Digestive

Medicines for Peptic ulcer disease

Open sores in the lining of the stomach or duodenum, usually caused by Helicobacter pylori infection or anti-inflammatory painkillers — treated by removing the cause and suppressing acid to let the ulcer heal.

Education and reference only. This explains which medicines are used and why, in plain language — it deliberately contains no doses and is not a substitute for advice from your doctor or pharmacist. Always discuss your own treatment with a qualified clinician, and check the BNF and the product labelling for prescribing detail.

Written by Meds Global Health Clinical Team · Clinically reviewed by Dr Muhammad Suffyan, MB BS, Founder & Clinical Director · Last reviewed · How we review

Quick answer

What is Peptic ulcer disease?

A peptic ulcer is a break, or open sore, in the protective lining of the stomach (a gastric ulcer) or the first part of the small intestine (a duodenal ulcer), where stomach acid has damaged tissue that should normally be protected. The two main causes are infection with a bacterium called Helicobacter pylori (H.

  • How it is treated: Treatment has two parts: healing the ulcer and removing its cause so it does not return.
  • Self-care: Avoiding or minimising NSAIDs and aspirin where possible (with your prescriber's advice), stopping smoking, cutting down on alcohol and managing stress all support healing and reduce the chance of recurrence.
  • When to seek help: A bleeding ulcer is an emergency — call 999 or go to A&E if you vomit blood or material that looks like coffee grounds, pass black tarry or bloody stools, feel faint, or develop sudden severe abdominal pain (which may signal perforation).

What it is

A peptic ulcer is a break, or open sore, in the protective lining of the stomach (a gastric ulcer) or the first part of the small intestine (a duodenal ulcer), where stomach acid has damaged tissue that should normally be protected. The two main causes are infection with a bacterium called Helicobacter pylori (H. pylori), which weakens the lining, and regular use of non-steroidal anti-inflammatory drugs (NSAIDs) or aspirin, which reduce the lining's natural defences. Typical symptoms are a gnawing or burning pain in the upper abdomen, sometimes related to eating, along with indigestion, bloating or nausea. Many ulcers heal well once the cause is addressed, but they can bleed or, rarely, perforate, and a bleeding ulcer is a medical emergency. Identifying the cause — testing for H. pylori and reviewing painkiller use — is central to treatment.

How it is treated

Treatment has two parts: healing the ulcer and removing its cause so it does not return. Suppressing stomach acid with a proton pump inhibitor (PPI) is the mainstay for healing, allowing the damaged lining to recover; H2-receptor antagonists are an alternative form of acid suppression, and antacids or alginates can ease symptoms in the meantime. If H. pylori is found, it is cleared with a short course of eradication therapy — a combination of a PPI plus two antibiotics taken together for a defined period. If NSAIDs or aspirin caused the ulcer, these are stopped or reviewed where possible, and ongoing acid protection is considered for people who must keep taking them. Confirming that a gastric ulcer has healed, and that H. pylori has cleared, is part of follow-up. This guide gives the principles only and does not provide the doses or specific regimens, which are prescribed individually.

For this condition, these medicines

Medicine classes used for Peptic ulcer disease

Each links to a full, dose-free guide — what it is, how it works, who can and cannot use it, side effects, interactions and FAQs.

Proton pump inhibitors Gastrointestinal The mainstay for healing the ulcer; strong acid suppression that lets the damaged lining recover, and a core part of H. pylori eradication. H2-receptor antagonists Gastrointestinal An alternative form of acid suppression where a PPI is unsuitable. Antacids and alginates Gastrointestinal Provide short-term symptom relief while underlying treatment takes effect. Penicillins Anti-infective Amoxicillin is used as one of the antibiotics in H. pylori eradication therapy — always in combination with a PPI, not alone. Macrolide antibiotics Anti-infective Clarithromycin is used as an antibiotic component of H. pylori eradication therapy, in combination with a PPI. Metronidazole Anti-infective Used as part of some H. pylori eradication regimens, particularly where there is penicillin allergy or as an alternative component.

Symptom checker

Symptoms that can point to Peptic ulcer disease

Peptic ulcer disease can be one cause of these symptoms. Each guide explains the other possible causes and the red-flag warning signs that mean you should get urgent help:

Chest painDiscomfort, pressure, tightness or sharp pain anywhere in the chest that can come from the…Abdominal painPain anywhere between the chest and the groin — cramping, burning, gnawing or sharp — whic…HeartburnHeartburn is a burning feeling in the chest caused by stomach acid rising into the gullet,…VomitingBringing up the contents of the stomach — usually a short-lived response to a tummy bug, m…Feeling full quicklyFeeling full after eating only a small amount, or losing your appetite earlier than usual …

Clinical formulas & tools

Calculators used in Peptic ulcer disease

Risk scores and formulas that inform assessment and treatment decisions in this condition:

Glasgow-Blatchford ScoreRisk stratification of upper GI bleeding.Rockall Score (pre-endoscopy)Risk after upper GI bleeding (clinical score).

By active ingredient

Specific medicines used for Peptic ulcer disease

Dose-free guides to individual active ingredients used in peptic ulcer disease — what each is, how it works, how to take it, and its advantages and disadvantages:

OmeprazoleA widely used proton pump inhibitor that strongly reduces stomach acid, for reflux, ulcers…LansoprazoleA proton pump inhibitor much like omeprazole, with a melt-in-mouth form useful for swallow…PantoprazoleA proton pump inhibitor that reduces stomach acid, often preferred with clopidogrel becaus…FamotidineAn acid-reducing medicine (H2 blocker) for heartburn, reflux and ulcers; gentler than a PP…EsomeprazoleA proton pump inhibitor that strongly reduces stomach acid for reflux and ulcers — closely…SucralfateA mucosal protectant that forms a protective coating over ulcers and damaged areas, shield…MisoprostolA prostaglandin medicine used to protect the stomach from anti-inflammatory ulcers and, se…Tripotassium dicitratobismuthateA bismuth chelate that coats and protects stomach ulcers and is used in some Helicobacter …RanitidineAn acid-reducing medicine for reflux and ulcers that has largely been withdrawn in the UK …

Beyond medication

Lifestyle and self-care

Avoiding or minimising NSAIDs and aspirin where possible (with your prescriber's advice), stopping smoking, cutting down on alcohol and managing stress all support healing and reduce the chance of recurrence. Do not stop a prescribed aspirin or anti-inflammatory on your own — discuss it first, as some are taken for important reasons such as heart protection.

When to get help

When to see a doctor

A bleeding ulcer is an emergency — call 999 or go to A&E if you vomit blood or material that looks like coffee grounds, pass black tarry or bloody stools, feel faint, or develop sudden severe abdominal pain (which may signal perforation). The risk scores linked here are used in hospital to assess upper-gastrointestinal bleeding. For ongoing indigestion-type pain without these features, see your GP for assessment and H. pylori testing.

999Emergency — call 999 or go to A&E
111Urgent advice — call NHS 111 or use 111 online
GPNon-urgent — see your GP or pharmacist

Not sure how urgent it is? It is always OK to call NHS 111 for advice, day or night.

Answers

Peptic ulcer disease: frequently asked questions

What medicines are used for peptic ulcer disease?

A proton pump inhibitor (PPI) is the mainstay for healing the ulcer by suppressing stomach acid; H2-receptor antagonists are an alternative, and antacids ease symptoms. If Helicobacter pylori is found, it is cleared with eradication therapy — a combination of a PPI plus antibiotics such as amoxicillin, clarithromycin or metronidazole. The exact combination and course are prescribed individually.

What causes peptic ulcers?

The two main causes are infection with Helicobacter pylori, a bacterium that weakens the stomach lining, and regular use of anti-inflammatory painkillers (NSAIDs) or aspirin, which reduce the lining's defences. Other factors such as smoking and heavy alcohol use can contribute. Finding the cause is key, because treatment differs.

How is Helicobacter pylori treated?

H. pylori is treated with a short course of eradication therapy — a proton pump inhibitor taken together with two antibiotics for a defined period. Taking the full combination exactly as prescribed matters, because partial treatment can fail and encourage resistance. A test is often done afterwards to confirm the infection has cleared.

Is a bleeding ulcer dangerous?

Yes — a bleeding ulcer is a medical emergency. Warning signs include vomiting blood or material resembling coffee grounds, passing black tarry or bloody stools, feeling faint, or sudden severe abdominal pain. Call 999 or go to A&E. Hospital teams use risk scores to assess the severity of upper-gastrointestinal bleeding and plan treatment.

Keep reading

Related articles

PPIs and acid reflux: how they work and what about long-term useA plain-English guide to proton pump inhibitors (PPIs) — how they ease acid reflux, when t…

Sources

Where this is drawn from

  • NICE CG184: Gastro-oesophageal reflux disease and dyspepsia in adults: investigation and management.
  • NICE CKS: Stomach ulcer.

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