According to a systematic review published in 'Cureus', peptic ulcer disease-affected patients who do not exhibit a favorable response to histamine-2 receptor antagonists (H2RAs) may achieve better treatment results by switching to proton pump inhibitors (PPIs). Maha Begg et al. aimed to evaluate the effectiveness and safety of PPIs and H2RAs for ulcers (pre-pyloric, duodenal, and gastric) and to assess the impact of continuing treatment with the same medication versus switching to a different class of drugs for ulcers that did not respond well to initial treatment.

For relevant literature searches, databases and search engines such as Google Scholar, Science Direct, Medical Literature Analysis and Retrieval System Online (MEDLINE), and PubMed were explored. Included in the review were systematic reviews, review literature, randomized controlled trials (RCTs), meta-analyses, and clinical trials of full-text articles issued in the English language encompassing humans.

Based on year of publication or age group, there were no restrictions. After conducting a thorough screening process, which involved quality assessment using several tools and applying filters that aligned with the eligibility criteria, a total of 8 articles were identified for analysis. Among these, one was a meta-analysis, two were review articles, and five were RCTs. The major outcome was the comparison of the adverse effects associated with PPIs and H2RAs.

The collective findings from most of the studies indicated that Omeprazole demonstrated superior efficacy in terms of ulcer healing and pain relief. Furthermore, it was noted that patients who exhibited limited responsiveness to H2RAs experienced enhanced treatment outcomes when transitioning to a PPI. Additionally, adverse effects resulting from chronic medication usage, encompassing symptoms such as gastrointestinal infections, headaches, constipation, and diarrhea were also reported.

Notably, individuals on long-term PPI therapy may require calcium supplementation to mitigate the risk of fractures, particularly among older adults. Regarding long-term treatment outcomes, the reviewed literature consistently supported the continued use of PPIs as the preferred approach for managing peptic ulcer disease.