Acid inhibition and long-term treatment of peptic ulcer disease

Acid is an influencing factor in most peptic diseases, including peptic ulcers. Acid inhibition, whatever the means used to obtain it, is followed by healing of most peptic ulcers. If acid inhibition is maintained recurrences are prevented (or diminished). A quantitative correlation between the degree of acid inhibition obtained and the effectiveness of treatment has been suggested in different studies. However, it is not possible to predict in the individual subject which rate of acid inhibition is needed for healing, and which rate is needed for avoiding relapse. Acid inhibition, apart from intrinsic toxicity of the drugs used to obtain it, is not without theoretical risks, particularly bacterial overgrowth and gastric carcinogenesis. To date, these effects lack practical importance at least with the doses and durations of treatments reported. Empirical data on acid inhibition and treatment of peptic ulcers, especially duodenal ulcers, are abundant. However, pathophysiological studies are scarce. Pathophysiological data should be studied in the future in groups of patients in order to design new strategies of treatment, particularly individual treatments. Acid inhibition by drugs or surgery remains the most important treatment of peptic ulcer disease. Long-term acid inhibition by drugs is safe and effective.