Peptic ulcer

A peptic ulcer (stomach ulcer) is a sore in the lining of your stomach or upper small intestine. Ulcers form when the protective layer in the lining has broken down, often because of a bacterial infection or frequent use of aspirin or similar medicine.

Peptic ulcers can cause pain in the belly, above the belly button. Ulcers can also bleed.

Symptoms

What are the symptoms of a peptic ulcer?

Common symptoms of a peptic ulcer include:

  • A burning, aching, or gnawing pain between the belly button (navel) and the breastbone. Some people also have back pain. The pain can last from a few minutes to a few hours. It may come and go for weeks.
  • Pain that usually goes away for a while after you take an antacid or acid reducer.
  • Loss of appetite and weight loss.
  • Bloating or nausea after eating.

Less common symptoms include:

  • Vomiting.
  • Vomiting blood or material that looks like coffee grounds.
  • Passing black stools that look like tar, or stools that contain dark red blood.

Different people have different symptoms.

Some ulcers don't cause symptoms. These are known as silent ulcers.

Causes

What causes peptic ulcers?

The most common causes of peptic ulcers are infection with Helicobacter pylori (H. pylori) bacteria and use of nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs include aspirin, ibuprofen (Advil or Motrin), and naproxen (Aleve). H. pylori and NSAIDs break down the protective mucus layer in the stomach or intestine.

Prevention

How are peptic ulcers treated?

To treat peptic ulcers, most people take medicines that reduce acid in the stomach. If you have an H. pylori infection, you'll also take antibiotics. You can help your ulcer heal by quitting smoking and avoiding alcohol. Using medicines such as aspirin, ibuprofen, or naproxen may increase the chance of your ulcer returning.

Diagnosis

Treatment

How are peptic ulcers treated?

To treat peptic ulcers, most people need to take medicines that reduce the amount of acid in the stomach. If you have an H. pylori infection, you will also need to take antibiotics.

You can help speed the healing of your ulcer and help prevent it from coming back if you quit smoking and avoid alcohol. If you keep using medicines such as aspirin, ibuprofen, or naproxen, you may increase the chance of your ulcer coming back.

Surgery is rarely used to treat an ulcer. But if your ulcer doesn't heal, or if you have life-threatening complications, you may need surgery.

Ignoring symptoms of an ulcer isn't a good idea. An ulcer needs to be treated. While symptoms can go away for a short time, you may still have an ulcer. Left untreated, an ulcer can cause life-threatening problems. Even with treatment, some ulcers may come back and may need more treatment.

When to call

Peptic ulcer disease: When to call

Call 911 anytime you think you may need emergency care. For example, call if:

  • You have symptoms of a heart attack. These may include:
    • Chest pain or pressure, or a strange feeling in the chest.
    • Sweating.
    • Shortness of breath.
    • Nausea or vomiting.
    • Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly or in one or both shoulders or arms.
    • Lightheadedness or sudden weakness.
    • A fast or irregular heartbeat.
  • You have sudden, severe, continuous belly pain or vomiting.
  • You vomit bright red blood or what looks like coffee grounds.
  • You pass maroon or very bloody stools.

Call your doctor now or seek immediate medical care if:

  • You have new or worse belly pain.
  • Your stools are black and look like tar, or they have streaks of blood.
  • You vomit.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You do not get better as expected.

Self-care

How can you care for yourself when you have a peptic ulcer?

  • Be safe with medicines. Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
  • Do not take aspirin or other NSAIDs such as ibuprofen (Advil or Motrin) or naproxen (Aleve). Ask your doctor what you can take for pain.
  • If you smoke, try to quit. Smoking can make ulcers worse. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
  • Avoid drinking alcohol as much as you can.
  • Eat a balanced diet of small, frequent meals. See a dietitian if you need help planning your meals. Avoid foods that make your symptoms worse.

Copyrighted material adapted with permission from Healthwise, Incorporated. This information does not replace the advice of a doctor.

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