John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
Acid pump inhibitors are even stronger than H2 blockers.
They work by stopping the "pump" that secretes acid into the stomach.
They are being used increasingly in triple and double regimens for infection.
Protective agents: These drugs do not affect the amount of acid in the stomach; instead, they protect the mucous lining of the stomach from acid.
One type is very thick and sticks to the ulcer, forming a physical barrier between the ulcer and the acid. An example is
The other type increases the amount of mucus, which forms a physical barrier, and
bicarbonate, which helps neutralize the acid. An example is
misoprostol (Cytotec); this agent is used only for treatment of ulcers caused by medication.
Antacids and products containing bismuth subsalicylate (such as Pepto-Bismol) also have protective effects.
Antibiotics: As part of a combination regimen, antibiotics eradicate H pylori, the bacteria that causes ulcers in many people.
A 2 week triple therapy that includes two antibiotics and bismuth subsalicylate is the most effective regimen. It eliminates the bacteria and prevents recurrence of ulcers in 90% of people who receive this treatment. Unfortunately, triple therapy has side effects such as upset stomach, nausea, vomiting, bad taste in the mouth, loose or dark stools,
yeast infections in women.
Any of several 2 week dual therapy regimens are simpler to follow, have fewer side effects, and work in about 80% of people who take them.
A newer triple therapy combining antibiotics and rabeprazole (Aciphex) works in just 1 week to eradicate
Gastrointestinal BleedingGastrointestinal bleeding either comes from the upper GI or lower GI tract. Upper GI bleeding can be caused by ulcers, gastritis, varices, cancer, or inflammati...learn more >>