Comparative Analysis: Omeprazole and Ranitidine for Ulcers

This report presents a systematic review comparing the efficacy of omeprazole and ranitidine in managing peptic ulcers. The study analyzed secondary data from databases like NCBI and Google Scholar, focusing on studies published between 2015 and 2020 that assessed the effectiveness of these medications. Inclusion criteria included studies in English, focusing on omeprazole and ranitidine treatment. Exclusion criteria involved studies in other languages, those published before 2015, and those out of scope. The review identified that omeprazole demonstrated higher effectiveness, with patients recovering within 3-4 weeks compared to over 4 weeks for ranitidine, which also often required higher doses and presented potential side effects. The analysis of selected studies showed omeprazole's effectiveness at 97.3% versus ranitidine's 82.35%, leading to the conclusion that omeprazole is the more effective treatment option for peptic ulcers. The report also provides background on peptic ulcers, their causes, and the need for comparative studies to determine optimal treatment strategies. The methodology section details the systematic review process, data sources, search strategies, and inclusion/exclusion criteria used to ensure the validity and reliability of the findings.

EFFICACY OF OMEPRAZOLE VS RANITIDINE IN
MANAGING PEPTIC ULCER
ABSTRACT
Background
Peptic ulcer is a kind of disease which is majorly formed due to inflammation within
stomach either due to stomach acid erosion or by some kind of bacteria H. pylori. It is a common
type of disease from which people suffer. There are many different kinds of treatment that can be
focused upon for treatment of peptic ulcer, but some of the most common areomeprazole and
ranitidine, although effectiveness of both the treatment is quite different. This systematic review
focusses upon analysis of efficacy of omeprazole vs ranitidine in managing peptic ulcer.
Omeprazole has been selected for peptic ulcer because it helps decreasing the amount of acid
stomach makes. Whereas has been used as a treatment for treating peptic Ulcer because it also
helps in preventing them from coming back after they have healed.
Methods
Method chosen for this study is systematic review of selected secondary data. Databases
used for this research work arencbi online library and google scholar search engine. Secondary
data for this research had been collected from ncbi online library and google scholar search
engine.
Inclusion criteria: Studies that were published between 2015 to 2020 were selected. Studies that
were based upon effectivity or usage of omeprazole and ranitidine for treatment of peptic ulcer
were selected. Studies that were written in English language were only selected.
Exclusion criteria: Studies in language other than English were excluded. Papers or articles that
were published before 2015 were not selected. Studies that were out of scope of the research
study were also excluded.
Key words
Five most common keywords used for searching appropriate studies for systematic
review for answering the research questions are as follows: omeprazole, ranitidine, peptic ulcer,
medicines, treatment
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Synopsis of results
During this course of searching appropriate articles, 20 relevant studies were searched for
that were related to the research topic. Out of those 20 studies, 5 of them were excluded while
screening due to duplicate data. When all the selected studies were analysed on the basis of
eligibility criteria 3 of them were excluded and only 12 studies were remaining. Lastly selected
articles were further evaluated on the basis of some common other criteria and again 5 articles
were excluded and at last only 7 articles were selected for this paper.
Results
This study gives a systematic review of efficacy of omeprazole vs ranitidine in managing
peptic ulcer. From the systematic review of various articles it was identified that omeprazole is
much more effective treatment for management of peptic ulcer. This is because patient given
omeprazole can recover within 3-4 weeks of time period whereas patients who are given
ranitidine recover in more than 4 weeks and also require high dose to be given to patient because
of which patient can suffer from some side effects. All the studies systematic review helps in
understanding results of Omeprazole were 97.3% whereas effectivity of Ranitidine were only
82.35%. This result clearly helps in explaining that Omeprazole is better for overall treatment
effect of peptic ulcer.
Conclusion
From the gathered evidence it has been analysed that from both the treatments it was
found that omeprazole was much more effective as compared to ranitidine treatment.
INTRODUCTION
Peptic ulcer is a disease that majorly develops on the lining of stomach or small intestine,
lower oesophagus. Peptic ulcer is majorly formed as a result of inflammation which is caused by
stomach acid erosion and by bacteria H. pylori.
It is one of the most common health problems which is faced by people [8]. treatment of
peptic ulcer can be done by medications that helps in decreasing production of stomach acid. But
if it is caused by bacteria then for this antibiotic are required. There are different kinds of
medicines that can be used for treatment of peptic ulcer. Most commonly given medicines that
are given to patients suffering from peptic ulcer are omeprazole and ranitidine. Rate of healing of
both the medicine is different and success percentage of treatment is also different. It forms when
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stomach's protective layer is broken down. When this happens digestive juice contain
hydrochloric acid and an enzyme called pepsin can damage the intestine or stomach tissue. The
reason because of which systematic review on this is being conducted is because there are
various kinds of treatment that can be given to the peptic ulcer patients and each of them has its
own effectiveness. But most commonly omeprazole vs ranitidine treatment methods are given to
patients.So systematic review of both the treatment will help inidentifying effectiveness and
suitability of both the treatments.
Aim
Main aim of this study is “To analyse efficacy of omeprazole vs ranitidine in managing
peptic ulcer”.
Objectives
Main objectives of the study are:
 To analyse effectivity of omeprazole for management of peptic ulcer.
 To analyse efficiency of ranitidine in managing peptic ulcer.
 To recommend most effective treatment out of omeprazole and ranitidine for treatment of
peptic ulcer.
Research questions
For framing questions PICO framework can be used:
P: Patient/
Population
I: Intervention C: comparison O: Outcome
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Population
selected for this
dissertation is patients
suffering from peptic
ulcer
Check effectiveness
of omeprazole for
treatment of peptic
ulcer
Check effectiveness
of ranitidine for
treatment of peptic
ulcer
How much effective
are omeprazole and
ranitidine in managing
peptic ulcer
Need of study
In this study efficacy of omeprazole vs ranitidine in managing peptic ulcer is analysed
and evaluatedand it is important to study effectivity of both the medicines in order to ensure high
success chances of treatment. It is important to measure effectivity of both the treatments in
managing peptic ulcer because both the treatment required different amount of doses to be given
to the patients. This study will help in understanding that which of these medicines are effective
and should be more preferred for treatment of peptic ulcer.
METHODS
Overview
In this methodological section, evaluation of methods chosen for the study with
appropriate reasons has been explained. This section will help in explaining methods with the
help of which answers for defied research questions has been achieved.
Conduct systematic review
For systematic review 7 studies from 20 were selected and reviewed so that efficacy of
omeprazole vs ranitidine in managing peptic ulcer can be identified. All the studies that were
based upon peptic ulcer and in which method of treatment was either omeprazole vs ranitidine
were included. Systematic review was done in following steps: Formulation of research question
was done so that it can be analysed whether systematic review is required or not. Them
objectives of research were developed and on the basis of aim and objective inclusion and
exclusion criteria for research was set. Them literature review was conducted and all the relevant
studiers to be included in the review were identified and included. Them using literature search
strategy secondary studies were selected. Lastly all the selected studies were analysed in which
study table was created and strength and characteristics of all the studies were identified so that
data can be interpreted.
Data Sources
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For this study secondary data sources had been selected for collection of required data
that had further been analysed so that appropriate information can be identified for answering
research questions. Mostly online data sources had been used for collection of secondary data for
the study. Many online libraries were used for collection data such as: Google Scholar, ncbi
database libraries were used because these are one of the most common libraries that has a large
database and can easily help in proving required data for the study. Not only this these online
libraries consist of large number of studies that can be used for selection of studies that are
within the scope of the study so that appropriate secondary data can be collected for systematic
review of research papers, articles that have already been published.
Literature search strategy
Search strategy for collection of appropriate and accurate secondary data following steps
were followed: First step is to identify search terms or key words using which research papers,
articles etc. for collection of secondary data [12]. Then second step is to identify online and
offline sources though which data will be collected. For this study online sources have been
selected for data collection. Third step is to set inclusion and exclusion criteria on the basis of
which literature is filtered as per credentials or author, publishers etc. Last step is to filter
literature as per date of publication and contribution of authors in analysing effectiveness of
treatment of peptic Ulcer.
Study selection
Study selection for the research study is done on the basis of following criteria: First is
that selected studies should not be beyond scope of the study [10]. Secondly it should fulfil all
the inclusion exclusion criteria set for the research. Selected studies will not only be related to
research area but will also help in answering all the research questions. Selected studies were
based upon usage of omeprazole and ranitidine for treatment of peptic ulcer. It can be said that in
this all the studies that focuses upon analysis of effectiveness of treatments that helps in
management of or treatment of Peptic Ulcer what been selected for systematic ulcer.
Inclusion and exclusion criteria
Inclusion and exclusion criteria help in selection of literature studies for secondary data
collection. In order to identify inclusion and exclusion criteria main requirements of the studies
were identified that were: not to include studies older than 6 years, studies should be in English
so that researcher can easily read and interpret it.
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Inclusion criteria: Studies that were published between 2015 to 2020 were selected. Studies that
were based upon effectivity or usage of omeprazole and ranitidine for treatment of peptic ulcer
were selected. Studies that were written in English language were only selected. Abstract of
study must contain at least 2 or more than 2 key words. Studies that had participants as patients
suffering from peptic ulcer were selected. Studies that were within the scope of research paper
and focused upon treatment of peptic ulcer using different kinds of treatment specifically
omeprazole and ranitidine were included. Research papers that focuses upon analysis of
treatment such as omeprazole or ranitidine for management of peptic Ulcer have been selected.
Exclusion criteria: Studies in language other than English were excluded. Papers or articles that
were published before 2015 were not selected. Studies that were out of scope of the research
study were also excluded. Other than this literature that did not had even single key word were
also excluded. All the research papers that have focused upon treatment other than omeprazole
and ranitidine have been rejected and not been selected.
Key words: omeprazole, ranitidine, peptic ulcer, medicines.
Outcome measures
Outcome measures that are less important then primary outcome measures but is a part of
secondary data analysis are known as secondary outcome measures [1]. There are various kinds
of methods that can be used for outcome measures for the research study. These outcome
measures are used for evaluation or analysis of effects of interventions of the study. For this
study thematic data analysis method had been chosen for measuring outcome and reaching to the
conclusion for answering main research question.
Validity and reliability
It is important to check validity and reliability of data selected for secondary data analysis
in order to maintain reliability and validity of current research study. It helps in identifying ways
in which secondary data can be analysed. In order to make this research study reliable only
published data available from authentic sources life government databases, online libraries were
selected. Studies in which methods of analysis, source of data had been explained clearly were
selected. In order to select validity and reliability of selected studies following factors were
checked: Whether, data collection have been done from authentic websites such as government
healthcare websites, online libraries or healthcare professional working in health and social care
organization where checked.
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RESULTS
For this dissertation overall 7 studies were selected in four stage exclusion of studies
were done for selection of 7 studies out of 20 studies.
PRISMA flow diagram for identfitying studies selected for systematic review
Identification: For this dissertation overall 20 studies were identified so that appropriate studies
for systematic review can be selected. For identification of these 20 studies, some key words
were used. All the studies that consist of two or more than two key words were included in the
study. These studies were identified using online databases or libraries or search engines. For this
paper overall two databases and search engines were used that are ncbi and Google scholar.
During this course of search on online databases only 20 relevant articles were identified that
were related to the study. When all the 20 articles were identified, screening of those articles
were done in which further some of the articles were excluded.
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Screening: All the selected articles were screened so that duplication of articles can be removed.
If there were any kind of duplicate articles then then those articles were removed or any article
focused upon same study with 70 percent similar data then those studies were removed. After
screening of all the 20 articles only 15 articles were selected. When screening of arties were
finished then eligibility of all the selected articles were checked by checking their characteristics
on the basis of inclusion and exclusion criteria.
Eligibility: Checking eligibility of studies for dissertation was one of the main factors on the
basis of which studies were selected to be included within systematic review [11]. All the articles
that were selected after screening were checked and evaluated on the basis of eligibility criteria
where characteristics of all the studies were checked on the basis of set inclusion and exclusion
criteria. After checking eligibility of studies only 12 studies were selected. These studies consist
of all the pre- defined characteristics that were required to be included within the studies for
answering main research question in an appropriate manner. Some of the main criteria on the
basis of which studies were excluded were: studies were older than 2015, were not in English
language and did not helped in addressing research question of the paper
Included: After selecting studies on the basis of eligibility criteria, their data, authenticity and
their publishing type were checked. When studies were checked on the basis of these factors out
of 12 only 7 studies were selected. Rest all the studies were excluded from this and out of 20
only 7 studies were selected.
In order to select these 7 studies following steps were followed: first of all, using
keywords like omeprazole, ranitidine, peptic ulcer, medicines, 20 studies were selected. Then
Out of these 20 studies duplicate studies were removed and after removal only 15 studies were
left. Then studies were analysed with the help of inclusion and exclusion criteria. And after this
evaluation only 12 studies were left. Then data collection sources of all the studies were checked
These four stages helped in selection of only appropriate studies for systematic review.
Characteristics on the basis of which studies were selected have been explained below:
Studies Characteristics
Clinical Control Study of 71 Cases of
Pediatric Peptic Ulcer Treated with
Omeprazole Triple Therapy and Ranitidine
Triple Therapy [8].
Year of Publishing: 2018
Population focused upon: patients treated with
Peptic Ulcer
Study- size: Study size of this paper was 71
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participants
Analysis: Primary data analysis
Treatment focused upon: omeprazole and ranitidine
Medical Management of Peptic Ulcer
Disease [14].
Year of Publishing: 2019
Population focused upon: Patients suffering from
peptic ulcer
Study- size: None
Treatment focused upon: All types of treatment
Peptic Ulcer Disease [7]. Year of Publishing: 2016
Population focused upon: Patients suffering from
peptic ulcer
Treatment focused upon: All types of treatment
Predictors of mortality in the elderly after
open repair for perforated peptic ulcer
disease [3].
Year of Publishing: 2017
Population focused upon: 65 years old patients
suffering from peptic ulcer
Analysis: Primary data analysis
Study- size: 2131 patients
Management of NSAID-associated peptic
ulcer disease [9].
Year of Publishing: 2016
Population focused upon: patients who had history
of peptic ulcer
Study- size: None
Treatment focused upon: omeprazole and ranitidine
High-dose omeprazole infusion compared
with scheduled second-look endoscopy for
prevention of peptic ulcer rebleeding: a
randomized controlled trial [2].
Year of Publishing: 2016
Population focused upon: received endoscopic
treatment for bleeding peptic ulcers
Analysis: Primary data analysis
Study- size: 153
Treatment focused upon: omeprazole
Peptic ulcer disease and non-steroidal anti-
inflammatory drugs [4].
Year of Publishing: 2017
Population focused upon: Patient had history of
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peptic ulcer
Study- size: None
Treatment focused upon: All types of treatment
Out of 20 reports retrieved from the databases, 7 were included for systematic review. 3 of
them focused upon comparison of omeprazole and ranitidine for treatment of peptic ulcer, 2 of
them provided details about peptic Ulcer and two of them explained medical management of
peptic Ulcer.
About Peptic Ulcer
2 studies provided details about Peptic Ulcer. One study was from Koria and discussed
about Peptic Ulcer, complications that can arise from it, and morality rate of Peptic Ulcer.
Another study is from United States and focuses upon surgeries performed for its treatment and
prediction of Mortality rate in elder people because of Peptic Ulcer. Study from Koria explains
that people with Peptic Ulcer with H. pylori infection has high mortality rate. Whereas United
states studies conducted upon peptic Ulcer evaluates that in elderly people complications
associated with Peptic Ulcer in elderly people are high because of which surgical repair for
treatment of Peptic Ulcer is performed less as a result mortality rate of Peptic Ulcer in elderly
people is high.
Medical management of peptic Ulcer
2 studies provide details about medical management of Peptic Ulcer. One study was from
Spain that explains that nonsteroidal anti-inflammatory drugs contribute majorly in the formation
of peptic ulcer because of which it becomes important to focus upon medical management for
mitigation of several complications. Another one was from USA also explains that use of Non-
steroidal anti-inflammatory drug increases risk of gastrointestinal complications such as ulcers or
bleeding. Factors like advanced age, history of peptic ulcer, Helicobacter pylori infection
increases its risk further. In such cases use of antisecretory drugs is one of the best medical
management that can help in minimize the risk of gastrointestinal complications in high-risk
patients and can further help in reducing risk of Peptic Ulcer. Comparison of both the studies
helps in understanding that in patients taking nonsteroidal anti-inflammatory drugs, taking 20 mg
of omeprazole daily is superior to ranitidine with respect to healing and preventing
gastroduodenal ulcers
Comparison of omeprazole and ranitidine for treatment of peptic ulcer
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3 studies provide details about Comparison of omeprazole and ranitidine for treatment of
peptic ulcer. One study was from China compares efficacy of Omeprazole triple therapy and
Ranitidine triple therapy in the treatment of peptic Ulcer. This study results clearly helps in
explain that Omeprazole triple therapy effectivity results were 97.3% whereas effectivity of
Ranitidine triple therapy were only 82.35%. this result clearly helps in explaining that
Omeprazole triple therapy is better for overall treatment effect of peptic ulcer. Second one was
from Hong Kong that explains that if a patient suffering from Peptic ulcer is given high dose of
omeprazole then it can help in preventing peptic ulcer rebleeding in an accurate manner as
compared to ranitidine. Third one was from Australia that explains that patients taking NSAID
drugs required triple amount of ranitidine daily dose as compared to omeprazole daily dose for
treatment of peptic Ulcer.
DISCUSSION
Overview of peptic ulcer
Li, Zhang And Xian, (2018) Peptic ulcer is a kind of disease in which a line of stomach,
lower oesophagus, or small intestine is developed because of the inflammation caused by
stomach acid erosion. There are three main types of peptic ulcer: gastric ulcer, oesophageal ulcer
and duodenal ulcer. There are many different kinds of causes because of this disease can occur
within individuals such as: Helicobacter pylori bacteria that causes stomach infection of
inflammation, frequent use of anti- inflammatory drugs, drinking, smoking, radiation therapy,
stomach cancer and many more. It is much easier for identification of peptic ulcer with the help
of some symptoms such as: changes within appetite, nausea, bloody or dark stools, unexplained
weight loss, indigestion, vomiting, chest pain.
Treatment available for management of peptic ulcer
Vernon, (2019) explains that there Are different kinds of treatment available for
treatment of peptic ulcer. But mostly treatment of peptic ulcer depends upon its cause. Mainly
treatment of peptic ulcer involves reduction in use of NSAIDs, killing of H. pylori bacterium and
healing of ulcer with proper medicine and therapies. One of the most effective way is by using
medicines that block acid production and promote healing. Proton pump inhibitors helps in
reduction of stomach acid by reducing or blocking some parts of cells that produce acid.
Omeprazole is a kind of medicine that helps in blocking acid production and promote healing.
But excessive use of this medicine is harmful for body as well because long term use of this kind
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of medicine of high dose of these medicines can result in increasing risk of hip, spine or wrist
fracture. Whereas, Kim, (2016) explains that there is another treatment method is by using
medicines that helps in reducing acid production. These kind of medicine helps in reducing
amount of acid production and make sure that only amount of acid which is required for
digestion is only. One of the most common medicine used for this is ranitidine. This medicine
helps in developing only amount of acid which is required for digestion only. It helps in reducing
amount of acid which is produced by stomach.
Daniel and et. al., (2017) says that that there are many other kinds of medicines that can
be used for peptic ulcer. Other than treating acid production or reduction, anti-biotics medicines
for treatment of H. pylori bacteria is also given to patients if peptic user is caused because of this
bacterium. These antibiotic medicines help in killing the bacterium. This can also include some
proton pump inhibitors as well. many times, excessive production of acid increase pain, for this
antacid can be given to patients so that stomach acids can be neutralized. But these medicines are
least preferred to be provided to patients because these medicines have some side effects as well
such as: diarrhoea, constipation.
Effectiveness of omeprazole for management of peptic ulcer
Chiu and et. al., (2016) explains that there are various research studies have taken place for
treatment of peptic ulcer and for identification of effectivity of medicines for treatment of peptic
ulcer. Omeprazole has been observed as one of the most effective medicine that can be used for
treatment of peptic ulcer especially in healing of gastric and duodenal peptic ulcers. Omeprazole
can be used a medicine for healing of gastric ulcer. Dose of omeprazole given to patients
provided different results like 20 mg dose of omeprazole given to patients daily is 90 percent
effective as compared to 40 mg dose of omeprazole given to patients as it is 97 percent effective.
Excessive stomach acid production and infection with H. pylori are strong predictors of peptic
ulcer development. Drini, (2017) further explains that effectiveness of omeprazole is irrespective
of peptic ulcer history or infection from H. pylori. Side effects of omeprazole are also moderate
like diarrhoea. So, it can be said that both standard and high dose of omeprazole are safe to be
given to patients. Even if it is withdrawn from use from peptic ulcer patients, it shows least
amount of side effects. Patients suffering from peptic ulcer can be treated and health within a
time period of 2 weeks with omeprazole medicine. Very few patients require to continue this
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