The other option in peptic ulcer therapy.

The treatment of peptic ulcer disease has been revolutionized for both the physician and the surgeon by the development of the histamine H2-antagonists, which have become the 'gold standard' for peptic ulcer therapy. However, it has been shown that several other drugs, including antacids, can match the ulcer-healing rate obtained with histamine H2-antagonist therapy with both a high- and a low-dose regimen. An important and well-documented option is the treatment of peptic ulcer disease with sucralfate. This drug, a basic amino salt of sucrose octosulphate , acts by binding to the protein of the matrix of the ulcer crater, thus coating the ulcer against the aggressive principle of acid-pepsin and probably also by a cytoprotective effect. Sucralfate is only absorbed in minimal quantities and no metabolic interaction with other drugs is therefore likely to occur. In many studies performed on different continents it has been demonstrated that sucralfate is superior to placebo in short-term duodenal and gastric ulcer healing and that the rate of healing is similar to that obtained by cimetidine. Evidence is also accumulating that sucralfate has a place in maintenance therapy to prevent recurrence of duodenal ulcer; preliminary studies also point to benefit in the therapy of reflux oesophagitis.