Peptic ulcer Mx

Q: 38 years old male is admitted to ICU with an upper GI bleed. Upper endoscopy showed active peptic ulcer disease. Proton pump inhibitor (PPI) was initiated. PPIs have higher healing rates in peptic ulcer disease in comparison to H2 receptor antagonists (H2RA)? 

A) True 

B) False 

 

Answer: A

PPIs are found to be superior to H2RA in peptic ulcer disease management. Not only they control symptoms faster but also have a higher healing rate. This is due to their ability to have more potent acid suppression. PPIs continue to keep that advantage in Non-steroidal-anti-inflammatory-drugs (NSAIDs) induced peptic ulcer disease. 

Previously, it was suggested that the combination of PPIs with H2RA will further enhance the management due to their different mechanism of action. This was not found to be true. Solo treatment with PPIs is enough in the treatment of non-H. Pylori peptic ulcer disease.

#GI

Reference:

Yeomans ND, Tulassay Z, Juhász L, et al. A comparison of omeprazole with ranitidine for ulcers associated with nonsteroidal antiinflammatory drugs. Acid Suppression Trial: Ranitidine versus Omeprazole for NSAID-associated Ulcer Treatment (ASTRONAUT) Study Group. N Engl J Med 1998; 338:719.