Gastric analysis to determine level of acidity may be helpful in some cases but there is much individual variation in gastric acid secretions among patients with ulcer. Because each patient responds differently to various modes of treatment, the medical regimen is planned according to individual needs and responses. Antacids, such as magnesium hydroxide and aluminum hydroxide, relieve the pain of ulcer by decreasing the levels of gastric acid and pepsin. It is an effective treatment for peptic ulcers but produces side effects in some patients, e.g., breast enlargement in men, mental confusion in elderly patients, and delayed hepatic metabolism of other drugs. Another drug, ranitidine, has an action similar to that of cimetidine, has greater potency, can be taken less frequently, and has fewer side effects than cimetidine.
Gastric ulcers are more likely to require surgery than are duodenal ulcers.
This procedure is often done in conjunction with vagotomy, division of the vagus nerve, which eliminates cerebral stimuli of the stomach muscle and glands, thereby reducing gastric motility and secretion. Dietary restrictions are usually limited to those foods, if any, that an individual identifies with the onset or worsening of symptoms. Exceptions are alcohol and caffeine, both of which are capable of inducing gastritis and promoting erosion of the gastric mucosa. It is generally agreed that what the patient with an ulcer eats is not as important as when it is eaten. Frequent and regular feedings throughout the day, rather than two or three large meals, are encouraged.