A peptic ulcer is a focused area of erosion of the stomach lining or small intestinal lining. Peptic ulcers can cause discomfort, bleeding, and even perforation. Generalized gastritis (swollen and inflamed stomach tissue) can also result from a breakdown of this lining.

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Peptic ulcer prevalence is estimated to be roughly 0.5% of the U.S. general population.1 Many of these individuals are older than 60 years old. There seems to be a small, but significant genetic connection with risk, but mostly environmental factors are involved. Risk factors associated with a higher incidence of peptic ulcer disease include:

  • Excessive neuroticism (worry, stress, anxiety, moodiness, envy, etc.)
  • Tobacco use
  • Regular use of nonsteroidal analgesic drugs (Ibuprofen, aspirin, naproxen, etc.)
  • Alcohol use
  • Low intake of foods that are high in phytosterols and phospholipids2 (nuts, seeds, legumes, vegetables, unrefined grains, etc.)
  • High intake of refined foods2 (white breads, white rice, granulated sugar, etc.)
  • Higher intake of meats and seafood

Protecting the stomach and intestinal lining by avoiding the above risk factors is important in order to avoid getting an ulcer. Many people do not realize that providing the right dietary building blocks (phytosterols, phospholipids, etc.) that make up the stomach and intestinal lining is an important strategy to keep it strong and less likely to break down. This may be why refined-food-heavy diets are associated with ulcers—because they are low in phytosterols and phospholipids. A Nutritarian eating style is high in the right foods that help protect the stomach and intestinal lining and recommends avoiding alcohol, tobacco, and unnecessary drugs, which can collectively reduce the risk of ulcer dramatically, if followed.

  1. Everhart JE, Byrd-Holt D, Sonnenberg A. Incidence and risk factors for self-reported peptic ulcer disease in the United States. Am J Epidemiol 1998, 147:529-536.
  2. Tovey FI, Bardhan KD, Hobsley M. Dietary phosphilipids and sterols protective against peptic ulceration. Phytother Res 2013, 27:1265-1269.

Action Plan


  • A Nutritarian eating style, which includes sufficient amounts of healthy plant fats (nuts, seeds, vegetables, legumes, whole grains) helps provide nutrients that are essential for strong stomach and intestinal lining cells (phospholipids, phytosterols).
  • Avoid alcohol, which is a risk factor for peptic ulcers.
  • Avoid tobacco in any form (smoking, chew, etc.), as it is a risk factor for chronic peptic ulcers.
  • Stop all refined foods (foods that are processed, and not whole).
  • Chew food exceptionally well, eat smaller meals at more frequent intervals.
  • Avoid animal products, and if using them, only use them in very small amounts so as not to trigger significant acid production.
  • A 4 ounce glass of vegetable juice, which contains at least 1 oz. of cruciferous greens such as cabbage, bok choy or kale twice a day is helpful to increase resistance of the lining.
  • Consider adding a supplement which contains zinc carnosine.

Other Considerations

  • Reduce stress and anxiety. Effective methods include exercise, meditation, and healthy social interactions.
  • If on medications for acid suppression, do not stop suddenly. It is usually best after this pain is resolved and healing has occurred to go from a stronger medication to a weaker one before discontinuing. Review with your doctor to find out if H. Pylori is a contributing issue for you and if more aggressive medical treatment is needed, if not improving.

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Ask The Doctor

The following are sample questions from the Ask the Doctor Community Platinum and higher members can post their health questions directly to Dr. Fuhrman. (All members can browse questions and answers.)


What is the best diet for an ulcer? All my doctor told me is to take Pepcid AC, and eat a bland diet!


Avoid any drinks such as alcohol, coffee or tea and certainly avoid any soft drinks. Avoid spicy foods. Reduce the amount of acidic foods, such as tomatoes and citrus, for now until it heals. Otherwise, you should be able to eat a variety of cooked vegetables, starchy and non-starchy, and perhaps fewer raw vegetables, but it is ok to eat all other fruits and berries. Cabbage juice or other cruciferous greens consumed two to four ounces twice/day is soothing and can help the ulcer heal. Some end up taking a zinc-carnosine supplement to help the ulcer heal.


My husband has just been diagnosed with a peptic ulcer. Can he juice and blend? He’s a very S.A.D eater, so I have to tread lightly, but I want to offer him some support and guidance.


It’s the entirety of the diet that is important, however, he should include cruciferous vegetables daily. Eliminate refined foods, sweets, dairy, oils, breads, pasta, coffee, tea, and alcohol. Yes, blend foods high in quercetin, such as apples, leafy greens, and citrus fruit. Juice cabbage, kale, carrots and beets. Include cooked tomatoes, red grapes, and parsley in his diet.