Mucosal Protecting Agents: First Choice in Uncomplicated Ulcer Disease?

Abstract

The clinical value of the mucosal protecting agents sucralfate and colloidal bismuth is compared with that of the acid inhibitors ranitidine and omeprazole. The efficacy of both protecting agents is comparable to that of ranitidine, but they are all surpassed by omeprazole. An advantage of colloidal bismuth is a lower recurrence rate of duodenal ulcer, possibly also seen with sucralfate. Clinically relevant side effects are rarer in protecting agents; in addition, protecting agents have the theoretic advantage of not interfering with physiologic gastric acidity. On the other hand, the mode of intake is more convenient in acid inhibitors. Thus, protecting agents are a reasonable alternative to acid inhibitors.

Key Words:

• Cimetidine
• colloidal bismuth
• duodenal ulcer
• peptic ulcer disease
• randomized clinical trials
• ranitidine
• stomach ulcer
• sucralfate
• therapeutic use