Preventing Ulcers: Lifestyle Changes, Diet & Prevention

Peptic Ulcer Prevention: Evidence‑Based Strategies

Most ulcers are caused by H. pylori or NSAIDs. Prevention targets these and modifiable lifestyle factors.

1. Eradicate H. pylori

Test‑and‑treat if dyspeptic; first‑line: PPI + clarithromycin + amoxicillin/metronidazole 14 days.

2. NSAID Stewardship

• Use lowest effective dose; shortest duration.
• Co‑prescribe PPI if risk factors (age >60, prior ulcer, anticoagulants, steroids).
• Consider COX‑2 selective inhibitor (celecoxib) if CV risk acceptable.

3. Lifestyle Modifications

• Quit smoking – Doubles ulcer risk, impairs healing.
• Limit alcohol – >2 drinks/day increases risk.
• Stress management – Not a direct cause, but exacerbates symptoms via acid hypersecretion.
• Diet – No universal “ulcer diet”; avoid personal triggers (spicy, fried, caffeine, citrus). Regular meals; high fiber may be protective.

4. Protective Medications

• PPIs for high‑risk NSAID users.
• Misoprostol (prostaglandin analog) if PPI contraindicated.

5. Surveillance

Endoscopy if alarm features (weight loss, bleeding, anemia, dysphagia) or age >60 with new dyspepsia.