What Is An Ulcer
When your stomach’s healthy, it’s coated in a layer of sticky mucus. This protects it from the harsh acid that breaks down your food. If something upsets this balance, you end up with more stomach acid and not enough mucus. Over time, that acid gnaws away at the tissue that lines your stomach. The painful and sometimes bloody open sore it causes is called an ulcer. Some are tiny, while others are over an inch long.
What Ulcer Treatments Are Available
If your ulcer is bleeding, your doctor may treat it during an endoscopy procedure by injecting medications into it. Your doctor could also use a clamp or cauterization to seal it off and stop the bleeding.
For most people, doctors treat ulcers with medications, including:
- Proton pump inhibitors : These drugs reduce acid, which allows the ulcer to heal. PPIs include Prilosec®, Prevacid®, Aciphex®, Protonix® and Nexium®.
- Histamine receptor blockers : These drugs also reduce acid production and include Tagamet®, Pepcid®, Zantac® and Axid®.
- Antibiotics: These medications kill bacteria. Doctors use them to treat H. pylori.
- Protective medications: Like a liquid bandage, these medications cover the ulcer in a protective layer to prevent further damage from digestive acids and enzymes. Doctors commonly recommend Carafate® or Pepto-Bismol®.
Symptoms Of Stomach 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
- 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 thats 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 arent treated. Bleeding ulcers can become life-threatening.
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When To Contact A Doctor
Anyone who thinks they may have an ulcer in their stomach should consult a doctor. Any stomach symptoms that last for more than a few days or keep happening need evaluation and treatment.
Symptoms of anemia, such as tiredness and breathlessness, may signal a slow-bleeding ulcer. More serious bleeding is an urgent medical problem, as people may vomit up blood, or stools are black and sticky.
Perforation is also an emergency. Without quick treatment, the wall of the stomach can become infected. Sudden stomach pain that gets worse can indicate perforation, and any signs of being very unwell with infection need treatment as soon as possible.
What Is A Peptic Ulcer
A peptic ulcer is a sore or hole that forms in the lining of the stomach or intestine.
The word “peptic” refers to the digestive tract. An ulcer in the lining of the stomach is a gastric ulcer. An ulcer in the first part of the small intestine is a duodenal ulcer.
The lining of the stomach is a layer of special cells and mucous. Mucous prevents the stomach and duodenum from being damaged by acid and digestive enzymes.
If there is a break in the lining , the tissue under the lining can be damaged by the enzymes and corrosive acid. If the ulcer is small, there may be few symptoms. The wound can heal on its own.
If the ulcer is deep, it can cause serious pain or bleeding. Rarely, acids in the digestive juices may eat completely through the stomach or duodenum wall.
Peptic ulcers are very common. They become more common as people age.
The bacterium Helicobacter pylori is believed to cause most peptic ulcers. This bacteria causes inflammation in the stomach lining. This probably makes the lining vulnerable. But only a minority of people infected with H. pylori develop ulcers.
Another common cause of ulcers is the use of nonsteroidal anti-inflammatory drugs . Examples of NSAIDs include aspirin, ibuprofen and naproxen .
NSAIDs block the formation of some prostaglandins. Prostaglandins are chemicals that normally help protect against ulcers. With less prostaglandins, ulcers are more likely to form.
- Excessive alcohol use
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What Are The Symptoms Of Peptic Ulcers
Each persons symptoms may vary. In some cases ulcers dont cause any symptoms.
The most common ulcer symptom is a dull or burning pain in your belly between your breastbone and your belly button . This pain often occurs around meal times and may wake you up at night. It can last from a few minutes to a few hours.
Less common ulcer symptoms may include:
- Feeling full after eating a small amount of food
- Bloody or black stool
Peptic ulcer symptoms may look like other health problems. Always see your healthcare provider to be sure.
What Is Peptic Ulcer Disease
Peptic ulcer disease is a condition in which painful sores or ulcers develop in the lining of the stomach or the first part of the small intestine . Normally, a thick layer of mucus protects the stomach lining from the effect of its digestive juices. But many things can reduce this protective layer, allowing stomach acid to damage the tissue.
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What Causes Stomach Ulcers
Stomach ulcers occur when the layer protecting the stomach lining from stomach acid breaks down. This allows the stomach lining to become damaged.
This is usually caused by:
- an infection with Helicobacter pylori bacteria
- taking non-steroidal anti-inflammatory drugs , such as ibuprofen or aspirin particularly if they’re taken for a long time or at high doses
There’s little evidence that stress or certain foods causes stomach ulcers.
More about the causes of stomach ulcers
What Should I Do If I Think I Have A Stomach Ulcer
Always seek medical care for a stomach ulcer. While you may be able to manage symptoms temporarily with over-the-counter medications, these wont heal the ulcer. You need to identify and treat the underlying cause. An untreated ulcer can lead to serious complications, even if your symptoms are mild. The major cause of stomach ulcers, H. pylori infection, can also lead to other complications.
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What Exactly Is A Stomach Ulcer
Stomach, or peptic, ulcers are open sores that develop on the inside lining of your stomach or the upper portion of your small intestine. This occurs when the thick layer of mucus that protects your stomach from digestive juices is diminished, which then enables digestive acids to eat away at the tissues that line your stomach, causing an ulcer.
According to Medscape, peptic ulcers are almost equally as common in men and women.
There are two types of peptic ulcers:
When To Seek Medical Advice
Visit a GP if you experience persistent symptoms of a stomach ulcer.
Contact a GP or NHS 111 immediately if:
- you are passing dark, sticky, tar-like stools
- you have a sudden, sharp pain in your tummy that gets steadily worse
Go to your nearest accident and emergency department or call 999 if:
- you are vomiting blood the blood can appear bright red or have a dark brown, grainy appearance, similar to coffee grounds
If you’re not sure that you have a stomach ulcer, see other causes of stomach ache.
Page last reviewed: 14 January 2022 Next review due: 14 January 2025
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How Are Peptic Ulcers Treated
Treatment will depend on the type of ulcer you have. Your healthcare provider will create a care plan for you based on what is causing your ulcer.
Treatment can include making lifestyle changes, taking medicines, or in some cases having surgery.
Lifestyle changes may include:
- Not eating certain foods. Avoid any foods that make your symptoms worse.
- Quitting smoking. Smoking can keep your ulcer from healing. It is also linked to ulcers coming back after treatment.
- Limiting alcohol and caffeine. They can make your symptoms worse.
- Not using NSAIDs . These include aspirin and ibuprofen.
Medicines to treat ulcers may include:
- Antibiotics. These bacteria-fighting medicines are used to kill the H. pylori bacteria. Often a mix of antibiotics and other medicines is used to cure the ulcer and get rid of the infection.
- H2-blockers . These reduce the amount of acid your stomach makes by blocking the hormone histamine. Histamine helps to make acid.
- Proton pump inhibitors or PPIs. These lower stomach acid levels and protect the lining of your stomach and duodenum.
- Mucosal protective agents. These medicines protect the stomach’s mucus lining from acid damage so that it can heal.
- Antacids. These quickly weaken or neutralize stomach acid to ease your symptoms.
In most cases, medicines can heal ulcers quickly. Once the H. pylori bacteria is removed, most ulcers do not come back.
How Can I Prevent A Stomach Ulcer From Occurring Or Returning
- Reduce NSAID use, if possible. Consider whether acetaminophen might substitute. If you take NSAIDs for medical reasons, talk to your doctor about reducing your dosage or switching your medication. Your doctor may also prescribe another medicine to take with NSAIDs to protect your stomach lining.
- Reduce other irritants that may contribute to too much stomach acid or erode your stomach lining, including smoking and alcohol use.
- Take an H. pylori breath test to find out if you have an overgrowth of the bacteria.
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How To Test For Stomach Ulcers
If your doctor thinks you may have a stomach ulcer, the initial tests will include some blood tests. These tests will help to check whether you have become anaemic because of any bleeding from the ulcer. The blood test will also check to see that your liver and pancreas are working properly.
The main tests that are then used to diagnose a stomach ulcer are as follows:
What Are The Symptoms Of Gi Bleeding
There are a few things that you can look for if you suspect that you might have GI or rectal bleeding. Your stool might become darker and sticky, like tar, if bleeding comes from the stomach or upper GI tract.
You may pass blood from your rectum during bowel movements, which could cause you to see some blood in your toilet or on your toilet tissue. This blood is usually bright red in color. Vomiting blood is another sign that theres bleeding somewhere in your GI tract.
If you experience any of these symptoms, or if you have vomit that looks like coffee grounds, contact a doctor immediately.
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How Is An Ulcer Diagnosed
Your doctor will ask you about your symptoms. They may do an endoscopy. This procedure involves inserting a thin, flexible tube attached to a camera down your throat and into your stomach. Your doctor will test your blood, breath or stool for H. pylori. They also can test a sample of your stomach lining. Your doctor also will ask you if you regularly take aspirin or anti-inflammatory medicines.
Why Painkillers Can Cause Trouble
You could develop an ulcer if you’re a regular user of some over-the-counter pain relievers like aspirin, ibuprofen, ketoprofen, or naproxen. When you take these nonsteroidal anti-inflammatory drugs too often or for a long time, they inflame the lining of your stomach. Your ulcers won’t have a chance to heal until you stop taking them.
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Causes Of Stomach Ulcers
Stomach ulcers occur when the layer that protects the stomach lining from stomach acid breaks down. This means the stomach lining becomes damaged.
This is usually a result of:
- an infection with Helicobacter pylori bacteria
- taking non-steroidal anti-inflammatory drugs , such as ibuprofen or aspirin particularly if they’re taken for a long time or at high doses
It used to be thought that stress or certain foods might cause stomach ulcers, but there’s little evidence to suggest this is the case.
Upper Gastrointestinal Endoscopy And Biopsy
Doctors may order an upper GI endoscopy to confirm the diagnosis of a peptic ulcer and try to find its cause.
For an upper GI endoscopy, a doctor uses an endoscopea flexible tube with a camerato see the lining of your upper GI tract, including your esophagus, stomach, and duodenum. During upper GI endoscopy, a doctor obtains biopsies by passing an instrument through the endoscope to take small pieces of tissue from your stomach lining. A pathologist will examine the tissue under a microscope.
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Treating Helicobacter Pylori Infection
If your stomach ulcer’s caused by a Helicobacter pylori bacterial infection, you’ll be given:
- a course of antibiotics
- a medication called a proton pump inhibitor
This is also recommended if it’s thought your stomach ulcer’s caused by a combination of an H. pylori infection and non-steroidal anti-inflammatory drugs .
What Treatments Are There For Ulcers
Your treatment will depend on the cause of your ulcer. For example, if our tests indicate that an infection caused by helicobacter pylori is what created your ulcer, well give you antibiotics to eliminate the bacteria.
Regardless of the cause, medications that help reduce the level of acid in your stomach can help the ulcer heal. And different lifestyle changes can accelerate healing as well, such as eliminating certain foods, abstaining from alcohol, and practicing stress management.
In severe cases, surgery may be required. Your provider at Prima Medicine will work with you to create a treatment plan for your situation.
If you have a stomach ulcer or want to see if you do, we can help. To learn more, book an appointment online or over the phone with Prima Medicine today.
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A Closer Look With An Endoscopy
This procedure lets your doctor see any ulcers and take a tissue sample, which can be tested for H. pylori. The doctor gives you medicine to make you feel sleepy, then puts a skinny tube with a tiny camera down your throat and into your stomach. Your doctor is likely to suggest this test if you’re older, have signs of bleeding, or find it hard to swallow, eat, or keep on enough weight.
When Should I Call The Doctor
- sudden, sharp, lasting belly pain
- bloody or black bowel movements
- bloody vomit or vomit that looks like coffee grounds
These could be signs of a serious problem for a child whos had a peptic ulcer, such as:
If your child takes NSAIDs and shows signs of a peptic ulcer, get medical help right away. Delaying diagnosis and treatment can lead to more problems and, possibly, the need for surgery. But with quick treatment, almost all peptic ulcers can be cured.
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Give Yourself Time To Heal
Stomach ulcers often respond well to treatment and sometimes heal within weeks. Your doctor may want to do another H. pylori test or endoscopy to make sure. An ulcer that doesn’t clear up could be due to many reasons, from not taking your drugs the right way or another health problem like Crohn’s disease. Be patient. Your doctor will gather more info about your symptoms and try other treatments to get your stomach feeling better.
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What Tests Will Be Done To Diagnose A Peptic Ulcer
Endoscopy. An upper endoscopy exam is expedient because allows healthcare providers to see inside your digestive tract and also take a tissue sample to analyze in the lab. The test is done by passing a thin tube with a tiny camera attached down your throat and into your stomach and duodenum. Youll have medication to numb your throat and help you relax during the test. Your healthcare provider may use the endoscope to take a tissue sample to test for signs of mucous damage, anemia, H. pylori infection or malignancy. If they take a sample, you wont feel it.
Imaging tests. Imaging tests to look inside the stomach and small intestine include:
- Upper GI series. An upper GI X-ray exam examines the stomach and duodenum through X-rays. Its less invasive than an endoscopy. For the X-ray, youll swallow a chalky fluid called barium, which will coat your esophagus, stomach and duodenum. The barium helps your digestive organs show up better in black and white images.
- CT scan. Your healthcare provider might recommend a CT scan if they need to see your organs in more detail. A CT scan can show complications such as a perforation in the stomach or intestinal wall. For the test, youll lie on a table inside a scanner machine while X-rays are taken. You may drink or have an injection with contrast fluid to make your organs show up better in images.
Tests for H. pylori. Your healthcare provider might want to test you separately for H. pylori infection. Tests may include:
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How Are Peptic Ulcers Diagnosed
Your healthcare provider will look at your past health and give you a physical exam. You may also have some tests.
Imaging tests used to diagnose ulcers include:
- Upper GI series or barium swallow. This test looks at the organs of the top part of your digestive system. It checks your food pipe , stomach, and the first part of the small intestine . You will swallow a metallic fluid called barium. Barium coats the organs so that they can be seen on an X-ray.
- Upper endoscopy or EGD . This test looks at the lining of your esophagus, stomach, and duodenum. It uses a thin lighted tube called an endoscope. The tube has a camera at one end. The tube is put into your mouth and throat. Then it goes into your esophagus, stomach, and duodenum. Your health care provider can see the inside of these organs. A small tissue sample can be taken. This can be checked for H. pylori.
You may also have the following lab tests to see if you have an H. pylori infection: