Modern Approaches to treatment of peptic ulcer in the practice of GPs from point of view of evidence - based medicine
DOI:
https://doi.org/10.58676/sjmas.v3i6.134Keywords:
Peptic ulcer disease (PUD), General practitioners (GPs), Evidence-based medicine (EBM), NSAID-induced ulcers, Proton pump inhibitors (PPIs)Abstract
Background: Peptic ulcer disease (PUD) remains a prevalent gastrointestinal condition that poses significant challenges in general practice. With the identification of Helicobacter pylori as a primary etiological agent and the growing use of NSAIDs, modern treatment has evolved significantly. The integration of evidence-based medicine (EBM) into clinical decision-making by general practitioners (GPs) plays a crucial role in optimizing patient outcomes. This study explores the application of EBM in the diagnosis, treatment, and prevention of PUD within primary care settings.
Materials and Methods: This research involves a comprehensive review of current clinical guidelines, randomized controlled trials (RCTs), and consensus reports. Emphasis was placed on the effectiveness of H. pylori eradication therapies, proton pump inhibitors (PPIs), and preventive strategies for NSAID- and aspirin-induced ulcers. The analysis also evaluates the evolving role of GPs in managing complications and preventing recurrence using risk stratification and collaborative care models.
Results: Triple therapy with PPIs, amoxicillin, and clarithromycin remains the gold standard for H. pylori eradication. Novel acid blockers like venireman have demonstrated non-inferiority to traditional therapies. For NSAID-induced ulcers, co-prescription of PPIs and COX-2 inhibitors shows high preventive efficacy. Updated guidelines recommend early resumption of anticoagulants post-endoscopy in bleeding ulcers. The role of GPs is expanding to include early diagnosis, lifestyle counselling, and long-term follow-up for high-risk patients. Prevention remains a cornerstone, particularly among elderly and polypharmacy patients.
Conclusion: Modern management of PUD demands a shift from reactive treatment to proactive, evidence-based prevention. GPs, as frontline providers, are uniquely positioned to implement guideline-driven approaches, enhance patient education, and coordinate multidisciplinary care. Embracing current evidence ensures safer, more effective management and reduces the risk of complications such as bleeding or perforation.
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