Ulcers occur when stomach acid damages the lining of the stomach, duodenum, or esophagus. A peptic ulcer is generally developing a sore in the digestive tract, where the lining of the stomach or duodenum is damaged by the stomach acids and digestive juices. The treatment of ulcer is based on what’s causing the ulcer. The treatment options include antibiotics to kill the Helicobacter pylori bacteria in the body. Treatment also focuses on lowering stomach acid levels so that the ulcer can heal, and mainly focus on eradicating the H. pylori infection. The various treatment options are listed below:

H. pylori infection treatment: The treatment of eradication of H. pylori requires a combination of several antibiotics combined with a proton-pump inhibitor, H2 blockers, or Pepto-Bismol in certain cases. The most commonly used antibiotics are tetracycline, amoxicillin, metronidazole (Flagyl), clarithromycin (Biaxin), and levofloxacin (Levaquin). The most common treatments for H. pylori infection include a proton pump inhibitor to reduce acid production, two antibiotics, and sometimes also bismuth subsalicylate (medication that is used to treat occasional upset stomach, heartburn, and nausea). Eradication of this bacterium also decreases the risk of developing gastric cancer in the future.

Antacids: Antacids are medications that help in neutralizing stomach acids. Antacids such as Maalox, Mylanta, and Amphojel are safe and much effective. These antacids may have few side effects, including diarrhea and constipation. There are chances that ulcers may return when antacids are discontinued.

Proton pump inhibitors (PPIs): PPIs reduce the number of stomach acids in the body. This treatment is prescribed for patients who test negative for H. pylori infection. PPIs such as omeprazole, lansoprazole, pantoprazole (Protonix), and esomeprazole are more potent than H2 blockers in suppressing acid secretion. The side effects may include headache, diarrhea, constipation, nausea, and rash. PPIs do not have any effect on a person’s ability of digestion. It may also cause loss of bone (osteoporosis) and low magnesium levels, and both of these side effects are easily identified and treated. PPIs are mostly preferred than H2 blockers for treating ulcers, as PPIs promote healing of ulcers in a greater percentage of people in a shorter period of time than H2 blockers.

Histamine-2 (H2) blocker: Histamine is the protein released in the stomach which stimulates gastric acid secretion. Histamine (H2) blockers are medicines designed to reduce the production of acid by blocking the action of histamine on gastric cells. The histamine drugs may include cimetidine (Tagamet), ranitidine (Zantac), famotidine (Pepcid) and nizatidine (acid). H2 blockers rarely produce side effects. The side effects include headache, confusion or hallucinations. Frequent monitoring of the dosages of these H2 blockers is needed.

Treatment may lead to surgery in rare cases. Surgery is primarily used to deal with a peptic ulcer with more complications. Even after the treatment, the patient may still have indigestion. In such cases, the doctor might advise some diet and lifestyle changes, and may also prescribe low-dose PPI or H2-receptor antagonists. Treating H. pylori infection and avoiding NSAIDs will successfully heal the ulcer and prevent from returning in almost all cases.