Peptic Ulcers

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 Types

• Stomach
– Gastric Ulcer

• Duodenum
– Duodenal Ulcer

• Oesophagus
– Oesophageal Ulcer
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 Treatment

• H2- Blockers

• Proton Pump Inhibitors

• Prostaglandin Inhibitors

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Mechanism of Action

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 Proton Pump Inhibitors

• Omeprazole, Lanzoprazole

• Mechanism
– They bind irreversibly to proton pump of parietal
cell (i.e. inhibit the H+-K+ ATPase)
– The proton pump (acid pump)is responsible for
the final step in the process of acid secretion

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Misoprostol (Prostaglanidin E1 Analogue)

• Misoprostol causes acid suppression and

cyto-protection by enhancing mucin and
bicarbonate production
• It is associated with a high incidence of
Diarrhea
– The Diarrhea is usually mild
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 Sucralfate
• It is a complex synthetic salt of sucrose and aluminium
octasulfate
• In the presence of acid, sucralfate forms an insoluble
amorphous complex that has the ability to adhere to
ulcerated tissue
• It forms a protective coating of the ulcer that might
prevent further acid peptic digestion
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 Antibiotics

• Eg: Amoxycillin and Metronidazole

• The rational of this combination is to prevent
relapses and eradicate the Helicobacter
pylori, that is reported to have a role in
relapses and exacerbation of the ulcer with
cancer consequences
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 Thank You

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