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Abstract

Ulceration of gastro-intestinal mucosa is caused by disruption of normal balance of corrosive effect of gastric acid and the protective effect of mucus on gastric epithelial cells. The major cause of ulcer is increased gastric secretions, which may be further aggravated by factors including NSAIDs, impaired production of somatostatins, Helicobacter pylori infection, by stress and dietary habits. Up to 80-90% of ulcers has been associated with H. pylori infection in the stomach. The parietal cells in the stomach secrete hydrochloric acid regulated by the protein H+/K+-ATPase also called proton pump. Acid secretion is also regulated by hormones such as gastrin, chemicals like acetylcholine and histamine. Acid neutralization was recognized as an effective treatment, however with the understanding of pathogenesis of peptic ulcer, treatment has become more effective. One approach for treating ulcer is to block the proton pump by using proton pump inhibitors like omeprazole, lansoprazole. In another approach, blocking of regulatory molecules that stimulate acid secretion like acetylcholine, histamine and gastrin either with anticholinergics or H2 receptor antagonist such as ranitidine, famotidine is effective. H.pylori infection can be eradicated using amoxycillin, clarithromycin, metronidazole or tetracycline. Combination therapy helps in complete eradication of peptic ulcer; one of the combinations, approved by USFDA is omeprazole with clarithromycin. Gastro retentive dosage forms may prove beneficial as they exhibit a prolonged gastric residence time and act locally and systemically.

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	JPR Solutions

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