Peptic Ulcer (stomach ulcers)

Symptoms   Causes   Self help   Supplements & other treatment   Nutrition & lifestyle discussion

Peptic ulcers are erosions in the lining of the small intestine (80%) or the stomach (20%) Most (70-90%) are caused by infection from Helicobacter pylori. People with peptic ulcers due to infection should discuss conventional treatment directed toward eradicating the infection - a combination of antibiotics and bismuth - with a medical doctor.

Self Help

Lifestyle changes

  • Aspirin and related drugs (non.steroidal anti-inflammatory drugs): Aspirin and related drugs can aggravate or interfere with the healing of peptic ulcers.
  • Avoid alcohol: Alcohol is known to increase stomach acidity, which can interfere with the healing of an ulcer.
  • Avoid coffee (including decaf) and tea: These beverages are known to increase stomach acidity, which can interfere with the healing of an ulcer.
  • Quit smoking: Smoking is known to slow ulcer healing.

Dietary changes

  • Avoid sugar: Sugar may exacerbate peptic ulcers in susceptible individuals.
  • Restrict salt intake: Salt is a stomach and intestinal irritant. Higher intakes of salt have been linked to higher risk of stomach (though not duodenal) ulcer. However, the amount of benefit obtainable by restricting dietary salt remains unknown.
  • Drink cabbage juice: Many years ago, researchers reported that cabbage juice accelerated healing of peptic ulcers.
  • Eat foods high in fiber: Results are mixed as to preventing or eliminating ulcers, but increased fiber may limit relapses.
  • Avoid food allergens: In the early 20th century the relationship between food allergies and peptic ulcer was first noted, and it was known that if the stomach lining is exposed to known allergens irritation and bleeding can result. Although additional research is needed, avoiding food allergens may be helpful for people with peptic ulcers. Consultation with a doctor is needed to discover to which foods a person is sensitive.
  • One recent study found that glutinous rice extract was helpful for lab animals with stress-induced ulcers.1

Learn more about nutritional, dietary and lifestyle recommendations.

Although it was originally discovered in the 1950s it was not until 1982 that researchers found that the bacteria helicobacter pylon could cause ulcers and could be treated with a simple antibiotic. It can also be caused or exacerbated by stress, alcohol, smoking, and dietary factors. Ulcers should not be treated without proper diagnosis.


Peptic ulcers are occasionally painless. However, the most common symptom is a dull ache in the upper abdomen that usually occurs two to three hours after a meal; the ache is relieved by eating. Other common symptoms include weight loss, bloating, belching, and nausea. Untreated, peptic ulcers often bleed and may cause sharp burning pain in the area of the stomach or just below it.


In 1982 it was discovered that a bacteria, helicobacter pylori, was present in many patients with ulcers. It was a rather revolutionary matter, allowing many with ulcers to treat them successfully with a simple antibiotic - ending years of controlled diets.

There are a number of known or likely causes of ulcers.

  • Helicobacter pylori causes about 60% of stomach ulcers and 90% of small intestinal ulcers. The bacteria was discovered in the 50s, but forgotten or overlooked and rediscovered in 1982. It's rediscovery ended years of restrictive diets and treatment with drugs such as cimetidine to control the symptoms of peptic ulcers. H. pylori lives in the mucous membrane lining the stomach causing inflammation and irritation. It also causes gastritis and indigestion. Some researchers feel it may contribute to stomach cancer development. It is more commonly found in the poor and institutionalized, where diet is often poor, although the cause might come from infected food, dishware, infected well water, or body fluids.
  • However, recent research also associates the medical move to eradicate H. pylori in children (to address the issue of gastric cancer) with increased gastroesophageal reflux diseases. So there may be benefits to the bacteria as well.2
  • Some drugs such as ibuprofin, aspirin, NSAIDs, and other drugs for heart attack, stroke, and arthritis.
  • Stomach cancers can first appear as ulcers, especially in the elderly.
  • Anxiety, stress, smoking, alcohol, and dietary factors.

Conventional Treatment

Ulcers are usually treated with antibiotics (e.g., amoxicillin, clarithromycin, tetracycline, metronidazole, and bismuth subsalicylate. In addition, to control acid stomach and other symptoms, drugs such as histamine H2 inhibitors, cimetidine, famotidine, nizatidine, ranitidine, proton pump inhibitors, omeprazole, and antacids are prescribed or taken as over-the-counter medications.

There is some evidence that proton pump inhibitors can cause hypersensitivity reactions - Omeprazole being the most frequent cause.3

Self Help

Nutritional supplements

  • Zinc plays a role in repairing tissue and may be helpful. Zinc-L-Carnosine may also be helpful.
  • Glutamine is helpful in healing after surgery and may be helpful for ulcers.
  • Other nutrients

Key herbs

  • Licorice Deglycyrrhizinated licorice (DGL) is a licorice extract that may protect the lining of the stomach and the duodenum by stimulating the protective agent, mucin. DGL is preferred to avoid side effects.
  • Mastic: This gummy extract has been shown to kill H. pylori in test tube research.

Other herbs

Other integrative approaches

  • Stress reduction Whether stress reduction techniques or psychological counseling helps prevent ulcers or ulcer recurrence has not been adequately studied in medical research.


See footnotes and research

Other footnotes

1. Gastroprotective Effects of Glutinous Rice Extract against Ethanol-, Indomethacin-, and Stress-induced Ulcers in Rats, Song, DU, et al, Chonnam Medical Journal, April 2014, 50(1), 6-14.
2. Is Helicobacter Pylori Always a "Bad Guy"?, Hojsak, I, et al, Current Pharmaceutical Design, October, 2013.
3. Evaluation and management of hypersensitivity to proton pump inhibitors, Bose, S., et al, Annuals of Allergy, Asthma & Immunology, December, 2013, 111(6, 452-457.