How Are Stomach Ulcers Treated?

Medically reviewed by Kumkum S. Patel MD, MPH

A stomach ulcer, also called a gastric ulcer, is an open sore on the lining of your stomach. Stomach ulcers develop when the stomach's protective mucosal lining breaks down, allowing digestive acids to damage the underlying tissue, forming an ulcer. 

Treatment for stomach ulcers depends on the underlying cause. Most stomach ulcers are treatable and will heal with dietary modifications, lifestyle changes, and prescription medications. Surgery is sometimes necessary for more severe stomach ulcers. 

Stomach ulcers are treated by gastroenterologists, doctors specializing in diagnosing and treating problems with the digestive system. In some cases, primary care providers can treat stomach ulcers.

Medications

Medications are the primary treatment for stomach ulcers. The type of medication(s) your healthcare provider prescribes will depend on what's causing the ulcer and the severity of your symptoms.

Prescription

The goals of prescription medications for stomach ulcers are to help reduce stomach acid production, kill H. pylori bacteria (if present), and protect the stomach lining from further damage. Common prescription medications for stomach ulcers include: 

• Proton pump inhibitors (PPIs): These medicines suppress gastric acid production in the stomach. Decreased acid prevents further damage to the stomach lining and reduces irritation and inflammation in the stomach, allowing the ulcer to heal. Examples of PPIs include Prilosec (omeprazole), Prevacid (lansoprazole), Nexium (esomeprazole), Protonix (pantoprazole), Aciphex (rabeprazole), and Dexilant (dexlansoprazole).

• Histamine H2 blockers: H2 blockers bind to histamine receptors in the stomach lining to decrease gastric acid secretion, helping relieve symptoms and promote ulcer healing. These medicines are similar to PPIs but are not as effective. Examples include Pepcid AC (famotidine), Tagament HB (cimetidine), and Axid AR (nizatidine).

• Antibiotics: Antibiotics treat stomach ulcers caused by an H. pylori bacterial infection. Your healthcare provider may prescribe two antibiotics to kill the bacteria, promote healing, and prevent the ulcer from returning. Commonly prescribed antibiotics include clarithromycin, amoxicillin, and metronidazole.

Over-The-Counter

Over-the-counter medications may be enough to help manage symptoms of mild stomach ulcers that cause intermittent symptoms. These primarily include antacids and acid blockers.

Antacids quickly relieve stomach ulcer symptoms like heartburn and indigestion. They help neutralize excess stomach acid to relieve stomach ulcer symptoms rapidly, such as heartburn and indigestion.

Acid blockers include over-the-counter proton pump inhibitors and H2 blockers. These medicines contain lower doses of the same medicines your healthcare provider may prescribe, such as Prilosec (omeprazole), Prevacid (lansoprazole), and Pepcid AC (famotidine).

Lifestyle

Lifestyle modifications are an integral part of stomach ulcer treatment. While they won't cure a stomach ulcer, lifestyle changes alongside medical treatment can speed up the healing process and reduce your risk of getting another one in the future. Common lifestyle modifications for treating stomach ulcers include dietary changes, stress management, not smoking, and not taking non-steroidal anti-inflammatory drugs (NSAIDs).

Dietary Changes

Contrary to popular belief, certain foods and beverages do not cause stomach ulcers. However, they may worsen stomach ulcer symptoms. A balanced diet rich in fruits, vegetables, lean proteins, and whole grains provides essential nutrients that support your digestive and overall health.

Limit your intake of foods that may trigger or worsen symptoms, such as spicy foods, acidic foods, fried foods, carbonated drinks, and dairy. Avoid eating close to bedtime or late at night, which can increase stomach acid production.

Stress Management

Stress increases stomach acid production, which can worsen stomach ulcer symptoms and delay the healing process. Finding healthy ways to manage stress, such as exercise, deep breathing, yoga, tai chi, or meditation, can help reduce stress and promote healing.

You may find it helpful to work with a therapist to develop healthy coping mechanisms if you struggle to cope with anxiety, depression, or excessive worrying.

Smoking Cessation

Smoking irritates the stomach lining and reduces blood flow, increasing your risk of stomach ulcers. It is also associated with a higher risk of complications, delayed healing, and stomach ulcer recurrence. Quitting smoking can promote healing and lower your chances of getting another stomach ulcer.

Avoid Nonsteroidal Antiinflammatory Drugs (NSAIDs)

NSAIDs are a common cause of stomach ulcers. Taking them to manage pain can worsen symptoms and increase your risk of complications, such as gastric bleeding. Avoid taking Advil (ibuprofen) or Aleve (naproxen) to prevent worsening stomach ulcers.

Tylenol (acetaminophen) is the safest pain reliever to take when you have a stomach ulcer, though it will not help manage common stomach ulcer symptoms, such as heartburn and indigestion.

Talk to your healthcare provider about which NSAIDs are safe for you to take.

Surgeries and Procedures

With proper medical management, most stomach ulcers heal without surgery. However, surgery may be necessary if the stomach ulcer has led to complications, such as severe bleeding, perforation through the stomach wall, or an obstruction. It is sometimes recommended if other treatments have been ineffective.

Stomach ulcer surgery can be performed using one of the following methods: 

• Laparoscopy: A minimally invasive technique that involves making small incisions in the abdomen and using a laparoscope equipped with a camera to visualize the stomach and perform the surgery.

• Endoscopy: A flexible tube equipped with a camera and surgical tools (endoscope) is inserted through the mouth and down into the throat and stomach.

• Open: Involves making a large incision in the abdomen to access the stomach and repair the ulcer. 
  

Several surgical procedures can effectively treat stomach ulcers. The procedure your healthcare provider recommends will depend on your symptoms and which complications they are treating, if any. These include: 

• Pyloroplasty: Involves widening the opening at the bottom of the stomach so stomach contents can quickly drain into the small intestine.

• Vagotomy: The vagus nerve stimulates stomach acid production. This surgery involves cutting one or more branches of the vagus nerve to reduce stomach acid production.

• Antrectomy: Involves removing the lower portion of the stomach (where most stomach acid is produced) and connecting the remaining stomach to the small intestine.

Complementary and Alternative Medicine

Complementary and alternative medicine (CAM) therapies may help relieve stomach ulcer symptoms, but their effectiveness in healing stomach ulcers is not well-established. CAM therapies should not replace standard medical treatments, and you should speak with your healthcare provider before adding them to your treatment plan. 

Probiotics

Probiotics are live microorganisms similar to the bacteria that naturally live in the digestive tract. Research suggests probiotics may accelerate the healing of stomach ulcers by decreasing stomach acid production and fighting H. pylori infection. In a 2016 study, probiotics reduced H. pylori by 64% and eliminated the bacteria in nearly a third of cases.

While probiotics show promise in helping treat and prevent stomach ulcers, more research is needed to determine the most effective strains, dosage, and treatment duration for using probiotics to treat stomach ulcers. 

Acupuncture

Acupuncture is a traditional Chinese medicine technique that involves inserting fine needles into specific points (acupoints) on the body. Studies exploring the effects of acupuncture show it reduces inflammation, pain, and stress, which may be beneficial for treating stomach ulcers when combined with conventional medical treatments. However, its impact on ulcer healing remains uncertain, and more research is needed to determine its effectiveness.

Living With and Managing Stomach Ulcers

With treatment, most stomach ulcers heal within 4 to 8 weeks. Some stomach ulcers may take longer to heal, and some people may experience recurrent ulcers. Following your treatment plan and sticking with your dietary and lifestyle changes can help promote healing and reduce your risk of developing another stomach ulcer. 

Living with a stomach ulcer and making the necessary lifestyle changes can be daunting. Changing your diet and quitting smoking can be difficult, especially if you have been doing these things for a long time. It takes time to make lifestyle changes, and you may find it helpful to start with small changes you can stick with. Ask your family, friends, and healthcare providers for support when needed. 

Related: How To Know if You Have a Stomach Ulcer

A Quick Review

Stomach ulcers develop when your stomach's protective mucosal lining is damaged, caused by an imbalance between stomach acid and the protective mucus lining. Medications, lifestyle modifications, and, in rare cases, surgery can all effectively treat stomach ulcers. Medications work by reducing stomach acid production, killing H. pylori bacteria, or protecting the stomach lining.

Untreated stomach ulcers can worsen symptoms and complications, such as bleeding and perforation. See your healthcare provider if you have symptoms of a stomach ulcer. They can provide a diagnosis and recommend the most effective treatments. Most stomach ulcers heal within 4 to 8 weeks with proper treatment and management. 

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