A peptic ulcer is a sore on the lining of the esophagus, stomach, or duodenum. Peptic ulcers have different names depending on their location in the GI system: gastric ulcer (for a peptic ulcer that develops in the stomach), duodenal ulcer (the ulcer that occurs in the upper part of the small intestine), and an esophageal ulcer (an ulcer that is located in the lower portion of the esophagus, which is usually associated with gastroesophageal acid reflux disease). We would be looking at stomach ulcers as this is prevalent.
There are different school of thought as to the cause of peptic ulcer. The first school of thought is that the cause of peptic ulcers is initiated by Helicobacter pylori (H. pylori) and long term use of non-steriodal anti inflammatory drugs( NSAIDs) like aspirin and ibuprofen. Looking at how these two major causes of Peptic ulcer come about, we need to address that they maybe some underlying health conditions that can trigger the ulceration of the gastric walls.
Helicobacter pylorus is a gram-negative bacillus that is found within the gastric epithelial cells. This bacterium is responsible for 90% of duodenal ulcers and about 70% to 90% of gastric ulcers. H. pylori infection is more common among those with lower socioeconomic status and is commonly acquired during childhood. The organism has a wide spectrum of advantage that enable it to thrive in such a harsh acidic environment like the stomach acid. This include the secretion of urease to breaks down urea into ammonia which protects the organism by neutralizing the acidic gastric environment and presence of flagella for movement towards the walls or epithelium of the stomach. It also release toxins and can burrow through the protective thick mucus layer of the stomach to cause tissue damage.
Non steroidal anti-inflammatory drugs(NSAIDs) like aspirin and ibuprofen is the second most common cause of peptic ulcers after H. pylori infection if used for a prolonged period.The secretion of prostaglandin during inflammation normally protects the gastric mucosa. NSAIDs block prostaglandin synthesis by inhibiting the COX-1 enzyme, resulting in decreased gastric mucus, making the underlying tissue vulnerable to stomach acids and H. pylori..
The other school of thought believes that the triggers or causes of peptic ulcers is dehydration and stress. Researchers who subscribe to this belief point out that approximately 40 percent of the population carries the bacterium H. pylori based on evidence -proven epidemiology.Howeber ,only one out of five people who are infected with this bacterium actually develop peptic ulcers. So H. pylori alone are not the cause of peptic ulcers. Medical practitioners who hold this theory believe that when people don't drink enough water, the lining of their stomach and duodenum are unable to generate the thick layer of mucus required to protect them from the highly acidic gastric juices. The mucus layer is thus more susceptible or vulnerable to attacks by the bacterium H. pylori.
Now, you have a clear overview of the different idealogy about the nature and cause of Peptic ulcer. Regarding the treatment of peptic ulcer is where the therapeutic preference comes in . In conventional medicine doctors aim to kill H. pylori through a combination of antibiotics (e.g., metronidazole, tetracycline, clarithromycin, amoxicillin), acid suppressors (various histamine or H2 blockers and proton-pump inhibitors), acid blockers, and stomach-lining protectors (e.g., bismuth subsalicylate). Using this approach, patients may have to take up to 20 pills a day for the triple therapy and may suffer many side effects (such as dizziness, nausea, headache, vomiting, diarrhea, dark stools, metallic taste in the mouth, and yeast infections in women) according to the NIH. This kind of treatment however can pose serious problem like antibiotics resistance and the destruction of good healthy bacteria in the guts or intestinal flora.
A more holistic and natural approach is water therapy . Since some medical practitioners view peptic ulcers to be caused by dehydration, which reduces and thins the stomach's and duodenum's mucus layer and makes the lining vulnerable to bacterial infection, they prescribe drinking a large glass of water approximately 30 minutes before each meal and drink about 2 liters of water each day. Researchers have long known that stress boosts acid production in the stomach while suppressing the body's natural immunity so that it is less able to fight off bacterial infection by H. pylori. Hence, cutting out stress is very imperative.
Other approach include the following citations:
•To treat gastric ulcers and cankerous sores, one can also use a natural herb called deglycyrrhizinated licorice (DGL), which is made from licorice with the glycyrrhizin removed. In numerous research studies, this herb has been shown to be effective in treating gastric ulcers (for example, Scandinavian Journal of Gastroenterology, Supplement, by Russell et al., 1984; the Journal of Pharmacy and Pharmacology, Morgan et al., 1983 and Bennett et al., 1980; Lancet, Glick, 1982; Gut, Bardhan et al., 1976; the Journal of the Association of Physicians of India, Balakrishnan et al., 1978).
•For treating ulcers, use a natural product called mastic gum, the resinous gum of a species of Greek spice tree belonging to the pistachio family (Pistacia lentiscus, now growing all over the Mediterranean and Middle Eastern regions), which has been used by the people of the Mediterranean for several thousand years to treat gastrointestinal problems. It is a natural antibiotic that can kill H. pylori but does not harm the friendly bacteria in the intestines. This resin has been through clinical trials with results published in the New England Journal of Medicine (1946, 1998) and Clinical and Experimental Pharmacology and Physiology (1984).
Water therapy for Peptic ulcer or the use of antibiotics depends on the nature of cause in understanding what treatment plan is the best option.
References:
• Article from Apek Water
Apek Water (2025) Peptic Ulcer, Water and Health. Available at: : https://www.freedrinkingwater.com/blogs/water-health/dehydration-peptic-ulcers
•Article from National Institute of Health (NIH)
Malik, T.F., Gnanapandithan, K. and Singh, K. (2023) 'Peptic Ulcers', National Institute of Health, 5 June. Available at: