What is the best medicine for ulcers in the intestine?

October 9, 2025 •

4 min read

Peptic ulcer disease is a common condition, affecting about 1 in 12 people in the United States [1.7.1]. Determining what is the best medicine for ulcers in the intestine depends on the underlying cause, which is most often a bacterial infection or the use of certain pain relievers [1.2.5, 1.11.2].

Quick Summary

Treatment for intestinal ulcers is tailored to the cause. Key medications include proton pump inhibitors (PPIs) and H2 blockers to reduce stomach acid, and antibiotics to eradicate H. pylori infections.

Key Points

Cause Determines Treatment: The best medicine for an intestinal ulcer depends on whether it's caused by an H. pylori infection or NSAID use [1.2.5].
PPIs are Primary: Proton Pump Inhibitors (PPIs) like omeprazole are first-line therapy for reducing stomach acid to allow ulcers to heal [1.4.1, 1.5.3].
Antibiotics for H. pylori: If H. pylori is present, a combination of antibiotics (like amoxicillin and clarithromycin) and a PPI is required to eradicate the infection [1.2.1, 1.3.2].
H2 Blockers as an Alternative: H2 blockers like famotidine also reduce acid but are generally considered less potent than PPIs for healing ulcers [1.5.1, 1.5.3].
Protective Agents: Medications like sucralfate and misoprostol can be used to coat and protect the ulcer from acid, aiding the healing process [1.8.1, 1.8.2].
NSAID-Induced Ulcers: Treatment involves stopping the NSAID and taking a PPI. Misoprostol can be used for prevention in high-risk patients [1.2.3, 1.9.2].
Healing Timeline: With appropriate treatment, most ulcers heal within 4 to 8 weeks, although symptoms can improve sooner [1.10.1, 1.10.2].

Understanding Intestinal Ulcers and Their Causes

Intestinal ulcers, also known as peptic ulcers, are open sores that develop on the inside lining of your stomach and the upper portion of your small intestine (the duodenum) [1.11.1]. They occur when stomach acid erodes the digestive tract's protective mucous layer [1.11.1]. The two most common culprits behind this damage are:

Helicobacter pylori (H. pylori) Infection: This bacterium lives in the mucous layer of the stomach and small intestine. While many people with H. pylori experience no issues, it can cause inflammation and lead to the formation of ulcers [1.11.1, 1.11.2]. H. pylori infection is responsible for the majority of peptic ulcers [1.2.5].
Long-term Use of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Regular use of over-the-counter and prescription pain relievers like ibuprofen, naproxen, and aspirin can irritate and inflame the lining of the stomach and intestine, making them susceptible to acid damage [1.2.5, 1.9.1].

The most common symptom is a burning or dull stomach pain, which can be worse between meals or at night [1.11.1, 1.11.4]. Other symptoms include bloating, feeling full quickly, heartburn, and nausea [1.11.1].

Primary Medications for Intestinal Ulcers

Treatment strategy hinges on the ulcer's cause. A healthcare provider will determine the appropriate course of action, which typically involves a combination of medications to reduce stomach acid and, if necessary, eliminate bacteria [1.2.1].

Medications to Reduce Stomach Acid

Reducing the amount of acid in the stomach is crucial for relieving pain and allowing the ulcer to heal. The two main classes of acid-reducing drugs are Proton Pump Inhibitors (PPIs) and Histamine (H2) Blockers.

Proton Pump Inhibitors (PPIs): These medications work by blocking the action of the cells that produce acid [1.2.1]. They are generally considered more powerful and effective for ulcer healing than H2 blockers [1.5.3, 1.5.5]. PPIs are a cornerstone of treatment for both H. pylori-related and NSAID-induced ulcers [1.4.2, 1.9.3]. Common PPIs include:
- Omeprazole (Prilosec) [1.2.1]
- Lansoprazole (Prevacid) [1.2.1]
- Esomeprazole (Nexium) [1.2.1]
- Pantoprazole (Protonix) [1.2.1]
- Rabeprazole (Aciphex) [1.2.1]
Histamine (H2) Blockers: These drugs also reduce the amount of acid released into the digestive tract [1.2.1]. While effective, they are sometimes seen as less potent than PPIs for ulcer healing but can still be used, especially for preventing duodenal ulcer recurrence [1.5.1, 1.5.3]. Examples include:
- Famotidine (Pepcid AC) [1.2.1]
- Cimetidine (Tagamet HB) [1.2.1]

Eradicating H. pylori Infection

If an H. pylori infection is detected, eradicating the bacteria is essential for healing the ulcer and preventing recurrence [1.2.3]. Treatment typically involves a combination of medications taken for 10 to 14 days [1.3.1]. Standard regimens include:

Triple Therapy: This involves a PPI and two antibiotics, such as clarithromycin and amoxicillin (or metronidazole for those with a penicillin allergy) [1.2.3, 1.3.2].
Bismuth Quadruple Therapy: Recommended as a first-line treatment, especially in areas with high clarithromycin resistance, this regimen includes a PPI, bismuth subsalicylate (Pepto-Bismol), and two antibiotics (metronidazole and tetracycline) [1.3.2, 1.3.4].

Medications That Protect the Intestinal Lining

In some cases, medications called cytoprotective agents are prescribed. These drugs work by protecting the tissue that lines the stomach and small intestine, forming a protective barrier over the ulcer to shield it from acid and allow it to heal [1.2.1, 1.8.1].

Sucralfate (Carafate): This medication coats the ulcer, protecting it from further damage [1.8.1, 1.8.2].
Misoprostol (Cytotec): This synthetic prostaglandin analog can help prevent ulcers in people who take NSAIDs regularly [1.2.4, 1.8.4]. It increases mucus and bicarbonate secretion and can inhibit acid secretion [1.8.2, 1.8.4].

Comparison of Common Ulcer Medications


Medication Class	Primary Action	Common Examples	Best For
Proton Pump Inhibitors (PPIs)	Block acid production [1.2.1]	Omeprazole, Lansoprazole, Esomeprazole [1.2.2]	Healing ulcers, treating H. pylori (with antibiotics), preventing NSAID-induced ulcers [1.4.2, 1.4.3]. Considered superior to H2 blockers for healing [1.5.3].
H2 Blockers	Reduce acid production [1.2.1]	Famotidine, Cimetidine [1.2.2]	Relieving ulcer pain and encouraging healing, though generally less potent than PPIs for this purpose [1.2.1, 1.5.3].
Antibiotics	Kill H. pylori bacteria [1.2.1]	Amoxicillin, Clarithromycin, Metronidazole, Tetracycline [1.2.1, 1.3.2]	Ulcers caused by H. pylori infection, used in combination with a PPI [1.3.5].
Cytoprotective Agents	Protect the lining of the stomach and small intestine [1.2.1, 1.8.1]	Sucralfate, Misoprostol [1.8.1]	Protecting the ulcer to promote healing; preventing NSAID-induced ulcers [1.8.2, 1.9.2].

Conclusion

There is no single "best" medicine for all intestinal ulcers, as the optimal treatment is highly dependent on the cause. For ulcers caused by H. pylori, a combination of a powerful acid-suppressing medication like a PPI and a course of multiple antibiotics is the standard of care [1.3.4, 1.3.5]. For ulcers resulting from NSAID use, stopping the NSAID and using a PPI to reduce acid is the primary approach [1.2.3, 1.9.1]. Cytoprotective agents may also be used to shield the ulcer and facilitate healing [1.8.1]. It is essential to consult a healthcare professional for an accurate diagnosis and a tailored treatment plan. With proper medication, most peptic ulcers heal within several weeks to a few months [1.10.1, 1.10.3].

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.

Authoritative Link: National Institute of Diabetes and Digestive and Kidney Diseases - Peptic Ulcers

Frequently Asked Questions

The two most common causes of intestinal (peptic) ulcers are infection with Helicobacter pylori (H. pylori) bacteria and long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin and ibuprofen [1.2.5, 1.11.2].

With proper treatment, most intestinal ulcers heal within 4 to 8 weeks. While symptoms may improve within a few days or weeks, the ulcer itself takes longer to fully heal [1.10.1, 1.10.2].

Both Proton Pump Inhibitors (PPIs) and H2 blockers reduce stomach acid, but PPIs are generally more powerful. PPIs block the final step of acid production, while H2 blockers block a chemical signal that tells your body to produce acid. For healing ulcers, PPIs are often considered more effective [1.2.1, 1.5.3].

You only need antibiotics if your ulcer is caused by an H. pylori infection. The treatment usually involves a 10 to 14-day course of two different antibiotics combined with an acid-reducing medication [1.2.1, 1.3.1].

Common side effects of PPIs are usually mild and can include headache, abdominal pain, diarrhea, gas, and nausea [1.6.1, 1.6.5]. Long-term use may be associated with an increased risk of bone fractures and certain nutritional deficiencies [1.6.1].

Antacids can provide rapid, short-term pain relief by neutralizing existing stomach acid, but they are generally not used on their own to heal an ulcer. They are often used for symptom relief alongside primary healing medications like PPIs [1.2.1].

Untreated ulcers can lead to serious complications, including internal bleeding (which can cause anemia or require hospitalization), a hole in the stomach or intestinal wall (perforation), or a blockage that prevents food from passing through the digestive tract [1.11.1, 1.11.4].