If you have a stomach or duodenal ulcer, you want straightforward actions — not confusion. Ulcers usually come from H. pylori infection or regular NSAID use. Treatment aims to kill the bacteria if present, protect the lining while it heals, and remove the things that caused the ulcer in the first place. Below you’ll find what doctors do, what you can change at home, and red flags that need urgent care.
First, your doctor will try to find out if H. pylori is the cause. That’s done with a breath test, stool antigen test, or sometimes an endoscopy. If H. pylori is found, a short course of antibiotics plus an acid-suppressing medicine (a PPI) is the usual plan. If H. pylori isn’t the issue, a PPI alone is often enough to let the ulcer heal.
Proton pump inhibitors (PPIs) — like omeprazole or esomeprazole — lower stomach acid so the tissue can repair. They’re usually taken for 4–8 weeks for straightforward ulcers; your doctor will tell you the exact length. If you must use NSAIDs (for arthritis, for example), your doctor may recommend switching drugs, lowering dose, or adding a PPI for protection.
For people who don’t respond or who have warning signs, endoscopy is used to look directly at the ulcer and rule out other problems. If an ulcer is bleeding heavily, medical teams can treat it right away in hospital.
Stop NSAIDs like ibuprofen and naproxen whenever possible; try acetaminophen for pain unless advised otherwise. Quit smoking — it slows healing and raises ulcer risk. Cut back on alcohol; heavy drinking irritates the stomach lining. You don’t need a bland-only diet, but avoid foods and drinks that trigger your symptoms (spicy food, caffeine, acidic drinks) and eat smaller, regular meals if large meals cause pain.
Probiotics can help some people during antibiotic treatment for H. pylori to reduce side effects, but they won’t replace antibiotics. Finish the full antibiotic course if you’re prescribed one — stopping early can mean the infection returns. After treatment for H. pylori, your doctor may repeat a noninvasive test (breath or stool) after about 4 weeks to confirm the bacteria are gone.
Watch for warning signs: black or tarry stools, repeated vomiting, severe sudden stomach pain, fainting, or vomiting blood. Those require immediate emergency care. If your pain returns after treatment, or you keep needing antacids, follow up with your provider — persistent ulcers need more evaluation.
Simple checklist: get tested for H. pylori if you have an ulcer, use a PPI as directed, avoid NSAIDs and smoking, finish any antibiotics, and seek urgent care for bleeding or severe pain. These steps cover most ulcers and help you get back to normal sooner.
