Peptic ulcer disease
Chronic relapsing disease with mucosal ulcer formation in the stomach or duodenum. Main causes: Helicobacter pylori infection and NSAID use.
ICD-10 K253 drugs
Also known as: Gastric and duodenal ulcer, PUD
Drugs used for this condition
- AEsomeprazoleFirst line · Drugs for peptic ulcer and GORD. Proton pump inhibitorsEsomeprazole is used for gastric and duodenal ulcers in adults. Standard dose 20–40 mg daily for 4–8 weeks. PPIs accelerate healing and reduce recurrence. In H. pylori-associated ulcer, esomeprazole is part of eradication therapy. In NSAID-related ulcers, the NSAID is discontinued and a PPI course is given with reassessment in 4–8 weeks.
- AOmeprazoleFirst line · Proton pump inhibitorsStandard therapy for peptic ulcer disease: omeprazole 20–40 mg once or twice daily for 4–8 weeks depending on ulcer location. In H. pylori-positive patients, as part of an eradication regimen. Maintenance therapy is used in recurrent ulcers, H. pylori-negative ulcers, and chronic NSAID users.
- APantoprazoleFirst line · Proton pump inhibitorsFirst-line for peptic ulcer disease. Duodenal ulcer course is 4 weeks, gastric ulcer 8 weeks. In H. pylori eradication, any PPI at double dose twice daily. Pantoprazole is preferred in patients on clopidogrel after coronary stenting.
How to read tiers A–F
Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.
- AStrong evidence – first or second line in international guidelines
- BRecommended in selected cases
- CStudy data contradict each other
- DBenefit not proven, no documented harm
- FDocumented harm, or risk without benefit