Peptic Ulcer Bleeding — ESEGH MCQ

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HardUpper Gastrointestinal and Ulcer BleedingPeptic Ulcer BleedingESEGH

A patient has an NSAID-associated gastric ulcer. H. pylori is negative and the NSAID can be stopped. What acid-suppression course does NICE recommend?

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Correct answer: D — Full-dose PPI for 8 weeks and review the NSAID indication

The best answer is “Full-dose PPI for 8 weeks and review the NSAID indication”. Stopping the offending drug addresses cause, while an 8-week full-dose PPI course permits ulcer healing. “PPI for 3 days” is less appropriate because this is inadequate for gastric-ulcer healing “H2-receptor antagonist for one day” is less appropriate because this is neither the recommended drug intensity nor duration “No acid suppression after NSAID withdrawal” is less appropriate because the established ulcer still needs healing therapy “On-demand PPI only when pain occurs” is less appropriate because symptoms do not reliably indicate mucosal healing

Reference: NICE CG184 GORD and dyspepsia: https://www.nice.org.uk/guidance/cg184/chapter/Recommendations