Antacid therapy for duodenal and gastric ulcer: the experience in the United States.

An intensive antacid regimen, 15 to 30 ml 1 and 3 hours after each meal and at bedtime, has a significant effect on duodenal ulcer healing as compared to placebo and is as effective as cimetidine in endoscopically assessed trials. The healing rates at 4 weeks for placebo, antacid, and cimetidine are about 24%, 59%, and 62%, respectively. Smoking reduces the frequency of ulcer healing irrespective of therapy. Ulcer recurrences are as frequent after antacid as after cimetidine. Extensive placebo-controlled trials have not been reported for antacid treatment of gastric ulcer, but regular antacid dosing was as effective as cimetidine in one trial. Both the acute relief of ulcer pain and the pain relief during several weeks of therapy are similar between antacid and placebo, but pain relief per se is not a reliable indicator of ulcer healing.