How is peptic ulcer treated?

Written by Jiang Guo Ming
Gastroenterology
Updated on March 18, 2025
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The treatment of peptic ulcers mainly depends on their cause. It is generally believed that infection with Helicobacter pylori is most closely related to peptic ulcers. In such cases, the first step is to check for Helicobacter pylori infection. If there is an infection, antibacterial treatment is generally used, with the common regimen being quadruple therapy: a proton pump inhibitor plus two antibiotics and a bismuth agent. If there is no Helicobacter pylori infection, symptomatic treatment is generally sufficient. The preferred method is to use acid-suppressing and stomach-lining-protecting medications, combined with symptomatic treatment. At the same time, it is helpful to develop good dietary and living habits, opt for a light and easy-to-digest diet, and eat regularly in fixed amounts. Avoid overeating and excessive fatigue; abstain from smoking and alcohol, and maintaining a good mood all help. (Medication should be used under the guidance of a professional doctor.)

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Written by Jiang Guo Ming
Gastroenterology
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Clinical characteristics of peptic ulcer

Peptic ulcer is a common and frequently occurring upper gastrointestinal disease. The most likely cause may be infection by Helicobacter pylori, with other potential causes including irritation from smoking and alcohol, poor dietary and living habits, severe psychological stress, or medications, among others. The primary change is usually an excessive secretion of gastric acid, which irritates the gastric mucosa leading to self-digestion and the appearance of gastric or duodenal erosion and ulcers. Clinically, it often presents as long-term, periodic, rhythmic upper abdominal pain, which may be located in the upper left abdomen or slightly right of the navel, and is often accompanied by regurgitation, belching, acid reflux, nausea, etc. If there is ulcer bleeding, it often presents as black stools or even vomiting blood, among other symptoms.

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Written by Jiang Guo Ming
Gastroenterology
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Why does a peptic ulcer bleed?

Peptic ulcers include gastric ulcers, duodenal bulb ulcers, and so on. Gastrointestinal bleeding is one of the common complications of peptic ulcers, usually caused by the ulcer being relatively large or deep, invading the blood vessels, leading to vessel rupture and resulting in bleeding. For minor bleeding, the patient may not have any discomfort symptoms, primarily indicated by black stools or a positive fecal occult blood test. If there is substantial bleeding, it can lead to symptoms such as vomiting blood. Such cases need attention and usually require hospitalization for observation and treatment. Sometimes, recurrent gastrointestinal bleeding may require surgical treatment.

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Written by Jiang Guo Ming
Gastroenterology
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How to treat peptic ulcers?

The treatment of peptic ulcers should be based on specific causes, as well as the patient's gender, age, medical history, and medication history, among other factors. Generally speaking, the primary cause of peptic ulcers is usually Helicobacter pylori infection. Therefore, the first step is to test for Helicobacter pylori. If Helicobacter pylori is present, antibacterial treatment is required, with the first choice being quadruple therapy, which includes a proton pump inhibitor, two types of antibiotics, and a bismuth agent, administered over a 10 to 14-day treatment course. If there is no Helicobacter pylori infection, the first choice would be proton pump inhibitors and gastric mucosal protective drugs, combined with symptomatic treatment. Meanwhile, it is crucial for patients with peptic ulcers to develop good eating and living habits, and relaxing their mindset can also be helpful.

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Written by Jiang Guo Ming
Gastroenterology
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What can people with peptic ulcers eat?

Peptic ulcers include duodenal bulb ulcers, gastric ulcers, complex ulcers, etc. In such cases, formal treatment should be administered first. Depending on whether there is a Helicobacter pylori infection, different treatment plans should be adopted. At the same time, it is important to develop good dietary and living habits, quit smoking and drinking, and ensure that the diet is light and easy to digest. While ensuring adequate nutrition, efforts should be made to minimize gastric irritation. Foods like soft and mushy rice, porridge, and soft noodles are preferable. Fresh vegetables and fruits are fine. Try to avoid overly cold, greasy, spicy, or irritating foods. Be sure to eat regularly and in moderation or have small, frequent meals, and avoid binge eating.

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Written by Zhu Dan Hua
Gastroenterology
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Can a peptic ulcer heal itself?

Peptic ulcers, commonly referred to as stomach ulcers and duodenal ulcers, are relatively common in clinical settings and generally have a good prognosis. For simple peptic ulcers, patients usually do not exhibit common symptoms such as abdominal pain, vomiting blood, bloody stools, abdominal distension, vomiting, etc., and these can often heal on their own. However, if a patient experiences typical upper abdominal symptoms like vomiting blood, bloody stools, or significant abdominal pain, especially pain in the lower back, it is advisable for the patient to seek timely treatment at a local hospital for further clarification. In treating this condition, a few points should be noted: First, pay attention to diet and rest, it’s advisable to eat smaller, more frequent meals and avoid spicy foods and abstain from smoking and alcohol. Second, if peptic ulcers are suspected, one might consider using supplementary oral medications, such as antacids or gastroprotective drugs etc., which generally lead to a good prognosis. Of course, if the patient does not exhibit any special symptoms, regular observation may suffice.