Treatment for Peptic Ulcers (Stomach or Duodenal Ulcers)

How do doctors treat peptic ulcers?

To treat peptic ulcers, doctors typically recommend medicines to help the ulcer heal. They also look for the cause of ulcers and treat or manage the cause. Talk with your doctor about the best treatment plan for you.

Healing peptic ulcers

Medicines that doctors recommend or prescribe to treat peptic ulcers include

• proton pump inhibitors (PPIs)
• H2 blockers
• other medicines

Treating the causes of peptic ulcers

Doctors treat the underlying causes of peptic ulcers to help the ulcers heal and prevent them from coming back.

Helicobacter pylori (H. pylori) infection

Doctors treat H. pylori infection with a combination of medicines. These medicines most often include

• two or more antibiotics
• a PPI
• in some cases, bismuth subsalicylate

Your doctor may avoid prescribing antibiotics you’ve taken in the past because the H. pylori bacteria may have developed antibiotic resistance to those antibiotics.

If you are given medicines, take all doses exactly as your doctor prescribes. If you stop taking your medicine early, some bacteria may survive and persist in your stomach. In other words,
H. pylori bacteria may develop antibiotic resistance.

To find out if the medicines worked, your health care professional may recommend testing you for H. pylori at least 4 weeks after you’ve finished taking the antibiotics.² If you still have an
H. pylori infection, your doctor may prescribe a different combination of antibiotics and other medicines to treat the infection. Making sure that all of the H. pylori bacteria have been killed is important.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

If you have a peptic ulcer caused by taking NSAIDs, your doctor may recommend changing your medicines.

If you have a peptic ulcer caused by taking NSAIDs, your doctor may recommend changing your medicines. Depending on the reason you have been taking NSAIDs, your doctor may suggest stopping NSAIDs, taking a different NSAID, taking a lower-dose NSAID, or taking a different medicine for pain.

If you need to keep taking NSAIDs, your doctor may recommend you also take a PPI.

Other causes

If your peptic ulcers aren’t caused by H. pylori infection or NSAIDs, doctors will check for uncommon causes. Depending on the cause, doctors may recommend additional treatments.

What if an ulcer doesn’t heal or comes back after treatment?

Taking medicines and treating the underlying cause heals most ulcers. However, if your ulcer doesn’t heal or comes back after treatment, your doctor may

• check for and treat any factors that could be causing the ulcer, such as an H. pylori infection.
• recommend you quit smoking, if you smoke. Smoking can slow ulcer healing.
• recommend or prescribe more medicines to help heal the ulcer.
• recommend an upper GI endoscopy to obtain biopsies.

In rare cases, doctors may recommend surgery to treat peptic ulcers that don’t heal.

How do doctors treat the complications of peptic ulcers?

Doctors typically treat complications of peptic ulcers in a hospital. In addition to treating the ulcer, doctors may recommend medical procedures, such as an upper GI endoscopy, or surgery to treat ulcer complications.

How can I prevent peptic ulcers?

If you smoke, quitting smoking can lower your risk for peptic ulcers.

If your doctor thinks you have a high risk for developing peptic ulcers caused by taking NSAIDs, your doctor may recommend changes to lower your risk, such as

• changing the medicines you take, if possible. For example, your doctor may change the type of NSAIDs you take, lower the dose of NSAIDs, or prescribe NSAIDs for a shorter time.
• taking PPIs along with NSAIDs.
• testing for and treating H. pylori infection before you start taking long-term NSAIDs.

If you have a peptic ulcer, finding and treating the underlying cause, such as H. pylori infection, can help lower the chance of developing future ulcers.

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