Sucralfate, sold under various brand names, is a medication used to treat stomach ulcers, gastroesophageal reflux disease (GERD), radiation proctitis, and stomach inflammation and to prevent stress ulcers. Its usefulness in people infected by H. pylori is limited. It is used by mouth (for upper GIT ulcers) and rectally (for radiation proctitis). Common side effects include constipation. Serious side effects may include bezoar formation and encephalopathy. Use appears to be safe in pregnancy and breastfeeding. How it works is unclear but is believed to involve binding to the ulcer and protecting it from further damage. Sucralfate was approved for medical use in the United States in 1981. It is available as a generic medication. In 2020, it was the 182nd most commonly prescribed medication in the United States, with more than 2million prescriptions. Medical uses Sucralfate is used for the treatment of active duodenal ulcers not related to the use of nonsteroidal anti-inflammatory drugs (NSAIDs), as the mechanism behind these ulcers is due to acid oversecretion. It is not FDA approved for gastric ulcers, but is widely used because of evidence of efficacy. The use for sucralfate in peptic ulcer disease has diminished recently, but it is still the preferred agent for stress ulcer prevention. Sucralfate has also been used for the following conditions: Active duodenal ulcer not related to NSAID use Maintenance therapy for resolved duodenal ulcers Gastric ulcer not related to NSAID use and gastritis due to GERD—Triple combination therapy with lansoprazole + cisapride + sucralfate can significantly improve symptoms and quality of life and was more cost-effective than ranitidine combination group. Aphthous ulcer and stomatitis due to radiation or chemotherapy—The 2013 guidelines of the International Society of Oral Oncology does not recommended sucralfate for the prevention of oral mucositis in head and neck cancer patients receiving radiotherapy or chemoradiation due to a lack of efficacy found in a randomized controlled trial. Gastro-esophageal reflux disease during pregnancy—First-line drug therapy combined with lifestyle and diet modification. Stress ulcer prophylaxis—The use of sucralfate rather than H2 antagonists for stress ulcer prophylaxis, and measures to prevent aspiration, such as continuous subglottic suctioning, have been shown to reduce the risk of ventilator-associated pneumonia (VAP). Sucralfate is less effective for prophylaxis against gastrointestinal bleeding than either a PPI or H2-blocker. For that reason, it is not commonly used for stress ulcer prophylaxis. Prevention of stricture formation—Sucralfate has an inhibitory effect on stricture formation