Stomach ulcers, which are also known as gastric ulcers, are painful sores in the stomach lining. Stomach ulcers are a type of peptic ulcer disease. Peptic ulcers are any ulcers that affect both the stomach and small intestines.
Stomach ulcers occur when the thick layer of mucus that protects your stomach from digestive juices is reduced. This allows the digestive acids to eat away at the tissues that line the stomach, causing an ulcer.
Stomach ulcers may be easily cured, but they can become severe without proper treatment.
Stomach ulcers are almost always caused by one of the following:
- an infection with the bacterium Helicobacter pylori (H. pylori)
- long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, or naproxen
Rarely, a condition known as Zollinger-Ellison syndrome can cause stomach and intestinal ulcers by increasing the body’s production of acid. This syndrome is suspected to cause less than 1 percent of all peptic ulcers.
A number of symptoms are associated with stomach ulcers. The severity of the symptoms depends on the severity of the ulcer.
The most common symptom is a burning sensation or pain in the middle of your abdomen between your chest and belly button. Typically, the pain will be more intense when your stomach is empty, and it can last for a few minutes to several hours.
Other common signs and symptoms of ulcers include:
- dull pain in the stomach
- weight loss
- not wanting to eat because of pain
- nausea or vomiting
- feeling easily full
- burping or acid reflux
- heartburn, which is a burning sensation in the chest)
- pain that may improve when you eat, drink, or take antacids
- anemia, whose symptoms can include tiredness, shortness of breath, or paler skin
- dark, tarry stools
- vomit that’s bloody or looks like coffee grounds
Talk to your doctor if you have any symptoms of a stomach ulcer. Even though discomfort may be mild, ulcers can worsen if they aren’t treated. Bleeding ulcers can become life-threatening.
Diagnosis and treatment will depend on your symptoms and the severity of your ulcer. To diagnose a stomach ulcer, your doctor will review your medical history along with your symptoms and any prescription or over-the-counter medications you’re taking.
To rule out H. pylori infection, a blood, stool, or breath test may be ordered. With a breath test, you’ll be instructed to drink a clear liquid and breathe into a bag, which is then sealed. If H. pylori is present, the breath sample will contain higher-than-normal levels of carbon dioxide.
Other tests and procedures used to diagnose stomach ulcers include:
- Barium swallow: You drink a thick white liquid (barium) that coats your upper gastrointestinal tract and helps your doctor see your stomach and small intestine on X-rays.
- Endoscopy (EGD): A thin, lighted tube is inserted through your mouth and into the stomach and the first part of the small intestine. This test is used to look for ulcers, bleeding, and any tissue that looks abnormal.
- Endoscopic biopsy: A piece of stomach tissue is removed so it can be analyzed in a lab.
Explore the interactive 3-D diagram below to learn more about stomach ulcers.
Treatment will vary depending on the cause of your ulcer. Most ulcers can be treated with a prescription from your doctor, but in rare cases, surgery may be required.
It’s important to promptly treat an ulcer. Talk to your doctor to discuss a treatment plan. If you have an actively bleeding ulcer, you’ll likely be hospitalized for intensive treatment with endoscopy and IV ulcer medications. You may also require a blood transfusion.
If your stomach ulcer is the result of H. pylori, you’ll need antibiotics and drugs called proton pump inhibitors (PPIs). PPIs block the stomach cells that produce acid.
In addition to these treatments, your doctor may also recommend:
- H2 receptor blockers (drugs that also block acid production)
- stopping use of all NSAIDs
- follow-up endoscopy
- probiotics (useful bacteria that may have a role in killing off H. pylori)
- bismuth supplement
Symptoms of an ulcer may subside quickly with treatment. But even if your symptoms disappear, you should continue to take any medication prescribed by your doctor. This is especially important with H. pylori infections, to make sure that all bacteria are eliminated.
Side effects of medications used to treat stomach ulcers can include:
- abdominal pain
These side effects are typically temporary. If any of these side effects cause extreme discomfort, talk to your doctor about changing your medication.
In very rare cases, a complicated stomach ulcer will require surgery. This may be the case for ulcers that:
- continue to return
- don’t heal
- tear through the stomach
- keep food from flowing out of the stomach into the small intestine
Surgery may include:
- removal of the entire ulcer
- taking tissue from another part of the intestines and patching it over the ulcer site
- tying off a bleeding artery
- cutting off the nerve supply to the stomach to reduce the production of stomach acid