Akansha Pandey¹, Pushpendra Kuumar²*, Prajwal Anil Gupta³, Diksha Jindal⁴ and Neethu Asokan⁵

¹Vidyawati Pharmacy College, Chandwak, Jaunpur 222129, Uttar Pradesh, India
²Maharaja Agrasen Himalayan Garhwal University, Pauri Garhwal, Uttarakhand, India
³National Institute of Medical Sciences and Research (NIMS), Rajasthan 303121, India
⁴Professor, Pharmaceutical Chemistry, College/ University-AIPBS, Adesh University, Bathinda, 151001, India
⁵Sri Sathya Sai University for Human Excellence, Kalaburagi, Karnataka, India

*Corresponding Author: Pushpendra Kuumar, Maharaja Agrasen Himalayan Garhwal University, Pauri Garhwal, Uttarakhand, India.

Received: July 21, 2025; Published: July 31, 2025

Abstract

Up to 10% of people worldwide suffer with peptic ulcer disease, making it a common yet serious chronic condition. Peptic ulcers develop when stomach juice pH is high and mucosal defences are weakened. Both the infection with Helicobacter pylori (H.) and nonsteroidal anti-inflammatory medicines (NSAIDs) have been linked to decreased mucosal resilience to damage. Internal gastrointestinal (GI) disruption due to the production of gastric acid or pepsin is what defines peptic ulcer disease (PUD). The stomach and the first part of the duodenum are common sites for the phenomenon. The jejunum, distal duodenum, and lower oesophagus might be affected. Patients with gastric ulcers often have epigastric discomfort 15-30 minutes after eating, whereas those with duodenal ulcers suffer pain 2-3 hours after eating. Side effects, relapses, and medication interactions have been reported with peptic ulcer therapies such as proton pumps inhibition chemicals and histamine (H2) receptor inhibitor molecules. However, the chemical compounds found in medicinal plants may be used to cure and prevent various illnesses. Therefore, in this analysis, we will look at some of the most often used medicinal plants for peptic ulcers and how they may be put to use in these capacities. Keywords: Peptic Ulcer; Gastric Disease, H. pylori Gastric Infection; Proton Pump Inhibition Medicine

References

1. Narayanan M., et al. “Peptic ulcer disease and Helicobacter pylori infection”. Missouri Medicine 115 (2018): 219-224.
2. Lanas A and Chan FKL. “Peptic ulcer disease”. Lancet 390 (2017): 613-624.
3. Lanas A., et al. “The changing face of hospitalisation due to gastrointestinal bleeding and perforation”. Alimentary Pharmacology and Therapeutics 33 (2011): 585-591.
4. Sonnenberg A. “Review article: Historic changes of helicobacter pylori-associated diseases”. Alimentary Pharmacology and Therapeutics 38 (2013): 329-342.
5. Søreide K., et al. “Perforated peptic ulcer”. Lancet 386 (2015): 1288-1298.
6. Zhang BB., et al. “Association between vacA genotypes and the risk of duodenal ulcer: A meta-analysis”. Molecular Biology Reports 41 (2014): 7241-7254.
7. Datta De D and Roychoudhury S. “To be or not to be: The host genetic factor and beyond in Helicobacter pylori mediated gastroduodenal diseases”. World Journal of Gastroenterology 21 (2015): 2883-2895.
8. Lanas Á., et al. “Risk of upper and lower gastrointestinal bleeding in patients taking nonsteroidal anti-inflammatory drugs, antiplatelet agents, or anticoagulants”. Clinical Gastroenterology and Hepatology 13 (2015): 906-912.e2.
9. Masclee GM., et al. “Risk of upper gastrointestinal bleeding from different drug combinations”. Gastroenterology 147 (2014): 784-792.
10. Huang JQ., et al. “Role of helicobacter pylori infection and nonsteroidal anti-inflammatory drugs in peptic-ulcer disease: A meta-analysis”. Lancet 359 (2002): 14-22.
11. Charpignon C., et al. “Peptic ulcer disease: One in five is related to neither Helicobacter pylori nor aspirin/NSAID intake”. Alimentary Pharmacology and Therapeutics 38 (2013): 946-954.
12. Levenstein S., et al. “Psychological stress increases risk for peptic ulcer, regardless of Helicobacter pylori infection or use of nonsteroidal anti-inflammatory drugs”. Clinical Gastroenterology and Hepatology 13 (2013): 498-506.e1.
13. McColl KE. “Helicobacter pylori-negative nonsteroidal anti-inflammatory drug-negative ulcer”. Gastroenterology Clinics of North America 38 (2009): 353-361.
14. Siddique O., et al. “Helicobacter pylori infection: An update for the internist in the age of increasing global antibiotic resistance”. American Journal of Medicine 131 (2018): 473-479.
15. Hooi JKY., et al. “Global prevalence of Helicobacter pylori infection: Systematic review and meta-analysis”. Gastroenterology 153 (2017): 420-429.
16. Zaki M., et al. “Pylori acutely inhibits gastric secretion by activating CGRP sensory neurons coupled to stimulation of somatostatin and inhibition of histamine secretion”. American Journal of Physiology-Gastrointestinal and Liver Physiology 304 (2013): G715-G722.
17. El-Omar EM., et al. “Helicobacter pylori infection and chronic gastric acid hyposecretion.” Gastroenterology 113 (1997): 15-24.
18. Moss SF., et al. “Effect of helicobacter pylori on gastric somatostatin in duodenal ulcer disease”. Lancet 340 (1992): 930-932.
19. Bhala N., et al. “Vascular and upper gastrointestinal effects of nonsteroidal anti-inflammatory drugs: Meta-analyses of individual participant data from randomised trials”. Lancet 382 (2013): 769-779.
20. Bjarnason I., et al. “Determinants of the short-term gastric damage caused by NSAIDs in man”. Alimentary Pharmacology and Therapeutics 26 (2007): 95-106.
21. L Kuna., et al. “Peptic Ulcer Disease: A Brief Review of Conventional Therapy and Herbal Treatment Options”. Journal of Clinical Medicine2 (2019): 179.
22. M Miftahussurur., et al. “The Potential Benefits of Vonoprazan as Helicobacter pylori Infection Therapy”. Pharmaceuticals10 (2020): 276.
23. , et al. “A review on peptic ulcer”. UPI Journal of Pharmaceutical, Medical and Health Sciences (2022): 19-26.
24. Echizen H. “The first-in-class potassium-competitive acid blocker, vonoprazan fumarate: Pharmacokinetic and pharmacodynamic considerations”. Clinical Pharmacokinetics 55 (2016): 409-418.
25. Jenkins H., et al. “Randomised clinical trial: Safety, tolerability, pharmacokinetics and pharmacodynamics of repeated doses of TAK-438 (vonoprazan), a novel potassium-competitive acid blocker, in healthy male subjects”. Alimentary Pharmacology and Therapeutics 41 (2015): 636-648.
26. Sakurai Y., et al. “Safety, tolerability, pharmacokinetics, and pharmacodynamics of single rising Tak-438 (Vonoprazan) doses in healthy male Japanese/Non-Japanese Subjects”. Clinical and Translational Gastroenterology 6 (2011): e94.
27. Shin JM., et al. “Characterization of a Novel Potassium-Competitive Acid Blocker of the Gastric H,K-ATPase, 1-[5- (2-Fluorophenyl)-1- (pyridin-3-ylsulfonyl)-1H-pyrrol-3-yl]-N methylmethanamine Monofumarate (TAK-438)”. Journal of Pharmacology and Experimental Therapeutics 339 (2011): 412-420.
28. Yang X., et al. “Vonoprazan: A novel and potent alternative in the treatment of acid-related disease”. Digestive Diseases and Sciences 63 (2018): 302-311.
29. Wang Y., et al. “Cytochrome P450-based drug-drug interactions of vonoprazan in vitro and in vivo”. Frontiers in Pharmacology 11 (2020): 53.
30. Jenkins H., et al. “Effect of multiple oral doses of the potent CYP3A4 inhibitor clarithromycin on the pharmacokinetics of a single oral dose of vonoprazan: A phase I, open-label, sequential design study”. Clinical Drug Investigation 37 (2017): 311-316.
31. Kagami T., et al. “Potent acid inhibition by vonoprazan in comparison with esomeprazole, with reference to CYP2C19 genotype”. Alimentary Pharmacology and Therapeutics 43 (2016): 1048-1059.
32. Kinoshita Y., et al. “Advantages and disadvantages of long-term proton pump inhibitor use”. Journal of Neurogastroenterology and Motility 24 (2018): 182-196.
33. Oshima T., et al. “Randomised clinical trial: Vonoprazan versus lansoprazole for the initial relief of heartburn in patients with erosive oesophagitis”. Alimentary Pharmacology and Therapeutics 49 (2019): 140-146.
34. Oshima T and Miwa H. “Potent potassium-competitive acid blockers: A new era for the treatment of acid-related diseases”. Journal of Neurogastroenterology and Motility 24 (2018): 334-344.
35. Akazawa Y., et al. “Vonoprazan-based therapy for Helicobacter pylori eradication: Experience and clinical evidence”. Therapeutic Advances in Gastroenterology 9 (2016): 845-852.
36. Sugano K. “Vonoprazan fumarate, a novel potassium-competitive acid blocker, in the management of gastroesophageal reflux disease: Safety and clinical evidence to date”. Therapeutic Advances in Gastroenterology 11 (2018): 1-14.
37. Garnock-Jones KP. “Vonoprazan: First global approval”. Drugs 75 (2015): 439-443.

Citation

Citation: Pushpendra Kuumar., et al. “Mechanism-Based Biomarkers for Peptic Ulcer Disease". Acta Scientific Pharmaceutical Sciences 9.9 (2025): 33-40.

Copyright

Copyright: © 2025 Pushpendra Kuumar., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.