Helicobacter is present in 70% of gastric ulcers and most of the remainder are associated with NSAID.
After triple therapy, continue anti-secretory treatment for two months.
Long term treatment with Misoprostol or a PPI should be considered in patients with proven gastric ulcer who have to take NSAIDs.
Repeat gastroscopy with biopsies is essential until complete epithelialisation. If ulcer remains unhealed for six months then surgery should be considered.
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