ROSH Gastrointestinal Practice Exam

Once the diagnosis of peptic ulcer disease is confirmed, what is the most appropriate treatment?

1. Antacids

2. Aspirin

3. Carafate

4. Clarithromycin, amoxicillin, and a proton-pump inhibitor

The correct answer is: Clarithromycin, amoxicillin, and a proton-pump inhibitor

The most appropriate treatment for confirmed peptic ulcer disease is a combination of clarithromycin, amoxicillin, and a proton-pump inhibitor. This regimen represents a standard approach for treating peptic ulcers caused by Helicobacter pylori infection, which is a common underlying factor in many cases of peptic ulcer disease. Using a proton-pump inhibitor helps to reduce gastric acid secretion, promoting healing of the ulcer and alleviating symptoms. The antibiotics, clarithromycin and amoxicillin, specifically target the H. pylori bacteria, aiming to eradicate the infection. The combination of these medications effectively addresses both the symptom management and the underlying cause of the ulcer, which is crucial for reducing the recurrence risk. Other options do not provide an effective comprehensive treatment for peptic ulcers. Antacids provide temporary symptomatic relief, but they do not treat the ulcer or eradicate H. pylori. Aspirin can actually exacerbate ulcers and is not a preventive or therapeutic agent in this setting. Carafate, while it may offer some protective effect on the stomach lining, does not address H. pylori infection and is not considered a first-line treatment. Therefore, the combination of clarithromycin, amoxicillin, and a proton-pump inhibitor is the most