Pharmacotherapy of acid-peptic disorders

In the past two decades, there have been tremendous changes in the understanding and therapy of acid-peptic diseases. Currently there are many new and effective approaches to the treatment of dyspeptic symptoms and the ulcerative and erosive diseases of the upper gastrointestinal tract. Application of an appropriate therapeutic strategy requires understanding of the pathophysiology of the disease process as well as the pharmacology of the available medications. In general, medications to neutralize gastric acid or suppress acid secretion are selected relative to the severity of the acid-mediated injury. Antacids are ideal for suppression of sporadic symptoms. H2-receptor antagonists are useful for the treatment of dyspepsia or uncomplicated ulcers. For the most severe injuries, proton pump inhibitors provide both relief of symptoms and healing of damaged mucosa.