From the Guidelines
To treat a gastric ulcer, start with lifestyle changes and medication, and if H. pylori infection is present, use triple therapy with a PPI plus two antibiotics, such as amoxicillin and clarithromycin, for 10-14 days, as recommended by the most recent guidelines 1. When treating gastric ulcers, it is essential to consider the presence of H. pylori infection, as eradication therapy can significantly reduce the risk of recurrent bleeding 1.
- Stop taking NSAIDs like aspirin and ibuprofen
- Avoid alcohol
- Quit smoking
- Limit spicy foods For medication, take proton pump inhibitors (PPIs) such as omeprazole (20-40mg daily) or pantoprazole (40mg daily) for 4-8 weeks. If H. pylori infection is present, triple therapy is recommended, consisting of a PPI plus two antibiotics, typically amoxicillin 1g twice daily and clarithromycin 500mg twice daily, for 10-14 days 1. Alternatively, bismuth quadruple therapy may be used, or sequential therapy with four drugs (amoxicillin, clarithromycin, metronidazole, and PPI) in selected cases, if compliance to the scheduled regimen can be maintained, and if clarithromycin high resistance is detected 1. For pain relief, use acetaminophen instead of NSAIDs, and antacids can provide temporary symptom relief between meals. It is crucial to follow the complete treatment course, even if symptoms improve quickly, to ensure complete healing and prevent recurrence. Recent studies have also explored the use of potassium-competitive acid blockers (P-CABs) in the treatment of peptic ulcer disease, but they are not recommended as first-line therapy due to higher costs and limited availability 1.
From the FDA Drug Label
Lansoprazole delayed-release capsules are indicated in adults for short-term treatment (up to eight weeks) for healing and symptom relief of active benign gastric ulcer [see Clinical Studies ( 14.4)]. Ranitidine tablets USP are indicated in: 4. Short-term treatment of active, benign gastric ulcer. Most patients heal within 6 weeks and the usefulness of further treatment has not been demonstrated.
Treatment of Gastric Ulcer:
- Lansoprazole: is indicated for short-term treatment (up to eight weeks) for healing and symptom relief of active benign gastric ulcer.
- Ranitidine: is indicated for short-term treatment of active, benign gastric ulcer, with most patients healing within 6 weeks. 2 3
From the Research
Treatment Options for Gastric Ulcers
- Proton pump inhibitors (PPIs) such as lansoprazole, omeprazole, and pantoprazole have been shown to be effective in treating gastric ulcers 4, 5, 6, 7, 8
- These medications work by reducing gastric acid secretion, which helps to heal the ulcer and relieve symptoms
- The healing rates for gastric ulcers with PPIs have been reported to be higher than with histamine 2-receptor antagonists such as ranitidine 7
Dosage and Administration
- The usual dosage of lansoprazole for treating gastric ulcers is 30 mg/day 4, 6, 8
- The duration of treatment may vary depending on the severity of the ulcer and the individual patient's response to treatment
- In some cases, higher doses of lansoprazole (up to 60 mg/day) may be used for more severe ulcers or for patients with Zollinger-Ellison syndrome 6
Efficacy and Safety
- Studies have shown that lansoprazole is highly effective in healing gastric ulcers, with healing rates of over 90% reported in some studies 4, 6, 8
- Lansoprazole has also been shown to be safe and well-tolerated, with a similar adverse effect profile to other PPIs such as omeprazole 5, 6, 8
- The most common adverse effects reported with lansoprazole include headache, diarrhea, dizziness, and nausea 6, 8