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Sucralfate and other non-antisecretory agents in the treatment of peptic ulcer disease.

Sucralfate as well as colloidal bismuth subcitrate (CBS) and probably also bismuth subsalicylate (BBS) are effective in the acute treatment of peptic ulcer disease. Sucralfate also has positive effects upon symptoms and healing of peptic lesions in reflux esophagitis. Healing rates in gastric and duodenal ulcers are equal to those obtained with H2-antagonists. Side effects are rare, transient and generally mild. Therapy with bismuth compounds should be restricted to 4-8 weeks (cave: bismuth encephalopathy). Healing rates of smokers with duodenal ulcers were the same as in non-smokers during sucralfate therapy. Sucralfate seems to be useful in the treatment (prophylaxis?) of NSAID-induced lesions in the upper gastrointestinal tract. The question of different recurrence rates in peptic ulcer disease after various kinds of medical treatment still remains open. The relationship between the etiology of peptic ulcer disease and Campylobacter pylori infection, as well as possible medical and therapeutic consequences, should be further investigated.