Peptic ulcers should be treated with acid reducing drugs and antimicrobial therapy, the US National Institutes of Health have recommended.
Their guidelines are based on the mounting evidence of a link between peptic ulcers and gastritis inflammation of the stomach lining and the bug Helicobacter pylori.
Recent research has shown that dual and triple combinations of the anti ulcer agent bismuth and antimicrobial drugs, such as tetracycline and metronidazole, can cure H pylori infection and reduce the rate of recurrence of ulcers in up to 90 per cent of patients.
These findings indicate that standard treatments using ranitidine (Zantac) are not effective, although the National Institutes said they could still be used to alleviate symptoms.
Ranitidine fared better in a double blind study of patients suffering hemorrhage from duodenal ulcer.
The test, carried out by the Center for Ulcer Research and Education in Los Angeles, concluded that ranitidine is safe if given long term to patients whose ulcers had healed after severe hemorrhage. It also reduced the risk of further bleeding.