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Patient Education

Stomach Ulcers

What is a stomach ulcer?

A stomach ulcer is a sore in the lining of your stomach. The medical term for them is peptic ulcers. A peptic ulcer can be in the stomach or in the beginning of the small intestine.

  • Gastric ulcer: an ulcer in the stomach
  • Duodenal ulcer: an ulcer in the small intestine

Stomach Ulcers

Stomach Ulcer - Peptic UlcerStomach Ulcer Symptoms

Stomach ulcers often have no symptoms. Some people will experience:

  • Burning stomach pain
  • Feeling of fullness, bloating, belching
  • Intolerance to fatty foods
  • Heartburn
  • Nausea

Pain that goes away after taking an antacid, like Tums or Maalox, and then returns may also be a symptom of stomach ulcers. Discomfort and pain are frequently worse at night and between meals.

Occasionally, symptoms will include:

  • Vomiting or vomiting blood
  • Dark blood in stools
  • Stools that are black and tarry
  • Trouble breathing
  • Unexplained weight loss
  • Appetite changes

Stomach ulcer causes

The most common cause of stomach ulcers is an infection with Helicobacter pylori (H. pylori). The transmission of this bacteria is not fully understood. Direct contact with bodily fluids and contaminated food or water may cause infection. Not all people who are infected with H. pylori will get an ulcer.

Long-term use of non-steroidal anti-inflammatory drugs (NSAIDs) is another possible cause of stomach ulcers. NSAIDs include over-the-counter aspirin (Excedrin), ibuprofen (Advil), and naproxen (Aleve). Prescription NSAIDs that are prescribed for diseases like rheumatoid arthritis or other orthopedic conditions can also cause ulcers with long-term use.

When NSAIDs are taken with some other medications, there is a greater risk of getting a stomach ulcer. These medications include:

  • Corticosteroids
  • Anticoagulants
  • Selective serotonin reuptake inhibitors (SSRIs) – antidepressants like Paxil and Zoloft
  • Osteoporosis medications – Actonel and Fosamax

Stress and spicy foods do not cause stomach ulcers. They can, however, make symptoms worse.

Stomach ulcer risk factors

A few risk factors can make it more likely that a peptic ulcer will develop.

  • Smoking – especially in people who are already infected with H. pylori
  • Drinking alcohol
  • Having a family history of ulcers

Additionally, people who take NSAIDs are more likely to develop an ulcer if they:

  • Are over 70 years of age
  • Take high doses of NSAIDs
  • Are female
  • Have a personal history of ulcer disease

Stomach ulcer complications

Blood loss is one of the complications associated with stomach ulcers. It can be slow and lead to anemia over time. If an ulcer starts bleeding suddenly, it can cause severe blood loss that may require a blood transfusion and hospitalization.

Rarely, an ulcer can create a hole in the stomach. This can lead to a severe infection of the abdomen called peritonitis.

Obstructions are also possible due to scarring or inflammation from an ulcer. Symptoms of obstruction may be a feeling of fullness or nausea and vomiting.

Stomach ulcer diagnosis

Stomach ulcers diagnosed are based on medical history and physical examination by a doctor. An upper endoscopy may be performed. This allows the gastroenterologist to view the inside of your stomach with a small camera.

Laboratory testing for H. pylori may also be conducted. It may consist of a blood test, a stool test, or a breath test. (Read more about testing for H. pylori)

Stomach ulcer treatment

Treatment with antibiotics may be necessary when there is an H. pylori infection causing the ulcer.

Medications may also be prescribed for treatment, including:

  • Proton-pump inhibitors: omeprazole (Prilosec), esmeprazole (Nexium)
  • Histamine blockers: famotidine (Pepcid), cimetidine (Tagamet)

Your doctor may also recommend antacids like Tums or Maalox for pain relief. Sucralfate may be recommended as well, which adds a protective layer to the surface of the ulcer while it heals.


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