The efficacy of gastric acid suppressive drugs, such as
histamine H2-receptor antagonists and H+K+
ATPase inhibitors, in the management of
peptic ulcer diseases has been well established. They accelerate the healing of
peptic ulcers, and maintenance
therapy with these drugs prevents
ulcer relapse. However, they do not modulate the natural course of
peptic ulcer.
Sucralfate, a
protective drug, has been shown to be equally effective in
ulcer healing and the prevention of
ulcer relapse. Some reports suggest that the relapse rate of
ulcers treated successfully with
sucralfate is less than that seen with
histamine H2-receptor antagonists.
Sucralfate has a true cytoprotective effect against agents noxious to gastric epithelial cells in monolayer culture. This action might be associated with its therapeutic efficacy in the treatment and prevention of
ulcer diseases. The role played by other
protective drugs in the management of
ulcer diseases is less clear and requires further studies.