[Uncomplicated peptic ulcer disease. The therapeutic prospects and practice].

The majority of peptic ulcers heal if gastric acidity is adequately reduced during a fraction of the day, either increasing intraluminal pH, or acting upon parietal cells membrane receptors. A single nocturnal dose of H2-receptor antagonists heal 90% of duodenal lesions within 6 weeks; gastric ulcers take about 8 weeks. Elimination half-life is short; there is no reversible. Few drug interactions are clinically significant. Antacids (aluminum hydroxide) and muscarine-1 receptor antagonists (pirenzepine) hold a second place in the general therapeutic strategy. Omeprazol, a blocker of the protons pump, accumulates intracellularly and is a very potent inhibitor of acid secretion; its clinical use is currently restricted to specific problems and only for brief periods. Colloidal bismuth and sucralfate exhibit a protective action by close adhesión to the ulcer itself. Prostaglandin E2 and analogues combine both inhibition of gastric acidity and direct gastrointestinal "cytoprotection"; they diminish the rate of gastric lesions recurrence in patients receiving anti-inflammatory non-steroid drugs. Moderate doses of H2-receptor antagonists during 6 month to 2 years significantly reduce recurrences of common-type gastroduodenal ulcers. Surgical therapy is useful for very especific situations.