Ulcers are small erosions, most likely caused by a bacterial infection such as H. pylori. Stomach ulcer disease is common, affecting millions of Americans yearly. The size of a stomach ulcer can range between 1/8 of an inch to 3/4 of an inch.

Gastric Ulcers

Gastric ulcers are erosions or sores that form in the mucosal lining of the stomach. They are usually caused by an infection with H. pylori or an imbalance between the secretion of stomach acid plus an enzyme called pepsin and the stomach’s mucosal lining, which leads to inflammation, or inflammation caused by nonsteroidal anti-inflammatory medications (NSAIDs), such as Ibuprofen, which worsen acid problems.

Commonly Prescribed (On-Label) Drugs: Cimetidine, Esomeprazole, Famotidine (Pepcid), Lansoprazole, Misoprostol, Nizatidine, Omeprazole, Ranitidine

Off-Label Prescription Drug Breakthrough Option: Sucralfate

Prevention of Gastric Ulcer

If stomach ulcers have been caused by H. pylori, they are cured by antibiotics, and that should end the problem. If caused by an imbalance of stomach acid and the stomach lining’s mucosal protection or inflammation caused by NSAIDs, medication is used, but there is a high risk of recurrence and preventive efforts are needed.

Commonly Prescribed (On-Label) Drugs: Lansoprazole/Naproxen

Off-Label Prescription Drug Breakthrough Option: Sucralfate

Mucosal Disease, Stress Related

Stress-related mucosal disease (SRMD) refers to a condition that may develop in the lining (mucosa) of the stomach and small intestine of critically ill patients in the intensive care unit (ICU). The physical or medical stresses on the body may cause erosions to develop in this lining leading to bleeding. Because upper gastrointestinal bleeding is often an indicator of poor prognosis, including death, care is focused on preventing such mucosal bleeding.

Commonly Prescribed (On-Label) Drugs: None

Off-Label Prescription Drugs Breakthrough Options: Lansoprazole, Pantoprazole (Protonix), Sucralfate

NSAID-induced Ulcer

Ulcers are sores or erosions that form in the mucosal lining of the stomach. Among the several ways they can develop are through the frequent use of nonsteroidal anti-inflammatory medications (NSAIDs), such as Ibuprofen. Some people do not realize that aspirin is also an NSAID. These drugs interfere with the metabolism of hormone-like substances in the body and upset the acid balance in the stomach.

Commonly Prescribed (On-Label) Drugs: Misoprostol

Off-Label Prescription Drug Breakthrough Option: Sucralfate

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