---
title: "Peptic Ulcer Disease (PUD): Conventional and Natural Treatments"
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canonical_url: "https://www.drdanwool.com/blog/peptic-ulcer-disease-pud-conventional-and-natural-treatments"
markdown_url: "https://www.drdanwool.com/llms/blog/peptic-ulcer-disease-pud-conventional-and-natural-treatments"
lastmod: "2025-04-29T14:34:00.000Z"
---

Medically reviewed by [Dr. Dan Wool, NMD](https://www.linkedin.com/in/drdanwool/)

 Arizona-licensed Naturopathic Physician and  Gastroenterology Specialist

 Updated: November 11, 2025

Summary: 

- What is Peptic Ulcer Disease and Causes: PUD involves open sores on stomach lining (gastric ulcers), duodenum (duodenal ulcers), or esophagus when protective mucous erodes from stomach acid and pepsin enzyme. Primary cause is Helicobacter pylori bacterial infection weakening stomach protection. Prolonged NSAID use (ibuprofen, aspirin) inhibits prostaglandin production irritating lining. Smoking, excessive alcohol, and stress increase acid production weakening mucous barriers.
- Conventional and Natural PUD Treatments: H. pylori eradication uses "triple therapy" combining antibiotics (clarithromycin, amoxicillin, metronidazole) with Proton Pump Inhibitors and bismuth for 10-14 days. Natural approaches include flavonoid-rich foods (apples, cranberries) inhibiting H. pylori, probiotics restoring gut balance, deglycyrrhizinated licorice (DGL) healing stomach lining, Manuka honey providing antibacterial effects, biofilm disruptors (bismuth, black cumin), and BPC-157 peptide reducing inflammation.
- Peptic Ulcer Disease (PUD) Complications and Prevention: Untreated PUD causes internal bleeding, perforation creating stomach holes requiring emergency surgery, and gastric outlet obstruction blocking food passage. Prevention requires H. pylori eradication, limiting NSAID use, anti-inflammatory diet with fruits and vegetables, smoking cessation, alcohol limitation, and stress management through meditation and yoga with regular healthcare monitoring.

## What is Peptic Ulcer Disease (PUD)?

Peptic Ulcer Disease (PUD) is a condition characterized by the formation of open sores, or ulcers, on the inner lining of the stomach, the upper part of the small intestine (duodenum), or sometimes the esophagus. These ulcers can form when the protective mucous lining of the digestive tract is eroded by stomach acid and digestive enzymes, leading to inflammation and ulceration [1] [2]. The term "peptic" refers to pepsin, a digestive enzyme in the stomach that plays a key role in breaking down food.

There are three main types of peptic ulcers depending on their location:

- Gastric Ulcers that form on the inside of the stomach.
- Duodenal Ulcers that develop in the upper part of the small intestine, known as the duodenum.
- Esophageal Ulcers which occur in the esophagus, often due to chronic acid reflux [1].

## Causes of Peptic Ulcer Disease

The primary causes of PUD are:

- Helicobacter pylori (H. pylori) Infection is caused by a bacterium which is a major cause of peptic ulcers. It weakens the protective mucous coating of the stomach and duodenum, letting acid get through to the sensitive lining beneath [2] [3]. H. pylori infections are quite common, and many people may carry the bacteria without developing ulcers but in some people, it can lead to significant inflammation and ulceration.
- Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) such as ibuprofen and aspirin, can irritate or inflame the lining of the stomach and small intestine, if used for prolonged periods, leading to ulcers. These medications inhibit the production of prostaglandins, which help protect the stomach lining from acid.
- Other Factors such as smoking, excessive alcohol consumption, stress, and spicy foods are less common but can exacerbate symptoms and block the healing process. Smoking and alcohol can both increase stomach acid production and weaken the mucous lining, making it more susceptible to damage.

## Conventional Peptic Ulcer Disease (PUD) Treatments

Traditional PUD treatments focus on reducing stomach acid, eradicating H. pylori infection, and protecting the lining of the stomach and duodenum [4] [5]:

- Antibiotics are used when an H. pylori infection is present. A combination of antibiotics is prescribed to kill the bacteria. Common medication approaches include clarithromycin, amoxicillin, and metronidazole. The treatment typically lasts for 10 to 14 days and is often combined as a "triple therapy" with acid-suppressing medications (PPIs) and bismuth (Pepto Bismol). 
- Proton Pump Inhibitors (PPIs) such as omeprazole, esomeprazole, and lansoprazole reduce stomach acid production, which aids in healing the ulcer. PPIs are highly effective in reducing acid secretion and are often used in combination with antibiotics for H. pylori eradication.
- H2-receptor antagonists like ranitidine and famotidine also reduce acid production but are less potent than PPIs. These medications block histamine receptors in the stomach, which are responsible for stimulating acid production.
- Antacids are over-the-counter medications that neutralize stomach acid and provide quick relief from pain. Antacids can be used as needed to alleviate symptoms but can’t heal the ulcer.
- Cytoprotective Agents are medications such as sucralfate and misoprostol that help protect the lining of the stomach and duodenum. Sucralfate forms a protective barrier over the ulcer, while misoprostol increases the production of protective mucus and bicarbonate.
- Lifestyle changes such as avoiding NSAIDs, reducing alcohol consumption, quitting smoking, and managing stress are also recommended to support the healing process and prevent the recurrence of PUD.

## Natural / Alternative Treatment Options for Peptic Ulcer Disease

Natural and alternative treatments for PUD focus on dietary changes, herbal remedies, and lifestyle changes [6] [7]:

- Dietary changes that can be beneficial are consuming food rich in fruits, vegetables, and whole grains to help protect the stomach lining. Foods high in flavonoids, such as apples, celery, and cranberries, have been shown to inhibit the growth of H. pylori. Additionally, foods rich in fiber can help reduce the risk of ulcers by promoting healthy digestion and reducing acid production.
- Probiotics in the form of supplements or foods like yogurt and kefir can help restore the balance of good bacteria in the gut, potentially reducing H. pylori infection. Probiotics such as Lactobacillus and Bifidobacterium have been shown to inhibit the growth of H. pylori and improve gut health.
- Herbal Remedies such as licorice root, [aloe vera,](https://drdanwool.com/blog/is-aloe-vera-good-for-acid-reflux) and chamomile have anti-inflammatory and soothing properties that may help heal ulcers. [Deglycyrrhizinated licorice (DGL)](https://drdanwool.com/blog/is-licorice-dgl-good-for-acid-reflux) is a form of licorice that has been processed to remove glycyrrhizin, a compound that can cause side effects. DGL has been shown to promote healing of the stomach lining and reduce ulcer symptoms. 
- Biofilm "busters". H. Pylori is known to create a biofilm (or a "roof") that keeps the immune system from detecting it and that can even help it resist conventional therapies; therefore it can live and grow, worsening symptoms.  A biofilm disruptor such as bismuth or black cumin degrade H, Pylori's defenses allowing therapies to be more effective, 
- Peptides. [BPC-157 is a peptide](https://drdanwool.com/blog/bpc157) shown to help reduce inflammation and ulcers. 
- Honey is known for its antibacterial properties and can help combat H. pylori and promote healing. Manuka honey, in particular, has been studied for its potent antibacterial effects and ability to support digestive health.
- Lifestyle changes such as reducing stress through relaxation techniques, quitting smoking, and limiting alcohol intake can support overall digestive health and prevent ulcers. Stress management techniques such as meditation, yoga, regular exercise, or whatever healthy habits work for you, can help reduce the impact of stress on the digestive system.

Other natural remedies that may be beneficial include turmeric, which has anti-inflammatory properties, and cabbage juice, which has been traditionally used to promote healing of the stomach lining.

## Complications Arising from Peptic Ulcer Disease

If left untreated, PUD can lead to serious complications [9] [8] such as:

- Internal bleeding is the result of blood vessel erosion caused by ulcers. Symptoms include vomiting blood, black or tarry stools, and anemia. Severe bleeding can be life-threatening and may require emergency medical intervention.
- Perforation of the ulcer is when a hole is formed in the wall of the stomach or duodenum, leading to peritonitis, a severe abdominal infection. Perforation is a medical emergency that requires immediate surgical intervention.
- Penetration of the ulcer into adjacent organs such as the pancreas or liver, can cause severe pain and complications leading to chronic pain and may require surgical treatment.
- Gastric Outlet Obstruction is swelling and scarring from ulcers that can block the passage of food through the digestive tract, leading to vomiting and weight loss. This condition may require endoscopic or surgical intervention to restore normal digestion.

Other potential complications include the development of strictures (narrowing of the digestive tract) and an increased risk of gastric cancer in individuals with chronic H. pylori infection.

## Peptic Ulcer Disease (PUD): Prevention and Complications

Preventive measures against PUD involve addressing its root causes and maintaining a healthy lifestyle [10]:

- Eradicate H. pylori If you have an H. pylori infection. You’ll need to follow your healthcare provider's treatment plan to eliminate the bacteria in combination with regular testing and treatment to prevent the recurrence of ulcers.
- Limit NSAID use and take them only under medical supervision. Consider alternatives for pain relief, such as acetaminophen. If NSAIDs are necessary, your healthcare provider may recommend using the lowest effective dose and taking them with food to reduce the risk of ulcers.
- A balanced diet rich in fruits, vegetables, and whole grains is essential. Avoid spicy, acidic, or other foods that irritate your stomach. Incorporating foods with natural anti-inflammatory and antibacterial properties can support digestive health.
- Avoid smoking and excessive alcohol consumption since they can damage the stomach lining and increase the risk of ulcers. Quitting smoking and limiting alcohol intake can significantly reduce the risk of developing ulcers.
- Manage stress by practicing stress-reducing techniques such as meditation, yoga, and regular exercise to support overall digestive health. Stress management can help prevent the exacerbation of ulcer symptoms and promote healing.

Other preventive measures include maintaining a healthy weight, staying hydrated, and avoiding excessive caffeine intake. Regular check-ups with your healthcare provider can help monitor your digestive health and catch any potential issues early.

## Frequently Asked Questions about Peptic Ulcer Disease

### What causes peptic ulcers?

Peptic ulcers form when H. pylori bacteria or long-term inflammation, often from NSAID use (ibuprofen, aspirin), erode the stomach's protective lining, enabling acid to damage tissue. Smoking, excessive alcohol and stress can create or worsen symptoms. Ulcers occur in the stomach, duodenum or esophagus, causing pain and potential bleeding.

### Can stress cause stomach ulcers?

Stress alone doesn't directly cause ulcers, but it worsens symptoms and slows healing. There are other causes (see above) but stress increases stomach acid, weakens immune function, and promotes inflammation -- all contributing to ulcer development. Managing stress through meditation, yoga and lifestyle changes supports healing.

### Can peptic ulcers be treated naturally without antibiotics?

Natural approaches complement conventional treatment. Dietary changes (flavonoid-rich foods like apples, cranberries), probiotics, [DGL licorice](/blog/is-licorice-dgl-good-for-acid-reflux), manuka honey, and [BPC-157 peptides](/blog/bpc157) support healing. Biofilm disruptors like bismuth or black cumin help defeat H. pylori's defenses. Meds are just one aspect of healing; it's best to have a holistic treatment plan, such as from a naturopathic doctor. 

### How do I prevent peptic ulcers from coming back?

We have to eradicate the H. pylori overgrowth and heal the tissue completely with treatment, then lifestyle strategies are the best prevention. Limit NSAID use, choose alternatives like acetaminophen. Eat anti-inflammatory foods (fruits, vegetables, whole grains), quit smoking, reduce alcohol and manage stress through yoga or meditation. Regular monitoring prevents recurrence and serious complications.

### How do I know if I have a stomach ulcer?

Burning stomach pain between meals or at night, feeling full quickly, bloating, heartburn, nausea, and dark/bloody stools indicate possible ulcers. Pain may temporarily improve after eating or taking antacids. Upper abdominal tenderness (typically in the upper middle gut), unexplained weight loss, or vomiting blood requires immediate medical attention and endoscopy for diagnosis.

## The Bottom Line on PUD

Peptic Ulcer Disease (PUD) is a condition characterized by painful sores in the lining of the stomach, duodenum, or esophagus. It is primarily caused by H. pylori infection and long-term use of NSAIDs. Conventional treatments include antibiotics, acid-reducing medications, and protective agents. Natural treatments focus on dietary changes, probiotics, herbal remedies, and lifestyle modifications.

Preventing PUD involves eradicating H. pylori, limiting NSAID use, maintaining a healthy diet, avoiding smoking and excessive alcohol, and managing stress. Early diagnosis and treatment are essential in the prevention of PUD.

Gastroenterologists will often scope (EGD), see ulcers, put the patient on "triple therapy" and walk away. Naturopaths like [Dr. Dan Wool in Scottsdale, Arizona](/about) get to the root cause and look at peptic ulcer disease more holistically in order to eradicate it permanently and create lasting healing.

About the Author

## Dr. Dan Wool, NMD

Dr. Dan Wool is a naturopathic doctor who specializes in gastroenterology, hormones and men's health in Scottsdale, Arizona. [Set up a free 15-minute discovery call with Dr. Wool today! ](https://drdanwool.com/booking)

[Read more about Dr. Wool's Gut Health Journey](/about)

## References:

[[1] Diagnosis and Treatment of Peptic Ulcer Disease and H. pylori Infection. Julia Fashner, MD, and Alfred C. Gitu, MD. American Family Physician, 2015. https://www.aafp.org/pubs/afp/issues/2015/0215/p236.html](https://www.aafp.org/pubs/afp/issues/2015/0215/p236.html)

[[2] Peptic Ulcer Disease - Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/10350-peptic-ulcer-disease](https://my.clevelandclinic.org/health/diseases/10350-peptic-ulcer-disease)

[[3] Peptic ulcer - Symptoms and causes - Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/peptic-ulcer/symptoms-causes/syc-20354223](https://www.mayoclinic.org/diseases-conditions/peptic-ulcer/symptoms-causes/syc-20354223)

[[4] Symptoms & Causes of Peptic Ulcers (Stomach or Duodenal Ulcers). National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/digestive-diseases/peptic-ulcers-stomach-ulcers/symptoms-causes](https://www.niddk.nih.gov/health-information/digestive-diseases/peptic-ulcers-stomach-ulcers/symptoms-causes)

[[5] Peptic Ulcer Disease Treatment Guidelines - LAcolon. https://lacolon.com/article/peptic-ulcer-disease-treatment-guidelines](https://lacolon.com/article/peptic-ulcer-disease-treatment-guidelines)

[[6] How to Cure Ulcers Through Naturopathy? - iCliniq. Dr. Aishwarya Ilavarasan. https://nativecare.icliniq.com/articles/alternative-medicine/cure-ulcers-through-naturopathy](https://nativecare.icliniq.com/articles/alternative-medicine/cure-ulcers-through-naturopathy)

[[7] Peptic ulcer | Complementary and Alternative Medicine - St. Luke's Hospital. https://www.stlukes-stl.com/health-content/medicine/33/000125.htm](https://www.stlukes-stl.com/health-content/medicine/33/000125.htm)

[[8] Overview of complications of peptic ulcer disease - UpToDate. Nimish B Vakil, MD, AGAF, FACP, FACG, FASGE. https://www.uptodate.com/contents/overview-of-complications-of-peptic-ulcer-disease](https://www.uptodate.com/contents/overview-of-complications-of-peptic-ulcer-disease)

[[9] What Are the Complications of Peptic Ulcer Diseases? - iCliniq. Dr. Glady Ann Thomas. https://www.icliniq.com/articles/gastro-health/peptic-ulcer-disease-related-complications](https://www.icliniq.com/articles/gastro-health/peptic-ulcer-disease-related-complications)

[[10] 7 Symptoms of Peptic Ulcer Complications - Verywell Health. https://www.verywellhealth.com/symptoms-of-peptic-ulcer-complications-1742819](https://www.verywellhealth.com/symptoms-of-peptic-ulcer-complications-1742819)