Peptic Ulcer Disease (PUD)

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Treatment

Treatment for peptic ulcer disease (PUD) depends on the underlying cause and the severity of the condition. PUD usually is treated using medications.

Peptic ulcer disease caused by Helicobacter pylori infection requires antibiotics (e.g., amoxicillin [Amoxil®, Trimox®], clarithromycin [Biaxin®], metronidazole [Flagyl®], tetracycline [Sumycin®]) to destroy the bacteria.

In most cases, "triple therapy," which consists of two antibiotics and another type of medicine to promote healing and reduce symptoms is used. To work with the antibiotics, physicians often prescribe one or more of the following:

• Proton pump inhibitors (PPIs; e.g., Prilosec®, Nexium®, Prevacid®)
• Histamine-2 (H-2) blockers (e.g., Pepcid®, Tagamet®, Zantac®)
• Bismuth subsalicylate (e.g., Pepto-Bismol®)

This combination of medicines generally is taken for 10 to 14 days. Patients who have peptic ulcer disease should take all medications as directed, even if symptoms improve during treatment. Antacids may be used to reduce pain and other symptoms during treatment.

In addition to medications, peptic ulcer disease treatment also may involve lifestyle modifications, such as smoking cessation, stress reduction, and dietary changes (e.g., avoiding foods that worsen symptoms). Patients who have PUD should avoid taking nonsteroidal anti-inflammatory drugs (NSAIDs).

In rare cases, surgery may be performed to treat severe peptic ulcer disease that does not respond to medications or to treat complications of PUD (e.g., perforation, obstruction). Types of PUD surgery include vagotomy (used to reduce the production of stomach [gastric] acid), pyloroplasty (used to widen the lower portion of the stomach [pylorus]), and partial gastrectomy (removal of part of the stomach).

Complications of surgery include the following:

• Adverse reaction to anesthesia
• Bleeding
• Infection
• Organ perforation (tear)

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