Integrative Strategies for Peptic Ulcer Disease: Therapeutic Synergy Between Conventional Treatments and Herbal Remedies in Helicobacter pylori Management

Peptic ulcer disease (PUD), a multifactorial and prevalent gastrointestinal disease, is predominantly associated with Helicobacter pylori (H.pylori) infection and chronic non-steroidal anti-inflammatory drug (NSAID) consumption.Although proton pump inhibitors (PPIs), histamine-2 receptor antagonists (H2RAs), and antibiotic-based eradication therapy have transformed outcomes, rising antibiotic resistance and drug side effects necessitate the development of alternative therapy.Herbal compounds have gained major attention due to their gastroprotective, anti-inflammatory, antimicrobial, and antioxidant activities.In this review, the pathogenesis of PUD with special reference to H. pylori infection is critically discussed, the traditional pharmacological treatment strategies are evaluated, and the potential of herbal plants as adjunct therapy is explored.Representative phytotherapeutics like Panax ginseng, Allium sativum, Curcuma longa, Zingiber officinalis, Zingiber zerumbet, and Camellia sinensis have exhibited mechanisms like inhibition of H. pylori virulence factors, suppression of pro-inflammatory cytokines, mucosal defense strengthening, and modulation of oxidative stress.Interestingly, some herbal compounds modulate cytochrome P450 enzymes and drug transporters, thus raising safety concerns in polypharmacy status.Although promising in vitro, in vivo data, well-designed large-scale clinical trials establishing the efficacy, safety, and herb-drug interaction profile of these agents in human beings are few.Standardization of herbal extracts, quality control, and regulatory standards are also absent, therefore making them a challenge to be included in evidence-based clinical practice.This review highlights the importance of interdisciplinary coordination in assessing the therapeutic potential of herbal medicine in PUD management and in promoting safer and more effective integrative approaches in the battle against H. pylorimediated gastric disorders.