However, to increase the success rate, the course of eradication of H. pylori requires a combination of two or more antibiotics. The use of antibiotics needs to follow the instructions and requirements of the treating doctor, the patient is not allowed to self-administer the drug.

To effectively treat stomach ulcers, patients need to visit medical facilities to choose the most suitable course. Patients can sometimes use over-the-counter medications such as acid-neutralizing drugs to relieve symptoms, but should not be subjective and should seek medical attention if the disease does not improve or progress.
Take medication as prescribed and complete the course prescribed by the doctor. Stopping drugs midway or forgetting doses, skipping doses, especially antibiotics can reduce the effectiveness of treatment, leading to treatment failure or endless recurrence of the disease.
Inform the doctor about the drugs the patient is taking, including other functional foods and supplements to avoid adverse interactions. The use of drugs before meals, after meals without the guidance of doctors, pharmacists can also change the effectiveness of treatment.
Pay attention to monitor the progress of the disease while taking the drug and go to the doctor immediately if dangerous symptoms appear such as abdominal cramps, vomiting, vomiting blood, black stools, weakness... It may be a sign of gastrointestinal bleeding complications that need to be treated promptly.
Pay attention to monitor the side effects of the drug as advised by the doctor, pharmacist or carefully read the drug instruction leaflet before use. Some drugs containing bismuth cause black stools, which should be carefully distinguished from black stools caused by gastrointestinal bleeding (accompanied by symptoms of abdominal cramps, vomiting ...).
Avoid using sour, hot spicy foods or hard, greasy foods that cause indigestion and bloating during treatment. Patients should also avoid alcohol as much as possible to increase the effectiveness of treatment and also because it can cause harmful interactions (palpitations, flushing, vomiting ...) with some antibiotics. like metronidazole, tinidazol ...

Follow the advice of your doctor, pharmacist on lifestyle changes, reducing bad habits such as avoiding alcohol, reducing smoking, eating healthy foods, lots of vegetables, fruits, rich in fiber ... It also helps control and avoid recurrence of the disease.
Diseases of the stomach account for about 26%, having the highest incidence of diseases of the gastrointestinal tract. Faced with the urgent situation for public health, the Pharmacy Center - VINMEC Health System has conducted in-depth research to come up with a SUPPORT PACKAGE TREATMENT OF Stomach Ulcers including functional foods to help prevent and comprehensive treatment support:
Bao Vi dan: Support to protect the stomach lining, reduce symptoms caused by stomach and duodenal ulcers, help improve digestion Smebiocta: Supplement beneficial bacteria for the digestive system Chemical used to treat symptoms of abdominal distension, bloating, irritable bowel syndrome using the Product Packages of Functional Foods at the Pharmacy Center - Vinmec Health System?
The product packages are designed according to medical standards, ensuring safety and bringing comprehensive treatment effects to customers Each product in the package is strictly and accurately controlled by input quality, have a mutual effect. Dosage and route of oral administration are designed to ensure just enough to maximize the effect, on the other hand, do not cause excess/deficiency or chemical reactions in the products together. Get advice from a pharmacist and support from a well-trained, highly qualified doctor if the need arises during use, but also detailed and scientific instructions on how to take it as well as the dose. Quantity per meal Dedicated and attentive staff, pharmacists, and doctors always put the health of customers first

References:
UptoDate, Antiulcer medications: Mechanism of action, pharmacology, and side effects , https://www.uptodate.com/contents/antiulcer-medications-mechanism-of-action-pharmacology-and-side-effects Healthline, Stomach Ulcers and What You Can Do About Them, https://www.healthline.com/health/stomach-ulcer
prevention NHS, Stomach ulcer, https://www.nhs.uk/conditions/stomach-ulcer/