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Gastric and duodenal ulcer - Prevention
Last reviewed: 04.07.2025
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One of the significant problems of peptic ulcer disease is the possibility of relapse (return) of the disease. In some cases, after successful completion of the course of treatment (disappearance of exacerbation symptoms, ulcer scarring), several months later the ulcer opens again.
[ Anti-relapse treatment of peptic ulcer disease and drug prevention
There are two possible regimens for anti-relapse treatment of peptic ulcer disease: continuous maintenance therapy, which involves long-term daily administration of one of the antisecretory drugs at half the dose; intermittent therapy.
Intermittent therapy, in turn, is carried out in two ways:
- Preventive therapy “on demand” means that the patient independently begins taking the medication (one of the antisecretory drugs) when symptoms of an exacerbation of peptic ulcer disease appear in the full daily dose for 2-3 days, and then in half for 2 weeks.
The indication for this therapy is the appearance of symptoms of peptic ulcer disease after successful eradication of H. pylori.
If after 3 days the symptoms have subsided (disappeared), you should continue taking these drugs for another 14 days; if the symptoms have not disappeared, you should immediately visit a doctor for FGDS and other examinations, as prescribed for an exacerbation of the disease, and make sure that the eradication of H. pylori has been successful.
- "Weekend therapy" involves taking an antisecretory drug for 3 days in a row - Friday, Saturday and Sunday. The drug is not taken on other days of the week.
Continuous maintenance therapy is more effective in preventing relapses, but side effects of medications should be taken into account.
The choice of a particular regimen, selection of drugs, their dosage and duration of administration is determined in each case by the doctor. Continuous maintenance therapy is indicated:
- if the patient has had complications of peptic ulcer disease in the past (bleeding, perforation);
- if it is necessary to take non-steroidal anti-inflammatory drugs - aspirin, ibuprofen, etc.;
- if previous treatment (at least 2 courses of eradication antimicrobial therapy) was unsuccessful;
- in the presence, in addition to a stomach or duodenal ulcer, of gastroesophageal reflux disease or an esophageal ulcer;
- if a patient over 60 years of age, despite proper treatment, has annual relapses of peptic ulcer disease.