Proton pump inhibitors (PPIs) for stomach ulcer

If you have a stomach ulcer, your doctor will most likely prescribe you a proton pump inhibitor medication.

An image illustration showing how proton pump inhibitors (PPIs) act on the stomach lining, inhibiting gastric acid production

Key takeaways:

  • Proton pump inhibitors (PPIs) are a group of drugs used to treat acid-related diseases like stomach ulcers.
  • There are different PPIs, such as omeprazole, lansoprazole, and pantoprazole, but they have similar functions and mechanisms of action.
  • Proton pump inhibitors are generally safe and effective for treating medical conditions like stomach ulcers, esophageal ulcers, and gastroesophageal reflux disease (GERD).

Proton pump inhibitors are among the most commonly used drugs worldwide. It is easy to abuse these medications as some of them, e.g., omeprazole and esomeprazole, are available over the counter. This means you do not need a doctor's prescription to purchase them.

In most acid-related diseases like stomach ulcers and esophagitis, proton pump inhibitors are usually recommended because studies have found them effective.

However, proton pump inhibitors can also cause adverse effects like headaches, nausea, rash, dizziness, constipation, flatulence, and diarrhea. If taken in the approved dosage, it has less tendency to cause serious side effects, but the risk of side effects increases with long-term use of the medication.

In this article, we will talk about different proton pump inhibitors and their role in treating stomach ulcers.

What are proton pump inhibitors (PPIs)?

Proton pump inhibitors (PPIs) are a class of drugs commonly used to treat acid-related diseases.

PPIs are administered to reduce acid secretion in the stomach. They are commonly used to treat diseases like peptic ulcer disease, esophagitis (inflammation of the esophagus), non-steroidal anti-inflammatory drug-induced ulcers, and Zollinger-Ellison Syndrome.

When it comes to reducing the amount of stomach acid made by glands in the stomach lining, proton pump inhibitors are powerful. The medications target the proton pumps in the stomach, which are small pumps that actively secrete stomach acid.

When you ingest a proton pump inhibitor, your body absorbs it into the bloodstream, where it acts on proton pumps and acid-making cells in the stomach wall to make them produce less acid. This is how PPIs help to treat acid-related disorders.

List of proton pump inhibitors for treating stomach ulcers

The following are some common proton pump inhibitors for treating stomach ulcers:

  • Omeprazole (Prilosec)
  • Pantoprazole (Protonix)
  • Lansoprazole (Prevacid)
  • Rabeprazole (Aciphex)
  • Esomeprazole (Nexium)

Best proton pump inhibitors for treating stomach ulcer

No "one" medication is best for everyone. Your doctor will tell you what medicines to take based on how you feel, how bad your condition is, and what your body needs. Some PPIs commonly prescribed by doctors for stomach ulcers include:


This is a PPI used in the treatment of esophageal and stomach diseases. It is marketed under the brand name Prilosec.

Omeprazole helps to treat symptoms like heartburn, cough, and difficulty swallowing and also helps to reduce the amount of stomach acid. It might take up to 4 days for omeprazole to be fully effective.

Omeprazole can be given through your veins or by mouth, and the amount and how often it is used depends on how bad the ulcer is. Your doctor will decide whether this is the best medication for you and how best to administer it.

Long-term use of the medication can cause side effects like abdominal pain, headaches, or more serious side effects like hypomagnesemia (low magnesium), rashes on your nose or cheeks, seizures, and increased joint pain.

You should immediately reach out to your doctor if the side effects worsen.


This PPI is used to treat problems in the stomach and esophagus that are caused by acid reflux, such as a peptic ulcer. It is marketed under the brand name, Protonix.

Like omeprazole, pantoprazole treats symptoms like heartburn, cough, and difficulty swallowing. It helps regulate the amount of acid the stomach produces, so it can help prevent stomach and esophageal ulcers.

It is administered either through your veins or your mouth, and the dosage and frequency of use depend on the severity of your ulcer.

Pantoprazole may cause side effects like diarrhea, upper respiratory tract infections, or headaches. It can also have severe side effects like increased joint pain, hypomagnesemia (low magnesium), rashes on the nose and cheeks, abdominal pain, and blood in the stool.

When you notice any of the symptoms, report them back to your doctor.


This is another PPI used to treat stomach ulcers. It can be in two forms—an oral capsule or a disintegrating capsule. Lansoprazole reduces the amount of acid in your stomach, thereby treating stomach ulcers.

These drugs may be combined with other drugs (combination therapy).

Lansoprazole may have side effects like constipation, headache, diarrhea, and nausea. It can also cause more severe side effects like weak muscle coordination, irregular menstrual cycles, breathing problems, rashes on your face, and tingling in your hands. You should contact your doctor if you notice any of these adverse effects.


Esomeprazole is one of the proton pump inhibitors that helps in the treatment of stomach ulcers and other acid-related disorders. This makes it suitable for ulcer treatments and prevents ulcer formation.

Because it can lower the amount of stomach acid made in the stomach, esomeprazole can be used to relieve heartburn symptoms.

Your doctor might tell you to stay away from esomeprazole if you are pregnant or lactating (breastfeeding).

Some people notice side effects like constipation, nausea, and headaches when they take esomeprazole. Also, after prolonged use of esomeprazole, some people might notice low magnesium symptoms in the blood.

All proton pump inhibitors should be avoided in pregnancy because the safety profile during pregnancy is not clear in humans. Doctors often prescribe ranitidine and cimetidine for pregnant people.

Are proton pump inhibitors safe?

Apart from the mild side effects that people experience with proton pump inhibitors, they are generally safe and effective, especially when taken in the right dosage.

However, when used for an extended period, it can pose some health risks, including:

  • Low levels of magnesium in the body (hypomagnesemia)
  • Low levels of vitamin B-12 in the body
  • Inflammation or injury to the kidneys
  • Spine or hip fractures
  • Hypergastrinemia (excess increase in the hormone that stimulates gastric acid production)

The American Patients Rights Association (APRA) reported that over 13,900 lawsuits were filed against Nexium, Prevacid, and other PPIs as patients reported experiencing serious side effects like bone fractures and kidney disease after using the medications. The patients claimed the manufacturers didn't warn them of those side effects.

Talk to your doctor if you have any side effects while taking a proton inhibitor to treat your stomach ulcer. Your doctor may recommend alternatives to PPIs, such as H2 blockers or lifestyle changes. Some home remedies may help relieve your stomach ulcer symptoms.

Other uses of proton pump inhibitors

Proton pump inhibitors can be used for treating more than just stomach ulcers. They can also be used for treating:

Esophageal ulcers: This type of ulcer occurs in the esophagus, which is the long tube that moves food from your mouth into your stomach. It is mainly caused by an infection with H. pylori bacteria. Proton pump inhibitors are effective remedies for this type of ulcer.

Zollinger-Ellison Syndrome: This is a condition where the stomach produces excess acid, and is a rare condition. Proton pump inhibitors are effective in treating this condition.

Non-steroidal anti-inflammatory ulcer: This is a type of stomach ulcer that is caused by the excessive use of these non-steroidal anti-inflammatory ulcer diseases.

Gastroesophageal reflux disease: In this condition, acid usually flows back into the esophagus. It often causes heartburn or inflammation of the esophagus.

Side effects of proton pump inhibitors

Proton pump inhibitors are considered safe for most people when taken as prescribed. However, some people may experience side effects with PPI use. Some common side effects associated with proton pump inhibitors include:

  • Diarrhea
  • Headaches
  • Nausea
  • Constipation
  • Vomiting
  • Abdominal pain

Some long-term side effects of PPI use include:

  • Reduction in kidney function
  • Allergic reactions
  • Reduction in liver function
  • Low levels of vitamin B-12 in the body
  • Inflammation or injuries to the kidney
  • Spine or hip fractures

How to use proton pump inhibitors

Most proton pump inhibitors are in the form of tablets or capsules. So they are taken by mouth, preferably 30 minutes before the first meal of the day. Your doctor will specify the dosage for you, and you should follow the dosage and direction of use judiciously.

Each proton pump inhibitor has its own dosage and direction of use. For instance, some PPI dosage recommendations start at 15mg per day, while some can start at 240mg per day.

Wrap up

Proton pump inhibitors are effective medications for treating stomach ulcers and other acid-related diseases. There are different types of PPIs; your doctor will recommend the best one for you depending on your symptoms, severity, and underlying health conditions.

While proton pump inhibitors are effective for treating most stomach ulcer cases, they can cause side effects. If the PPI you are taking is making you feel sick, your doctor can prescribe alternative medications for you. Certain medications, e.g., clopidogrel drugs, can also interact with PPIs. Speak with your doctor about possible drug interactions.

Stomach ulcers can cause discomforting symptoms that make it difficult to sleep at night. Read this article that offers tips on how people with stomach ulcers can get a good sleep.


  1. Ahmed A and Clarke JO. (2022). Proton pump inhibitors
  2. Bernshteyn MA and Masood U (2022). Pantaprazole
  3. Lanza FL, et al., (2009). Guidelines for prevention of NSAID-related ulcer complications
  4. Shan N and Gossman W. (2022). Omeprazole
  5. Johnson TJ and Hedge DD (2002). Esomeprazole: a clinical review