Stomach Ulcers: What Causes Them, Symptoms and Treatment

Published December 9th, 2021 by Chris Riley
Fact Checked by
Jacqueline Hensler
Medically Reviewed:
Dr. Angel Rivera

What are stomach ulcers | Causes | Symptoms | Diagnosis | Treatment | Prevention

A stomach ulcer is a sore or hole in the stomach lining and is also known as peptic ulcer disease. A stomach ulcer can cause pain and discomfort, but often people with stomach ulcers do not have any symptoms at all. Find out more about what causes stomach ulcers, how they are diagnosed, and how to treat them.

What are stomach ulcers?

Stomach ulcers are a type of lesion that can form on the lining of your stomach. They are caused by a break in the stomach lining, also called the gastric mucosa due to it being covered in a layer of mucus, which allows stomach acids to come into contact with the underlying tissue. This can cause pain, inflammation, and even bleeding. They may also occur in the first part of your lower intestine and in your esophagus too, which are called esophageal ulcers. When you have a peptic ulcer in your stomach it is called a gastric ulcer, while an ulcer in your intestine is called a duodenal ulcer.

What causes stomach ulcers?

Stomach ulcers are stomach lesions that occur when stomach acid and enzymes damage stomach tissue. They can be caused by a number of factors, but most often they develop when there is too much stomach acid in the stomach. They are typically caused by an infection with Helicobacter pylori (H. pylori), but can also be caused by medications like aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs). There are several things that can cause stomach ulcers, including:

  • Helicobacter pylori bacteria: This is the most common cause of stomach ulcers. It is a type of bacteria that lives in your stomach and can damage the stomach lining and causes a bacterial infection. 
  • NSAIDs: Nonsteroidal anti-inflammatory drugs, such as ibuprofen or aspirin, can irritate the stomach lining and lead to ulcers.
  • Alcohol: Drinking alcohol can damage the stomach lining and increase the risk of stomach ulcers.
  • Smoking: Smoking cigarettes can increase the risk of stomach ulcers and make them harder to treat.
  • Stress: Stress can aggravate stomach problems and lead to stomach ulcers.

What are the symptoms of a stomach ulcer?

Stomach ulcers produce several symptoms, including stomach pain or discomfort in the upper abdomen that may spread to your back. This common symptom can be intermittent at first but gets worse over time, and it may come and go for a few days before you eventually feel stomach pain more frequently. You might feel nauseous or vomit blood if you have an ulcer that is bleeding. You might also have a loss of appetite, unexplained weight loss, and black stools if there is blood in your stomach. Other symptoms may include bloody stools caused by gastrointestinal bleeding, bloating, and weight loss, among others. Here is a more complete list of the most common symptoms of stomach ulcers:

  • Bloody or black stool
  • Nausea
  • Stomach pain, specifically abdominal pain
  • Weight loss
  • Loss of appetite
  • Vomiting
  • Bloating
  • Feeling full
  • Dark or bloody vomit due to internal bleeding
  • Eating or taking antacids reduces pain in your stomach
  • Heartburn
  • Acid reflux and burping

How do doctors diagnose a stomach ulcer?

Your doctor will perform a physical exam and ask you about your medical history and any medications you may be taking. You may be asked to describe the stomach pain that you are feeling, for example, whether it is a dull pain or a sharp pain. If there is blood in your vomit or stool, this can also help them make an accurate diagnosis as these are common signs of stomach ulcers.

You might need tests like endoscopy, a procedure where they insert a long, thin, flexible tube with a camera on the end through your stomach to see what is going on, or an upper gastrointestinal (GI) series where you swallow barium, called a barium swallow, and they take an X-ray of the stomach and digestive tract. The doctor may also perform an endoscopic biopsy where they take a tissue sample from your stomach and analyze it. Blood, stool, and breath tests are also common to test for the H. pylori bacterium to ensure it is not an H. pylori infection.

How are stomach ulcers treated?

Depending on the cause of the ulcer, doctors may recommend different treatments. If the stomach ulcer is caused by H. pylori, your doctor will likely prescribe antibiotics to kill the bacteria. If you are taking NSAIDs, your doctor may recommend that you stop taking them and take other medications to help reduce stomach acid. You may also need to make some dietary changes, like avoiding spicy foods or acidic foods. Doctors usually treat stomach ulcers using medications like antibiotics and medications that reduce stomach acid called proton-pump inhibitors or PPIs. If the stomach ulcer is bleeding, you may need to have surgery to stop the bleeding. Probiotics, which introduce healthy bacteria to your gut, antacids, or bismuth, the active ingredient in Pepto Bismol, may also be prescribed.

How can stomach ulcers be prevented?

The best way to prevent stomach ulcers is to avoid the things that cause them. This means not taking NSAIDs if you don’t need them, avoiding alcohol, and quitting smoking. You can also reduce your risk of stomach ulcers by eating a healthy diet and managing your stress levels. Taking probiotics may also help to protect against stomach ulcers. If you are taking NSAIDs, your doctor may also recommend that you take a stomach protector like misoprostol or omeprazole to help reduce your risk of developing an ulcer. If you have any questions about stomach ulcers, please talk to your doctor. Your doctor will be able to advise you on the best treatment options.

How do stomach ulcers affect your lifestyle?

Stomach ulcers can cause a loss of appetite and weight loss which can lead to malnutrition. If you have stomach pain, you may feel nauseous and vomit blood or black material. You might also experience heartburn if the stomach ulcer is near the esophagus as well as bloating, feeling full after eating only a small amount of food, and stomach cramps. All of these symptoms can affect your quality of life by making it difficult to eat, work, or socialize. If you are experiencing any of these symptoms, please talk to your doctor. They will be able to help you get relief from your symptoms and improve your quality of life.

Summary

Stomach ulcers, also called peptic ulcers, are caused by acid in your esophagus, small intestine, or stomach corroding the lining of your stomach. It can be caused by a number of things including the bacteria H. pylori,  long-term use of NSAIDs, and stomach lining damage from alcohol and smoking, among other reasons. There are a number of common ulcer symptoms that can let you know if you have stomach ulcers including heartburn, bloating, weight loss, or malnutrition due to feeling nauseous after eating only small amounts of food. Your doctor may use endoscopy, or stool, breath, or blood tests to diagnose your symptoms although that is not always necessary for a correct diagnosis. Effective treatments for stomach ulcers include antibiotics to kill H. pylori bacteria, medications to reduce stomach acid, and surgery if the stomach ulcer is bleeding. Prevention of stomach ulcers includes not taking NSAIDs unnecessarily, eating a healthy diet, managing your stress levels, and taking probiotics. If your symptoms get worse or you have a medical emergency it is advisable to seek medical attention immediately. If you have any questions about stomach ulcers or their treatment please talk to your doctor or healthcare provider as they will be able to help you with your stomach ulcer symptoms and get you relief from them. 

References and Sources:

Cleveland Clinic 

NIH

American Family Physician

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