Complete list of medicines for stomach ulcers
The mechanism of the onset and development of stomach ulcers has not yet been fully understood. On the one hand, it has been proven that the culprit of the infection is a special pathogenic microorganism - Helicobacter pylori. On the other hand, a strong immunity, a healthy lifestyle, a correct diet and a stable neuropsychological status of a person would not have allowed Helicobacter pylori to proliferate and provoke peptic ulcer disease. Therefore, the approach to the treatment of this ailment must be comprehensive.
Competent therapy for stomach ulcers includes:
- Taking several types of medications according to a special scheme;
- Compliance with the recommended diet and food intake;
- Correction of the psycho-emotional sphere and rejection of bad habits;
- Spa treatment;
- Surgery (if required).
Medical treatment of stomach ulcers is performed using three main groups of drugs:
- Antibiotics;
- Histamine receptor blockers;
- Proton pump inhibitors (PPIs).
Adjunctive therapy is carried out using several more types of drugs:
- Anticholinergics;
- Antacids;
- Reparants;
- Anabolics;
- Gastroprotective agents;
- Antispasmodics;
- Analgesics;
- Ganglion blockers;
- Antiemetic;
- Vitamins;
- Immunostimulants.
Content:
- Stomach ulcer treatment regimen
A complete list of medicines for stomach ulcers:
- Antibiotics
- Histamine receptor blockers
- Proton pump inhibitors (PPIs)
- Gastroprotective agents, anabolic steroids and reparants
- Holinoblockers
- Antacids
- Antiemetics
- Antispasmodics
- Ganglion blockers
Stomach ulcer treatment regimen
The most effective is a two-stage peptic ulcer treatment regimen:
- Stage I lasts 7 days. During this period, the patient is prescribed a complex of two antibiotics, usually metronidazole and clarithromycin, as well as a proton pump inhibitor, for example, lansoprazole. The drugs can be replaced by analogs at the decision of the attending physician, the dosage is also set individually. The goal of the first stage of treatment is the complete destruction of Helicobacter, and in 95% of cases, the task can be coped with;
- Stage II takes 14 days and is only required if Helicobacter pylori is still detected in the stomach after the first stage. Against the bacteria, a tandem of antibiotics metronidazole + tetracycline is used, and the therapy is supplemented with one of the bismuth drugs, and also with PPIs (omeprazole, rabeprazole) and a histamine receptor blocker (ranitidine, famotidine).
Treatment must be reinforced with anti-inflammatory, analgesic, antispasmodic, wound healing, antiemetic and other drugs that relieve unpleasant symptoms of stomach ulcers and accelerate the healing process. Folk remedies (herbal teas and infusions), vitamins, natural extracts, such as aloe vera, are very useful. However, any medication should be consulted with your gastroenterologist.
Peptic ulcer disease is very individual, characterized by different indicators of acidity and is often accompanied by complications from other organs. In addition, antibiotic therapy almost always has side effects in the form of digestive upset and pain. Treatment of acute stomach ulcers is recommended to be carried out in a hospital under the constant supervision of qualified specialists.
On the subject: Is there an effective drug therapy for stomach ulcers?
Complete list of medicines for stomach ulcers
Antibiotics:
-
Clarithromycin. Semi-synthetic antibiotic from the macrolide group. A direct descendant of erythromycin, it is one hundred times more resistant to the destructive action of hydrochloric acid, more complete and quick assimilation, good tissue distribution and a long half-life. Due to this, clarithromycin outperforms erythromycin and is recommended as the main antibiotic for the treatment of stomach ulcers;
- Amoxicillin. Semi-synthetic antibiotic of the penicillin group. Unlike penicillin, it is resistant to the corrosive action of gastric juice, is absorbed almost completely (by 93%), spreads faster through tissues and fluids, more fully covers the body and remains in it longer, which allows prescribing amoxicillin for peptic ulcer disease twice, rather than four times a day. day;
- Metronidazole. Antimicrobial and antiprotozoal drug of a very broad spectrum of action. One of the oldest, most reliable and effective antibiotics, it belongs to the group of essential medicines. Metronidazole is a synthetic analogue of azomycin, a natural antibiotic produced by bacteria of the genus Streptomycetes. Harmful microorganisms and protozoa interact with metronidazole, as a result of which its 5-nitro group is restored. And she, in turn, destroys the DNA of parasites and microbes;
-
Tetracycline. An antibiotic from the tetracyclines group. It has a bacteriostatic effect, that is, it disrupts the interaction between ribosomes and transport RNAs, as a result of which protein synthesis by bacterial cells is suspended, and they die. Tetracycline is active against many gram-positive and gram-negative microorganisms, as well as against most enterobacteria, including Helicobacter pylori.
Histamine receptor blockers:
- Ranitidine. The drug is a second generation of histamine blockers. Reduces the activity of pepsin (a digestive enzyme responsible for breaking down proteins). Normalizes the pH level in the stomach, inhibits the synthesis of hydrochloric acid. Depending on the dosage, it protects the mucous membrane from the destructive effects of excess acidity for 12-24 hours;
- Nizatidine. The drug of the second generation of blockers of histamine III receptors. Suppresses both its own synthesis of hydrochloric acid by the walls of the stomach and excessive synthesis provoked by acetylcholine, histamine and gastrin - enzymes and mediators. Significantly reduces pepsin hyperactivity and keeps the pH level in a state of physiological norm for 12 hours after ingestion;
- Roxatidine. The drug is the second generation of blockers of histamine H2-receptors. It inhibits the activity of pepsin, normalizes the acid-base balance of the stomach, reduces the secretion of hydrochloric acid caused by food, gastrin, histamine, acetylcholine, and also suppresses the basal synthesis of gastric juice. It is rapidly absorbed and acts within an hour after ingestion. The effect lasts from 12 hours to one day, depending on the dosage;
- Famotidine. It is also a second generation drug for histamine H2 receptor blockers. Inhibits both basal and provoked by external stimuli secretion of hydrochloric acid by cells of the gastric mucosa. Thus, it protects the patient's body well from the unwanted effects of pepsin, histamine, gastrin and acetylcholine;
- Cimetidine. The drug of the first generation of blockers of histamine III receptors, but still has not lost its relevance. It also well regulates the pH level in the stomach, inhibits the synthesis of hydrochloric acid and suppresses the activity of the enzyme pepsin. It is cheaper than the above modern counterparts, but it is considered less effective due to the short period of continuous action (6-8 hours).
Proton pump inhibitors (PPIs):
- Lansoprazole. Inhibitor of H + -K + -ATPase - an enzyme responsible for accelerating the exchange of hydrogen ions. Regardless of the reasons for the hypersecretion of hydrochloric acid, lansoprazole inhibits its production at the final stage, that is, immediately before secretion into the gastric cavity;
- Omeprazole. It also inhibits the action of the proton pump by inhibiting the activity of the enzyme H + -K + -ATPase. Hydrogen ions penetrate worse between the cell membranes of the gastric mucosa, and this interferes with the production of gastric juice. And it does not matter what exactly provokes the hypersecretion of hydrochloric acid - food intake or the action of enzymes and mediators;
- Rabeprazole. It is better known under the pariet trademark. This drug not only inhibits the secretion of hydrochloric acid, blocking the action of H + -K + -ATP-ase, but also has a detrimental effect on Helicobacter pylori, the culprit of stomach ulcers. Rabeprazole takes effect one hour after ingestion and protects the mucous membrane for up to two days in a row;
- Esomeprazole. The drug, which is a dextrorotatory isomer of omeprazole, and has a similar effect. It also inhibits the synthesis of hydrochloric acid at the last stage by impairing hydrogen exchange between the membranes of the cells of the gastric mucosa. Being a weak base, esomeprazole is activated in the acidic environment of the parietal tubules and inhibits the action of the proton pump.
Gastroprotectors, anabolics and reparants:
- Sucralfat. The drug has antiulcer, adsorbent, enveloping, antacid and protective effects. It practically does not affect the healthy mucous membrane, and in conditions of increased acidity of the diseased stomach it breaks down into sucrose sulfate and aluminum, which allows it to bind mucus proteins and form a strong protective film in the places of ulceration. After taking sucralfate, the walls of the stomach for 6 hours receive protection from excess hydrochloric acid, pepsin, waste products of harmful bacteria and bile thrown from the pancreas;
- Solcoseryl. A powerful reparant and cytoprotector. Restores the gastric mucosa, promotes healing of ulcers, improves cell metabolism. It is produced from the blood of dairy calves and is a hemodialysate with a molecular weight of 5000 D. The potential of solcoseryl has not yet been fully studied, however, the use of this drug at the stage of healing of a stomach ulcer, that is, after an active antimicrobial phase, gives extremely good results;
- Enprostil and misoprostol are synthetic analogs of prostaglandin E2 and E1, respectively. These substances are similar to hormones and are produced in almost all tissues of the human body. Prostaglandins are mediators of allergy and inflammation, they regulate blood pressure, normalize muscle tone, reduce gastric acidity and inhibit gastric acid secretion;
- Biogastron. The active ingredient of this drug is carbenoxolone, a synthetic analogue of glycyrrhizic acid. Scientists extract this valuable material from licorice root. Biogastron has a pronounced anti-inflammatory effect and is used to treat ulcerations on the mucous membrane of the mouth, esophagus and stomach. The drug is well known abroad, and is rarely used in Russia, although it has great potential;
- Actovegin. Effective reparant and antihypoxant. Like solcoseryl, it is made from blood and is a hemodialysate with a molecular weight of 5000 daltons. Ultrafiltration makes Actovegin able to penetrate cell membranes, improve oxygen and glucose uptake and ensure rapid regeneration of damaged and inflamed tissues;
- Bismuth tripotassium dicitrate. The most optimal preparation of bismuth for the treatment of stomach ulcers. In conditions of high acidity, it quickly forms a protective film that covers the damaged areas of the mucous membrane. In addition, bismuth tripotassium dicitrate enhances the production of prostaglandin E2 and inhibits the vital activity of Helicobacteria, which cause peptic ulcer disease;
- Amigluracil. Effective anabolic and reparant. Accelerates the synthesis of proteins and amino acids, promotes healing of ulcers and wound surfaces, improves immunity and helps the body to cope with infections on its own by enriching the blood with immune cells. It is successfully used at the final stage of recovery after gastric and duodenal ulcers;
- Methyluracil. Also a popular immunostimulant, anabolic and reparant. Stimulates the synthesis of leukocytes, accelerates nucleic acid metabolism, promotes rapid regeneration and epithelialization of damaged tissues and mucous membranes. The anti-inflammatory effect of methyluracil is explained by its inhibitory effect on proteolytic enzymes. At the final stage of gastric ulcer treatment, the drug helps scarring and cell renewal;
- Oxyferriscarbon sodium. Anti-inflammatory, analgesic and wound healing preparation based on iron with the addition of sodium salts and alloxanic acid. It is used to treat peptic ulcers of the esophagus, small and duodenal ulcers, as well as stomach ulcers;
- Romazulan. A herbal medicine based on chamomile, which has a complex effect: relieves spasms, relieves pain, kills microbes and stimulates the healing of wounds and ulcers. Romazulan solution is used externally, for skin lesions, diseases of the oral cavity and urogenital area, and internally, diluted with water, for the treatment of peptic ulcer and gastritis;
- Histidine hydrochloride. The drug is an amino acid that, when it enters the body, undergoes a decarboxylation reaction, and as a result, histamine is formed, a mediator that has a multifaceted effect on the body. Histamine stimulates the production of epinephrine, stimulates smooth muscles, increases the permeability of the vascular walls, increases the heart rate, and causes the stomach to produce more gastric juice, which is necessary for some types of gastric ulcer.
Holinoblockers:
- Gastrocepin. The active substance, pirenzepine, belongs to the group of M1-cholinergic receptor blockers, but unlike atropine, the most famous representative of this group, it does not inhibit the activity of cholinergic receptors of the heart, eyes, salivary glands and other organs, but only affects the gastric mucosa, forcing it produce less hydrochloric acid and pepsinogen;
- Buscopan. The drug has a blocking effect on the M-cholinergic receptors of the stomach, kidneys, gallbladder and urinary bladder, and also works as an antispasmodic. Buscopan relieves spasms of smooth muscles and somewhat reduces the level of secretion of gastric juice, which makes it possible to symptomatically alleviate the condition of patients with gastric ulcer;
- Platyphyllin. It blocks M-cholinergic receptors of internal organs and eyes about 8 times weaker than atropine, and also blocks H-cholinergic receptors to some extent. Outperforms atropine due to the fact that it causes tachycardia less often. Platyphyllin has an antispasmodic effect on the walls of the stomach and intestines, dilates blood vessels and lowers blood pressure;
- Metacin. It also belongs to M-cholinergic receptor blockers, milder than atropine. Well reduces the tone of the gallbladder and bladder, relieves spasms and eliminates pain in the stomach, suppresses the secretion of gastric juice, sweat, saliva, normalizes blood pressure. Less frequently than atropine, it causes unwanted surges in heart rate, dilated pupils and increased intraocular pressure;
- Etpenal. Cholinergic receptor blocker of both types - "H" and "M". An effective local anesthetic that has a good effect on both the central and peripheral nervous systems. Etpenal is used for the symptomatic treatment of stomach ulcers, as well as bronchial asthma and Parkinson's disease, as it relieves spasms and reduces tremors.
Antacids:
- Almagel. Absorbent, enveloping and analgesic medicine that is well known to all ulcers. Almagel protects the gastric mucosa from the destructive effects of excess hydrochloric acid and pepsin, absorbs toxic waste products of bacteria and interferes with the absorption of phosphates. Thus, it does not cure stomach ulcers, but helps to relieve its painful symptoms and reduce the harm caused by the inflammatory process on the patient's body as a whole;
- Maalox. Antacid preparation based on magnesium and aluminum hydroxides. Maalox reacts with hydrochloric acid and neutralizes its excess, moreover, there is no repeated, compensating secretion. This drug normalizes the pH level and protects the gastric mucosa, but, like Almagel, does not eliminate the very cause of peptic ulcer disease;
- Gastal. A more advanced, combined antacid, which, in addition to magnesium and aluminum hydroxides, contains magnesium carbonate. Immediately after ingestion, it allows for two hours to artificially maintain a physiologically normal pH level in the stomach - 3.5, by neutralizing the excess of hydrochloric acid. Stomach ulcer does not heal, but saves from pain and heartburn;
- Phosphalugel. Antacid preparation based on aluminum phosphate. It has a more pronounced and lasting effect than the above drugs of the same type. Phosphalugel not only neutralizes excess hydrochloric acid, but also inhibits the activity of the enzyme pepsin. It reliably envelops the walls of the stomach, creating a protective barrier for irritants, but does not have a destructive effect on Helicobacter pylori, therefore it can only be used for symptomatic relief of the condition of patients with peptic ulcer;
- Sodium bicarbonate. Baking soda is the simplest and most affordable antacid. Soda solution helps relieve heartburn and stomach pain in gastritis and ulcers, and is also used to fight acidosis caused by general intoxication of the body or diabetes.
On the subject: List of antacids, their action, features
Antiemetics:
- Motilium. The active ingredient is domperidone, the opposite of dopamine. The drug blocks the activity of dopamine receptors and increases the tone of the lower esophageal sphincter, accelerates the movement of food through the digestive tract, stimulates the motility of the stomach and intestines. Motilium has no effect on the secretion of gastric juice, it simply relieves attacks of nausea and vomiting in gastritis and stomach ulcers;
- Cerucal. The drug, which prevents the transmission of nerve impulses along the visceral channels from dopamine receptors to the vomiting center in the brain, and also stimulates intestinal motility, increases the tone of the lower esophageal sphincter and promotes the vigorous movement of food through the digestive tract. Thus, even if there are objective reasons for vomiting, it can be avoided;
- Metoclopramide. The drug blocks dopamine and serotonin receptors, due to which it is possible not only to stop vomiting attacks, but also to stop hiccups and avoid diarrhea, which can be a side effect of moving food too quickly from the stomach to the rectum. Metoclopramide does not affect the secretory functions, but there is still not a sufficiently substantiated medical opinion that this drug promotes the healing of gastric ulcers.
Antispasmodics:
- Galidor. The active ingredient is bencyclar - a myotropic antispasmodic, blocker of calcium channels, serotonin receptors and sympathetic nerve nodes. Perfectly relieves spasms of blood vessels and smooth muscles, increases the elasticity of erythrocytes, lowers blood pressure, but may slightly increase the heart rate. Halidor in large doses is considered a tranquilizer. For stomach ulcers, it is indicated as a pain reliever;
- Dibazol. Myotropic antispasmodic, a benzimidazole derivative. It has a smoothing effect on the muscles of internal organs, blood vessels and capillaries, normalizes blood pressure, dilates the vessels of the brain and accelerates the transmission of nerve impulses between synapses. Perfectly relieves headaches and muscle pain, but it works for a short time, therefore, in the treatment of stomach ulcers, more advanced and modern antispasmodics are usually prescribed;
- Papaverine. Calcium channel blocker, mild myotropic antispasmodic. Expands blood vessels and capillaries, lowers blood pressure and smooth muscle tone, relieves pain in the internal organs caused by muscle spasm well, but it does not work for long and does not sufficiently affect the parasympathetic nervous system to save from severe pain in case of stomach ulcers. Therefore, at present, papaverine is not considered as a reliable pain reliever;
- No-Shpa. The most popular antispasmodic. The active substance, drotaverine, is very similar in structure and pharmacological action to papaverine, but it acts more pronounced and lasting. No-Shpa prevents the flow of calcium molecules into the cells of smooth muscles, thereby relieving pain in migraines, periodic female ailments and peptic ulcer disease. The range of application of No-Shpy is very wide, and it is this myotropic antispasmodic that is prescribed in cases where anticholinergic blockers are contraindicated to the patient for any reason - drugs that better relieve pain, but not suitable for everyone.
Ganglion blockers:
- Benzohexonium. It inhibits the conduction of impulses between the ganglia (large nerve nodes) of the sympathetic and parasympathetic nervous systems, and also inhibits the activity of all endocrine glands, including the gastric mucosa, adrenal cortex and pancreas. Benzohexonium is used for the symptomatic treatment of stomach ulcers, cholecystitis, bronchial asthma, cholelithiasis and many other diseases;
- Dimekolin. A more perfect analogue of benzohexonium. It has a pronounced antispasmodic effect on blood vessels, muscles and internal organs by blocking nerve impulses between ganglia, therefore it is successfully used to relieve acute attacks of pain in peptic ulcer disease, pancreatitis, hepatitis, cirrhosis, cholecystitis, gallstone disease. Sometimes dimekolin is prescribed for patients with persistent arterial hypertension;
- Camphonius. Quaternary ammonium compound. Well reduces pressure, reduces the tone of the coronary arteries and peripheral blood vessels, smoothes the muscles of internal organs. Camphonium, like all ganglion blockers, is used for symptomatic relief of the condition of patients with stomach ulcers, in addition, the drug is sometimes prescribed for hypertensive patients and patients with obliterating endarteritis.
- Quateron. Mono-quaternary ammonium compound. Better inhibits the conduction of nerve impulses between the ganglia of the parasympathetic nervous system than the sympathetic, therefore it is used precisely to relieve pain in ulcers and patients with specific colitis. Quateron dilates the coronary arteries slightly, therefore it is rarely prescribed as an antihypertensive drug;
- Temekhin. It interferes with the transmission of nerve impulses from preganglionic to postganglionic vegetative fibers, and due to this effectively relieves muscle spasms and dilates blood vessels. Temekhin has a beneficial effect on arterioles, therefore, it is relevant for persistent arterial hypertension and angina pectoris, and for patients with stomach ulcers it is prescribed to reduce gastric hypersecretion and reduce pain caused by spastic phenomena.
The author of the article: Gorshenina Elena Ivanovna | Gastroenterologist
Education: Diploma in the specialty "General Medicine" received at the Russian State Medical University named after N. I. Pirogova (2005). Postgraduate studies in the specialty "Gastroenterology" - educational and scientific medical center.
