Peptic Ulcer Treatment

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An ulcer is a sore or lesion that forms in the lining of the stomach or duodenum, which is the first part of the small intestine. Ulcers in the stomach are called gastric or stomach ulcers, and those in the duodenum are called duodenal ulcers. Both can be referred to as peptic ulcers.

Most peptic ulcers can be healed with proper treatment. Research has found that the majority of peptic ulcers are caused by an infection with a bacterium called Helicobacter pylori (H. pylori), and standard treatment in these cases is a combination of drugs, including antibiotics and a proton pump inhibitor (see below).


The discovery of the link between ulcers and H. pylori has resulted in a new treatment option. Now, in addition to treatment aimed at decreasing the production of stomach acid, doctors may prescribe antibiotics for patients with H. pylori.

By eliminating H. pylori means the ulcer may now heal and most likely will not come back. However, antibiotics alone are not used to treat H Pylori. The most commonly recommended first-line treatment is a combination of a proton pump inhibitor and the antibiotics amoxicillin and clarithromycin for two weeks. This is sometimes given in a single prescription called "Prevpac."

In penicillin allergic people, a drug called metronidazole is sometimes substituted for the amoxicillin.

Sometimes a PPI may be combined with bismuth (Pepto Bismol) along with the two antibiotics. After H. Pylori is eradicated, all of the antacid medications can be continued.

Proton pump inhibitors include:

Lifestyle modifications

In the past, doctors advised people with ulcers to avoid spicy, fatty and acidic foods. However, it has been shown that a bland diet is ineffective for treating or avoiding ulcers.

This doesn't mean a bland diet is bad for ulcer sufferers. In fact, avoiding spicy foods may help you feel better since some people find certain foods irritating. Smoking is a different issue: It has been shown to delay ulcer healing and has been linked to ulcer recurrence. Therefore, people with ulcers should not smoke.

What Causes Peptic Ulcers?

Ulcers form when the protective lining of the stomach or duodenum (known as the mucosa and submucosa) becomes eroded. Small ulcers may not cause any symptoms, but large ulcers can cause serious bleeding. Most ulcers occur in the first layer of the inner lining. If the ulcer erodes beyond that, a hole can open that goes all the way through the intestine, called a perforation of the intestinal lining. A perforation is a medical emergency.

Despite the popular belief that peptic ulcers are caused by spicy foods or stress, the reality is that most of the time, peptic ulcers are caused by infection with a bacterium called Helicobacter pylori (H pylori). Most 


"Common GI Problems: Volume 1." American College of Gastroenterology.

Frank L. Lanza, M.D., F.A.C.G., "A Guideline for the Treatment and Prevention of NSAID-Induced Ulcers." American College of Gastroenterology.

"H. pylori and Peptic Ulcer." NIH Publication No. 05–4225 October 2004. National Digestive Diseases Information Clearinghouse (NDDIC).

"What I need to know about Peptic Ulcers." NIH Publication No. 05–5042 October 2004. National Digestive Diseases Information Clearinghouse (NDDIC).

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