How is peptic ulcer disease (PUD) managed when NSAID therapy cannot be discontinued?

Updated: Apr 26, 2021
  • Author: BS Anand, MD; Chief Editor: Philip O Katz, MD, FACP, FACG  more...
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Answer

For patients who must continue with their NSAIDs, PPI maintenance is recommended to prevent recurrences even after eradication of H pylori. [3, 4] If NSAIDs must be continued, changing to a cyclooxygenase (COX)-2 selective inhibitor is an option. However, the use of a traditional NSAID and once-daily proton pump inhibitor (PPI) is comparable to a selective COX-2 inhibitor with respect to ulcer bleeding in patients with a history of peptic ulcer disease. [59] In general, 6-8 weeks of therapy with a PPI is required for complete healing of a duodenal ulcer.


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