Stomach Ulcer: Symptoms & Treatment
Stomach ulcer guide: symptoms, causes, diagnosis, and treatment. Learn when to seek help and how to prevent ulcers with simple, expert-backed tips.
Introduction
A stomach ulcer is a sore in the lining of your stomach that can cause burning pain, nausea, and other digestive symptoms. Ulcers are common and very treatable, but without proper care, they can lead to serious problems like bleeding. The good news: effective tests and medicines exist, and most people feel better quickly once the right treatment starts. This guide explains symptoms, causes, diagnosis, and treatment, plus when to seek help and how to prevent ulcers.
What Is An Ulcer?
- An ulcer is an open sore that forms when stomach acid and digestive juices damage the protective lining of the digestive tract.\
- “Peptic ulcer disease” includes ulcers in the stomach (gastric ulcers) and in the first part of the small intestine (duodenal ulcers).
The Two Most Common Causes Are:
- Infection with Helicobacter pylori (H. pylori), a bacteria that lives in the stomach.
- Regular use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen.
- Spicy foods and stress do not cause ulcers, but they can make symptoms feel worse.
Stomach Ulcer Symptoms
Symptoms can vary. Some people have mild or no symptoms; others have significant discomfort. Common signs include:
- Burning or gnawing pain in the upper belly (often between the breastbone and belly button)
- Pain that may improve or worsen with food
- Bloating, belching, or feeling full quickly
- Nausea or occasional vomiting
- Loss of appetite or unintentional weight loss
Red Flags: Get Urgent Medical Care Now If You Have
- Vomiting blood or material that looks like coffee grounds
- Black, tarry stools or maroon-colored stools
- Sudden severe abdominal pain
- Fainting, dizziness, or signs of shock
- Persistent vomiting or inability to keep fluids down
Consult a Top General Physician
Causes And Risk Factors
Main Causes
- H. pylori infection: This common bacterium weakens the stomach’s protective lining, making it easier for acid to cause an ulcer. It spreads through saliva and contact with contaminated food or water.
- NSAIDs: These pain relievers can irritate the stomach lining and reduce protective chemicals that guard against acid.
Other Factors That May Increase Risk Or Slow Healing
- Smoking (impairs healing and increases ulcer risk)
- Heavy alcohol use (irritates the lining)
- Older age
- A history of ulcers or ulcer complications
- Taking blood thinners (for example, warfarin), antiplatelet medications (like aspirin), or corticosteroids, especially when combined with NSAIDs
- Rare conditions that cause high acid levels, such as Zollinger–Ellison syndrome
- Severe illness or major injury (can lead to “stress ulcers” in hospitalised patients)
How Are Ulcers Diagnosed?
Your clinician will start with your symptoms and medical history, then may recommend:
- Tests for H. pylori:
- Urea breath test (noninvasive and highly accurate)
- Stool antigen test (noninvasive and accurate)
- Endoscopic biopsy (during an upper endoscopy, if needed)
- Blood antibody tests are less useful because they cannot tell what is active from past infection.
- Upper endoscopy (EGD): A small camera is used to look at the oesophagus, stomach, and duodenum. This is recommended if you have red-flag symptoms, severe or persistent symptoms, recurrent ulcers, or if your clinician needs to take biopsies. For some gastric ulcers, repeat endoscopy may be advised to confirm healing and rule out other conditions.
Treatment: What Works And Why?
Goals of treatment are to relieve pain, heal the ulcer, clear H. pylori if present, and prevent complications or recurrence.
If H. Pylori Is Present
- Combination therapy: Most people receive two or more antibiotics plus a proton pump inhibitor (PPI) that reduces stomach acid, typically for 10–14 days. A commonly used option in many places is bismuth quadruple therapy (PPI + bismuth + two antibiotics).
- Confirm eradication: After finishing antibiotics, your clinician will usually retest with a urea breath test or stool antigen test at least 4 weeks after treatment, and after stopping PPIs for 1–2 weeks.
- This ensures the infection is truly gone.
If NSAIDs are The Cause
- Stop the NSAID if possible. Ask about alternatives like acetaminophen for pain.
- Acid suppression (usually with a PPI) is prescribed to heal the ulcer, often for 8 weeks.
- If you must continue an NSAID, your clinician may recommend the lowest effective dose, possibly a COX-2 selective NSAID, plus ongoing PPI protection. Misoprostol is another protective option but may cause side effects (such as diarrhoea) and is not safe in pregnancy.
Medicines That Reduce Acid And Protect The Lining
- Proton pump inhibitors (PPIs): The most effective medicines to heal ulcers and prevent recurrence.
- H2 blockers: Reduce acid and can help symptoms; some are available over the counter.
- Bismuth subsalicylate: Can be part of H. pylori treatment regimens and may help soothe the lining.
- Antacids: Provide quick symptom relief but do not heal the ulcer.
Treating Complications
- Bleeding ulcers may need endoscopic therapy, medicines, and sometimes hospitalisation.
- Perforation (a hole in the stomach or intestine) is a surgical emergency.
- Gastric outlet obstruction (swelling or scarring that blocks food) may need endoscopic procedures or surgery.
Self-Care During Recovery
- Take all medicines exactly as prescribed and complete the full course of antibiotics if given.
- Avoid NSAIDs unless your clinician says otherwise.
- Do not smoke; it slows healing and increases recurrence.
- Limit alcohol; it can irritate the stomach lining.
- Eat in a way that feels good for you:
- There’s no single “ulcer diet,” but small, frequent meals can help.
- Avoid foods and drinks that trigger your symptoms (for some, these include spicy foods, fatty foods, citrus, coffee, and alcohol).
- A food diary can help identify personal triggers.
- Consider probiotics as an add-on during H. pylori therapy to reduce side effects like diarrhoea; they are not a stand-alone treatment.
- Manage stress and prioritise sleep, these do not cause ulcers, but good habits may reduce symptom flares and support recovery.
Prevention Tips
Reduce The Chance Of H. Pylori
- Wash your hands regularly with soap and water.
- Eat food that’s properly cooked and drink safe, clean water.
Use Pain Relievers Wisely
- Avoid NSAIDs when possible; ask about alternatives (e.g., acetaminophen).
- If you need an NSAID, use the lowest effective dose for the shortest time.
- If you’re at higher risk (age over ~60, prior ulcer, taking blood thinners or steroids), ask your clinician about protective therapy with a PPI.
- Don’t smoke, and moderate alcohol intake.
When To See A Healthcare Professional?
- Recognising when to seek medical attention for digestive issues is crucial, as symptoms can range from mild discomfort to signs of a severe emergency.
- Seek immediate care for vomiting blood, black or maroon stools, sudden severe abdominal pain, fainting, or signs of shock.
- Make an appointment soon if you have ongoing upper belly pain, unexplained nausea, early fullness, or symptoms that last more than a couple of weeks.
- Call your clinician if symptoms return after treatment or if medicines are not helping.
Consult a Top General Physician
Consult a Top General Physician
Dr. Mohammed Kamran
General Practitioner
5 Years • MBBS, FIDM
Nashik
Apollo 24|7 Clinic - Maharashtra, Nashik
Dr. Rajib Ghose
General Physician/ Internal Medicine Specialist
25 Years • MBBS
East Midnapore
VIVEKANANDA SEBA SADAN, East Midnapore
Dr. Shaik Abdul Kalam
General Practitioner
3 Years • MD (Physician)
Visakhapatnam
Apollo 24|7 Clinic - Andhra Pradesh, Visakhapatnam
(150+ Patients)
Dr. Vasanthasree Nair
General Practitioner
15 Years • MBBS
Angamaly
Apollo 24|7 Clinic - Kerala, Angamaly
(500+ Patients)
Dr. Ramya Hari
General Practitioner
18 Years • Medical Head & Family Physician, DG Shipping Approved Doctor, Panel Physician - UK Visa Medicals
Chennai
Apollo Medical Centre Kotturpuram, Chennai
Consult a Top General Physician
Dr. Mohammed Kamran
General Practitioner
5 Years • MBBS, FIDM
Nashik
Apollo 24|7 Clinic - Maharashtra, Nashik
Dr. Rajib Ghose
General Physician/ Internal Medicine Specialist
25 Years • MBBS
East Midnapore
VIVEKANANDA SEBA SADAN, East Midnapore
Dr. Shaik Abdul Kalam
General Practitioner
3 Years • MD (Physician)
Visakhapatnam
Apollo 24|7 Clinic - Andhra Pradesh, Visakhapatnam
(150+ Patients)
Dr. Vasanthasree Nair
General Practitioner
15 Years • MBBS
Angamaly
Apollo 24|7 Clinic - Kerala, Angamaly
(500+ Patients)
Dr. Ramya Hari
General Practitioner
18 Years • Medical Head & Family Physician, DG Shipping Approved Doctor, Panel Physician - UK Visa Medicals
Chennai
Apollo Medical Centre Kotturpuram, Chennai
Frequently Asked Questions
What causes a stomach ulcer?
Most ulcers are caused by H. pylori infection or regular NSAID use (like ibuprofen or naproxen). Smoking, heavy alcohol use, older age, and certain medicines (blood thinners, antiplatelets, corticosteroids) increase the risk and can slow healing. Rarely, conditions that increase stomach acid (such as Zollinger–Ellison syndrome) are responsible.
How is H. pylori diagnosed?
Noninvasive tests, the urea breath test and stool antigen test, are most commonly used. During an endoscopy, your doctor may also take a biopsy for testing. Blood antibody tests are generally not recommended to diagnose active infection.
Can diet cause or cure ulcers?
No. Diet doesn’t cause ulcers, and there’s no single diet that cures them. However, certain foods and drinks can worsen symptoms for some people. Avoid your personal triggers, focus on balanced meals, and limit alcohol. Follow your prescribed medicines to heal the ulcer.
How long does an ulcer take to heal?
With treatment, many ulcers heal within several weeks. If H. pylori is present, you’ll take antibiotics plus acid-suppressing medicine and then get retested to confirm the infection is gone. Some gastric ulcers require repeat endoscopy to verify healing.
Are proton pump inhibitors (PPIs) safe?
PPIs are very effective and commonly used to heal ulcers. Most people take them for a limited time. Long-term use is sometimes needed for specific conditions and should be guided by your clinician, who will balance benefits and potential risks.