What are the recommended first-line treatments for patients diagnosed with peptic ulcer disease?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 14 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Offer H pylori eradication therapy to people who have tested positive for H pylori and who have peptic ulcer disease .

For people using NSAIDs with diagnosed peptic ulcer, stop the use of NSAIDs where possible. Offer full-dose PPI (see table 1 in appendix A) or H2RA therapy for 8 weeks and, if H pylori is present, subsequently offer eradication therapy .

Offer people with gastric ulcer and H pylori repeat endoscopy 6 to 8 weeks after beginning treatment .

Offer people with peptic ulcer (gastric or duodenal) and H pylori retesting for H pylori 6 to 8 weeks after beginning treatment .

Offer full-dose PPI (see table 1 in appendix A) or H2RA therapy for 4 to 8 weeks to people who have tested negative for H pylori and are not taking NSAIDs .

Educational content only. Always verify information and use clinical judgement.