Sinus ulcers are ulcers that occur in the sinus region, which is the distal part of the stomach, and treatment requires a protocol that addresses the cause. The two main etiologies of these ulcers are H. pylori infection and damage from aspirin and NSAIDs. Inflammation of the mucosa following H. pylori infection reduces the ability to resist injury and the role of physicochemical injury factors is relatively enhanced. Aspirin and NSAIDs can directly damage the mucosa and can inhibit the regenerative and repair functions of the mucosa. In both cases, mucosal damage is not self-repairing. Minor damage can gradually worsen and become ulcers. For the treatment of sinus ulcers, the presence of H. pylori infection and the history of aspirin and NSAID use are evaluated first. If H. pylori infection is present, the maximum possible eradication of the bacteria is sought. The ulcer can be cured. If taking aspirin or NSAIDs, discontinue as much as possible if other conditions allow. If discontinuation is not possible, eradicate H. pylori as much as possible because, in the presence of H. pylori infection, mucosal damage and ulcer development caused by aspirin or NSAIDs are significantly more likely to occur in the absence of bacterial infection. Of course, in patients with multiple coexisting diseases or discontinuation of aspirin, etc. may not be realistic, and in such cases strong gastric acid inhibiting agents such as lazoles need to be applied continuously, and mucosal protective agents can also be added together to maintain treatment for ulcer healing or to reduce the chance of serious complications such as bleeding and perforation. Therefore, the treatment of gastric ulcer can be summarized into three aspects: eradication of germs, protection of mucosa, and careful use of drugs.