If you have a peptic ulcer, dietary changes can help alleviate your symptoms and speed up recovery by reducing stomach acid levels and reducing pain flare-ups. Suggested stomach ulcer diets are low in gastric irritants like alcohol and spicy foods and high in fiber-rich whole grains and vegetables.
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Foods to avoid with ulcers include caffeine, alcohol, chili and peppers. If you have H. pylori, diet changes such as eating probiotics and vitamin C-rich foods might help eradicate the bacteria — along with taking prescribed antibiotics.
What Is a Peptic Ulcer?
A peptic ulcer is a sore in your stomach lining (also called a gastric ulcer) or the lining of your duodenum, which is the first part of the small intestine (an ulcer here is called a duodenal ulcer).
MedlinePlus explains that these ulcers occur when the walls of your stomach or duodenum are damaged, causing open sores. Peptic ulcers have been linked to Helicobacter pylori (H. pylori) bacteria infection, and to long-term use of nonsteroidal anti-inflammatory medicines (NSAIDs) like ibuprofen and aspirin.
According to the Mayo Clinic, burning stomach pain is the most common symptom. The symptoms may be most intense between meals and at night, when your stomach is empty. Other common symptoms of a peptic ulcer include:
- Feeling full or bloated
- Heartburn (also known as acid reflux)
- Intolerance to fatty foods
There are also less common, potentially severe symptoms like vomiting, vomiting blood (which may look black), feeling faint, blood or dark blood in stools, trouble breathing, unexplained weight loss and changes in appetite.
Read more: Remedies for Ulcer Pain
Diagnosing a Peptic Ulcer
The only way to definitively diagnose a peptic ulcer is through an upper GI endoscopy, which is when your doctor uses a flexible scope with a camera on the end of it to inspect your esophagus, stomach and duodenum.
An upper GI endoscopy is typically done while the patient is under light sedation, and takes about 15 to 30 minutes. The procedure allows the doctor to physically see any ulcers present in your stomach lining or duodenum.
Your doctor can also do some tests to check for H. pylori infection. H. pylori is a common bacterium that doesn't always cause symptoms, but it can sometimes break down the lining of your stomach or duodenum, causing ulcers.
According to the Centers for Disease Control and Prevention, H. pylori causes over 90 percent of duodenal ulcers and up to 80 percent of gastric ulcers. The bacteria have also been linked to gastritis (an inflammation of your stomach lining) and stomach cancer. There are blood, stool and breath tests that your doctor can do to check for the presence of H. pylori.
Treating a Peptic Ulcer
The best treatment for your ulcer will depend on what caused it, as well as any other health conditions you have or prescription medications you are taking. One common ulcer treatment is a proton pump inhibitor (PPI), which, as Mayo Clinic explains, reduces stomach acid levels by "blocking the action of the parts of cells that produce acid."
Other options include antacids to neutralize stomach acid, or acid blockers that reduce the levels of acid. Lowering acid levels can help reduce pain symptoms and promote healing.
If your ulcer was caused by H. pylori infection, your doctor might recommend antibiotics to get rid of the bacterial infection. The Mayo Clinic says that common antibiotics for this include include amoxicillin, clarithromycin, levofloxacin, metronidazole, tetracycline and tinidazole, but the exact combination and dosage varies from patient to patient. Plus, some infections may be resistant to antibiotics.
If your ulcer was caused by overusing NSAIDs, your doctor will likely recommend that you limit using NSAIDs or cut them out entirely. Continuing to use NSAIDs can worsen your symptoms, or make it more likely that you will develop another stomach ulcer in the future.
Read more: Foods That Will Not Irritate Gastric Ulcers
Peptic Ulcer Diet Recommendations
You can load up on foods that reduce stomach acid to lessen your symptoms, and research recommended foods to avoid with ulcers. It's important to note that everyone is different, so foods that will worsen some people's symptoms may not affect others. Keep a record of which specific foods and drinks worsen your symptoms, and try your best to avoid them.
UMass Medical School says you should avoid any gastric irritants that can increase stomach acid secretions. Suggested foods to avoid with ulcers include caffeinated drinks, chiles, alcoholic drinks, chocolate, carbonated beverages and peppers. Other foods that could trigger ulcer flare-ups include:
- Dairy products. The Ohio State University Wexner Medical Center says that drinking large amounts of milk can increase stomach acid secretion and suggests that whole milk, cream and butter are all foods to avoid with ulcers.
- Fatty foods, including deep-fried foods, lard, margarine and high-fat meats like bacon.
- Spicy foods. You might find that certain spices and seasonings cause that burning stomach pain, in which case it's best to avoid them.
Read more: Diet Plan for a Stomach Ulcer
H. Pylori Diet
If you do have H. pylori, antibiotics can be prescribed to treat the infection. There are also some dietary changes you can make to help eradicate the bacteria, alongside the prescribed medications.
H. pylori diet recommendations include increasing your vitamin C intake. An August 2018 review of literature published in the journal Frontiers in Physiology concluded that it's "worthwhile" to include pharmacologic ascorbate in H. pylori treatment.
You can speak with your doctor about vitamin C supplements, or load up on vitamin C-rich foods like guavas, strawberries, broccoli, cauliflower, cabbage, blueberries, blackberries, kiwis, bell peppers, spinach, kale and Swiss chard.
Another option: Probiotics. An October 2017 article in Applied Microbiology and Biotechnology recommended combining probiotics with standard antibiotic H. pylori treatments. This may help to improve the rates of eradication, while lowering the risks of side effects associated with antibiotics. Consider adding probiotic foods like kombucha, miso, kefir, sauerkraut, pickles and yogurt with live cultures to your H. pylori diet.
Read more: Foods Not to Eat With Pylori Bacteria
Is This an Emergency?
- MedlinePlus: "Peptic Ulcer"
- Mayo Clinic: "Peptic Ulcer: Overview"
- UMass Medical School: "Upper Gastrointestinal Tract Disorders"
- National Institute of Diabetes and Digestive and Kidney Diseases: "Upper GI Endoscopy"
- MedlinePlus: "Helicobacter Pylori Infections"
- Ohio State University Wexner Medical Center: "Avoiding Gastric Stimulants"
- Frontiers in Physiology: "Vitamin C and Helicobacter Pylori Infection: Current Knowledge and Future Prospects"
- Applied Microbiology and Biotechnology: "Helicobacter Pylori Treatment: Antibiotics or Probiotics"
- Centers for Disease Control and Prevention: "Helicobacter Pylori"
- Mayo Clinic: "Peptic Ulcer: Diagnosis"