How do you treat ulcers in the US? An overview of diagnosis and care

October 1, 2025 •

3 min read

According to one study, ulcers affect about 8% of the world population, and in the US, most peptic ulcers are caused by H. pylori bacteria or long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs). Knowing how do you treat ulcers in the US is critical, and the approach depends heavily on the underlying cause, ranging from medication to address infections to lifestyle changes for symptom management.

Quick Summary

Treatment for ulcers in the US is primarily determined by the cause, with most cases involving medication to reduce stomach acid and address underlying infections. Key therapies include antibiotics for H. pylori, proton pump inhibitors (PPIs) for acid reduction, and lifestyle adjustments to promote healing.

Key Points

Diagnosis is Key: Identifying whether an ulcer is caused by H. pylori or NSAID use is the critical first step.
Medication is Standard Care: Treatment involves medications like PPIs for acid and, if needed, antibiotics for H. pylori.
Lifestyle Changes are Essential: Avoiding NSAIDs, quitting smoking, and reducing alcohol are crucial.
Advanced Procedures for Complications: Endoscopic procedures or surgery may be required for bleeding or perforation.
Most Ulcers Are Curable: With proper diagnosis and treatment, most ulcers are curable, especially those caused by H. pylori.

Ulcer Causes and Diagnosis

Identifying the cause of an ulcer is the first step in treatment. The most common causes are infection with Helicobacter pylori (H. pylori) bacteria and the long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or aspirin. Diagnostic methods can include:

Endoscopy: A camera on a flexible tube is used to view the stomach and small intestine, allowing for visual confirmation of the ulcer and collection of tissue samples to test for H. pylori.
Tests for H. pylori: Breath, stool, or blood tests can detect the presence of the bacteria.

Understanding the cause is vital because treatment for an NSAID-induced ulcer differs from that of a bacterial one. NSAID ulcers often heal after stopping the medication, while H. pylori requires antibiotics.

Medication-Based Treatment Approaches

Medication is the primary way to treat ulcers in the US, focusing on eliminating the cause and reducing stomach acid.

Targeting H. pylori Infections

If H. pylori is present, a doctor will likely prescribe a combination of medications for 10 to 14 days, often called "triple" or "quadruple" therapy. This typically includes:

Antibiotics: Two different types, such as amoxicillin, clarithromycin, or metronidazole, are used to kill the bacteria. It is crucial to complete the full course.
Proton Pump Inhibitor (PPI): This medication reduces stomach acid, which helps the antibiotics work effectively.
Bismuth subsalicylate: Sometimes included to aid in killing the bacteria and protecting the stomach lining.

Reducing and Neutralizing Stomach Acid

Medications to reduce acid are key for ulcers not caused by H. pylori or as part of H. pylori treatment. PPIs are commonly prescribed for ulcer healing. H2-blockers also reduce acid production but are less potent than PPIs. Mucosal protective agents like sucralfate protect the ulcer from acid. Antacids offer temporary relief by neutralizing acid but do not treat the underlying cause.

Comparison of NSAID- and H. pylori-Induced Ulcer Treatments


Treatment Component	H. pylori-Induced Ulcer	NSAID-Induced Ulcer
Primary Goal	Eradicate bacteria and heal the ulcer	Stop NSAID use and heal the ulcer
Antibiotics	Required (Triple or Quadruple therapy)	Not required
Acid Suppression	Required (PPIs are standard)	Often used (PPIs or H2-blockers)
Protective Agents	May be used (e.g., bismuth, sucralfate)	May be used (e.g., sucralfate, misoprostol)
Key Action	Follow full course of antibiotics	Stop NSAID usage completely
Long-Term Management	Lower recurrence risk if bacteria are cleared	May require ongoing protective medication if NSAIDs must continue

Lifestyle and Dietary Adjustments

Alongside medication, lifestyle changes are important for healing and preventing ulcers. Avoiding NSAIDs is crucial if they caused the ulcer. Acetaminophen may be a safer pain alternative. Quitting smoking hinders healing and increases recurrence risk. Limiting alcohol and caffeine can irritate the stomach lining. While stress is not a cause, managing it may help symptoms. Avoiding foods that cause symptoms and including probiotics may be beneficial. For more information on managing diet, consult resources like the {Link: Canadian Society of Intestinal Research https://badgut.org/information-centre/health-nutrition/diet-for-ulcer-disease/}.

Advanced Procedures and Surgery

For complicated or treatment-resistant ulcers, more advanced interventions may be needed. Endoscopic treatment can stop bleeding. Emergency surgery is for severe complications.

Conclusion

Treating ulcers in the US requires diagnosis and a tailored approach. Medications like antibiotics for H. pylori and acid reducers are central. Lifestyle changes are vital. Severe cases may require intervention. Seek medical advice for diagnosis and treatment.

Frequently Asked Questions

Do not treat an ulcer without a doctor's diagnosis. Over-the-counter antacids offer temporary relief but don't address the cause.

With appropriate medical treatment, most ulcers heal within four to eight weeks, but this varies.

The fastest way is an accurate diagnosis and following the prescribed treatment, including antibiotics and PPIs. Promptly addressing the cause is key.

If H. pylori is eliminated, recurrence risk is low. Ulcers can return if NSAIDs continue or the infection isn't fully eradicated.

Yes, avoiding irritants like spicy, acidic, or high-fat foods and including probiotics may help.

Acetaminophen is generally safer than NSAIDs. Consult your doctor before taking new medication.

Both reduce stomach acid, but PPIs block enzymes more effectively, while H2-blockers block histamine receptors.