Role of protective drugs in the prevention of ulcer relapse

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.