If you have been diagnosed with a
peptic ulcer caused by infection with Helicobacter pylori (H. pylori)
bacteria, you will need treatment with antibiotic medicines to kill the
If your ulcer is caused by the use of nonsteroidal
anti-inflammatory drugs (NSAIDs), stop using them. NSAIDs slow or prevent the
healing of an ulcer.
Medicines that reduce the amount of acid
produced by the stomach are used to treat all forms of peptic ulcer disease.
These include H2 blockers and proton pump inhibitors (PPIs).
Lifestyle changes, such as quitting smoking and not drinking too
much alcohol, are important for helping ulcers heal. Limit alcohol to 2 drinks
a day for men and 1 drink a day for women.
Ulcers that do not respond to treatment may have developed
complications or may actually be cancer. You may need an endoscopy so that your
doctor can look at the inside of your stomach and your upper small intestine to
check for H. pylori or can collect a tissue sample
(biopsy) that can be tested for cancer. But sometimes when symptoms do not get
better with treatment, they are caused by something else that may or may not be
a serious problem. Make sure you talk with your doctor to get to the bottom of
Because the medicines now used to treat peptic ulcer
disease work so well, surgery is rarely used to treat peptic ulcer disease.
Surgery generally is reserved for people who have a life-threatening
complication of an ulcer, such as severe bleeding,
perforation, or obstruction. In some cases, even these complications can be
treated without surgery.
infection. Treatment to eliminate
Helicobacter pylori (H. pylori) bacteria usually involves combining two antibiotics
with an acid reducer such as a proton pump inhibitor or sometimes a bismuth
compound. Curing the infection speeds the healing of an ulcer and makes the
ulcer less likely to recur. It is important to take all the medicine your
doctor prescribes so that the bacteria are killed and do not come back. Do not
stop taking the medicine just because you feel better. If the bacteria are not
eliminated by the antibiotics, they may become even more difficult to kill
NSAIDs. If at all possible, you will need to stop
nonsteroidal anti-inflammatory drugs (NSAIDs). If you
must continue taking an NSAID, other medicines may be used to protect the
stomach. For more information, see the Medications section of this
Hypersecretory condition. Acid reducers are most
often used to treat an ulcer caused by a hypersecretory condition (a condition
in which your stomach produces excessive acid). Also, your doctor may
want to conduct other tests to find out whether there is another cause for the
Unknown cause. If no cause can be found (idiopathic
ulcer), your ulcer will usually be treated with an acid reducer. Long-term
treatment depends on the severity of the ulcer and other factors, such as the
size of the ulcer, whether you have had complications, and what other
treatments have been used.