Stomach ulcers are painful sores that can be found in the stomach lining or small intestine. Stomach ulcers are also known as peptic ulcers. They occur when the thick layer of mucus that protects your stomach from digestive juices is reduced.
According to the American Gastroenterological Association, an estimated four million people have stomach ulcers and one in 10 people will develop the condition over their lifetime (AGA).
Stomach ulcers are easily cured, however they can become severe without treatment.
Stomach ulcers are not necessarily caused by one single factor. The decrease in the stomach’s mucus lining that leads to an ulcer is commonly caused by:
- an infection with the bacterium Helicobacter pylori (H. pylori)
- long-term use in excess of the recommended dosage of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen
- Zollinger-Ellison syndrome—a rare disease that makes the body produce excess stomach acid
Certain factors and behaviors put people at higher risk for developing stomach ulcers:
- frequent use of steroids (such as those for treating asthma)
- hypercalcemia (overproduction of calcium)
- family history of stomach ulcers
- being over 50 years old
- excessive consumption of alcohol
There are a number of symptoms 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 area between your chest and belly button. Normally, the pain will be more intense when your stomach is empty and it can last for a few minutes or several hours.
Other common symptoms include:
- dull, burning pain in the stomach
- weight loss
- not wanting to eat because of pain
- nausea or vomiting
- heartburn (burning sensation in the chest)
- pain improves when you eat, drink , or take antacids
Talk to your doctor if you experience symptoms of a stomach ulcer. Even though discomfort may be mild, ulcers can get worse if they aren’t treated.
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 are taking. To rule out H. pylori infection, a blood, stool, or breath test may be ordered. In a breath test, you will 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:
You will be instructed to drink a thick white liquid (barium) that makes the stomach and small intestine show up on X-rays. A radiologist will then read the X-rays to see if you have an ulcer, scar tissue, or a blockage that is preventing food from passing thru the digestive system normally.
A thin, lighted tube is inserted through the mouth and into the stomach to look for the presence of an ulcer. Your doctor will give you a mild sedative or painkiller to eliminate any discomfort resulting from the procedure.
During the endoscopy, a piece of stomach tissue is removed, so that it can later be analyzed. This type of test is typically used on older people, or those that have experienced weight loss or bleeding.
Treatment will vary depending on the cause of your ulcer. If your stomach ulcer is the result of H. pylori, you will need antibiotics. For mild to moderate stomach ulcers, your physician will usually prescribe the following medications:
- H2 blockers: to prevent your stomach from making too much acid
- proton pump inhibitors: blocks the cells that produce acid
- over-the-counter antacids: to help neutralize stomach acid
- cytoprotective agents: to protect the lining of the stomach and small intestine, such as Pepto-Bismol
Symptoms of an ulcer may subside quickly with treatment. Even if your symptoms disappear, you should continue to take any medicine prescribed by your doctor. This is especially important for H. pylori infections to ensure that all bacteria are destroyed. Doctors will also suggest that you avoid smoking, alcohol, and any medications or foods that can trigger symptoms.
Certain side effects associated with stomach ulcer treatment include:
These side effects are temporary. Talk to your doctor about changing your medication if you experience extreme discomfort as a result of these side effects.
In very rare cases, a complicated stomach ulcer will require surgery. These include ulcers that:
- keep returning
- don’t heal
- tear the stomach or small intestine
- 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 sewing it over the ulcer site
- tying off a bleeding artery
- cutting off nerve supply to stomach to reduce the production of stomach acid
Seek treatment as soon as you believe that you might have a stomach ulcer. The longer an ulcer is untreated, the more likely you are to develop complications. If you experience any of the following symptoms, you should seek medical treatment:
- sudden, sharp pain that does not stop
- black or bloody stools
- bloody vomit
- vomit that looks like coffee grounds
These could be signs that ulcer has eroded through the stomach, or broken a blood vessel. Scar tissue development is another possible complication. The tissue can prevent food from moving from the stomach into the small intestine. All of these scenarios require surgery (NIDDK, 2012).
To prevent the spread of bacteria and reduce risk of bacterial infection, wash your hands with soap and water on a regular basis and make sure that all food is properly cleaned and cooked thoroughly.
To prevent ulcers caused by NSAIDs, stop using these medications (if possible) or limit their use. In you need to take NSAIDs, be sure to follow the recommended dosage and avoid alcohol while taking these medications.
Certain lifestyle changes can also help prevent ulcers from forming. Limiting alcohol consumption, avoiding tobacco products, and properly managing stress can all contribute to a healthy stomach lining.
Written by: Shannon Johnson
Medically reviewed by George Krucik, MD