Gastric ulcers: Biomaterial‑based strategies for tissue regeneration and future perspectives on environment‑designed biomaterials

Despite significant progress in our understanding of stomach physiology and the identification of key etiological factors, peptic ulcer disease continues to be a prevalent condition with global health implications. Current therapeutic interventions primarily target systemic pharmacological pathways, focusing on the suppression of acid secretion and the management of Helicobacter pylori infection. However, these therapeutic approaches frequently fail to achieve effective local tissue regeneration, complete mucosal restoration, functional re-establishment, or prevention of recurrence. Consequently, biomaterial-based approaches emerge as promising strategies to facilitate tissue-directed protection, drug delivery, and mucosal reestablishment. This review critically examines the proposed biomaterial platforms for the treatment of gastric ulcers. It employs a comparative analytical framework structured around central design trade-offs, encompassing adhesion and in situ retention, stability within the gastric environment, and controlled degradation under acidic, enzymatic, and mechanical stress. The integration of material properties, delivery routes, therapeutic functionality and translational maturity is a fundamental aspect of this analysis. A further analytical comparison framework is built to undertake and identify principles that govern performance, clinical potential and translational processes. Furthermore, the review under discussion emphasizes that future progress in the treatment of gastric ulcers is contingent on environment-specific biomaterial design intended to address chemical, biological, and mechanical constraints simultaneously. Furthermore, it puts forward a series of actionable priorities to guide the development of next-generation biomaterials, with a particular focus on enhanced local efficacy, durability, and translational feasibility for the management of peptic ulcers. STATEMENT OF SIGNIFICANCE: This work looks at new ways to treat stomach ulcers using biomaterials, combining advanced hydrogels, endoscopic delivery, and in situ bioprinting technologies. Our approach is different from traditional treatments and mucus protectants. We use materials that stick to the stomach, resist acid, and react to outside stimuli. These materials create protective barriers, deliver drugs directly to the area, and help tissue grow in the harsh conditions of the stomach. This paper talks about how to use modern design (like mucoadhesive and mucus-inspired hydrogels) with minimally invasive technologies (like endoscopic application and direct intragastric bioprinting) to create new treatments for stomach ulcers. These treatments could be used in procedures and are of great interest to the biomaterials and clinical communities.