Symptoms include pain in your upper abdomen, often near your breastbone. The pain may ache or burn and be relieved by eating. Sometimes bleeding occurs. This can lead to black, tarry stools (melena) or vomiting bright red blood or reddish brown clumps of partially digested blood that look like coffee grounds (hematemesis).
Your doctor will check for an ulcer with a test called an endoscopy, done with a long, flexible tube and medicine to make you sleepy. A sample of your stomach lining is looked at under the microscope.
Symptoms
A peptic ulcer happens when acid in the organs that food travels through, called the digestive tract, erodes the protective lining of the stomach or duodenum. This may cause a painful open sore that sometimes bleeds. In most people, the ulcers that appear in their stomach and esophagus are caused by infection with a germ called Helicobacter pylori and overuse of medications such as NSAIDs.
Stomach pain is the most common symptom. It is usually gnawing, burning, or aching and felt between the belly button and breastbone. It is often relieved by antacids, and it may come and go for days or weeks. Some people don’t have typical symptoms, though.
Other symptoms of a gastric ulcer are a sour taste in the mouth, loss of appetite, and weight loss. You might have a bloated feeling in your abdomen, especially after meals. The bloating is because of the extra gas from the ulcer. Your stools may be black, sticky and thick (called melena) or look like coffee grounds.
Your healthcare professional will check for a Helicobacter pylori infection and an ulcer with a breath test or by looking for them in your stomach with imaging tests such as X-rays or CT scans. A more detailed exam is done with an upper endoscopy, in which you are sedated and a long, thin tube (endoscope) goes down your throat. The healthcare provider can use the endoscope to see and take a sample of the ulcer, which is then tested for bacteria.
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The doctor will also ask about your past health and your family’s history of peptic ulcers. Then they will feel your stomach and listen to your belly for sounds that indicate inflammation. They will want to know if you have been taking a medicine called a proton pump inhibitor (PPI). These are drugs that reduce the amount of stomach acid made. They are taken by people who have a history of peptic ulcer disease or who take a NSAID, such as aspirin, naproxen (Aleve(r), Naproxen(r), and ibuprofen (Advil(r), Motrin(r) and others).
If your doctor suspects you’re bleeding from an ulcer, they might do more tests. These might include a blood test or an ultrasound exam of your stomach and duodenum. They might also do an upper endoscopy to find the source of your bleeding and to cauterize it or inject a medicine that makes your ulcers clot.
Diagnosis
The first symptom of a peptic ulcer is often gnawing pain or discomfort in the middle of your belly (belly button) and breastbone. It may be relieved by eating or taking an antacid. The pain can last a few minutes to a few hours. It may come and go, especially between meals or at night.
Most ulcers are in the stomach, but they can also be in the first part of the small intestine that leads out of the stomach, called the duodenum. A few ulcers occur in the throat, called the esophagus. They can cause problems like heartburn, stomach or chest pain, nausea, bloating and vomiting.
Your doctor can diagnose a gastric ulcer by asking about your symptoms and medical history, doing a physical exam, and ordering tests. These include a breath test, blood or stool sample, or a procedure with an endoscope (a lighted tube with a camera that is inserted into your mouth). A breath test is the most common way to discover H. pylori, the bacteria that can cause an ulcer.
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A peptic ulcer can sometimes be seen on an X-ray or CT scan. But the most accurate way to find an ulcer is with an endoscopy. During this procedure, your doctor inserts a thin tube with a lighted camera on the end into your mouth and down to your stomach and duodenum. With the help of this flexible camera and a specialized tool called a biopsy forceps, your provider can identify an ulcer and see if it is bleeding.
Usually, your doctor will prescribe medicine to treat the ulcer and heal the lining of your stomach. These medicines might include antibiotics to kill the H. pylori bacteria and acid-suppressing drugs that reduce your stomach’s ability to produce acids. Some medicines coat and protect the ulcer during healing and others stop the bleeding. Your doctor might also recommend avoiding foods and drinks that make your symptoms worse, including alcohol and nonsteroidal anti-inflammatory medications (NSAIDs). If you take these medications, ask your doctor for safer alternatives. If your ulcer is severe, you may need to have a procedure to repair the hole in your stomach or duodenum.
Treatment
A stomach ulcer can be painful and uncomfortable, but it’s not usually serious. You can usually get relief with a combination of lifestyle changes and medicine. You may also try home remedies, such as avoiding foods that make your symptoms worse and taking probiotics to improve the health of your digestive tract. But if your symptoms don’t go away, you should see your doctor to find out what is causing the problem and receive medical treatment.
The most common cause of ulcers is infection with the bacteria Helicobacter pylori, or H. pylori. This bacteria can cause a lot of damage to the lining of your stomach and small intestine, causing an inflammation called gastric ulceration. If left untreated, this inflammation can lead to complications such as a bloody ulcer or a hole in the stomach wall (perforation).
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When you’re diagnosed with a peptic ulcer, your healthcare provider will first want to check for H. pylori infection and then look for the ulcer itself inside your stomach. A doctor can do this by doing an upper endoscopy exam, in which they use a long, thin tube with a camera on the end to look inside your digestive tract. They can also do this using a procedure called a barium swallow, in which you drink a liquid that coats the inside of your digestive tract and makes any ulcers show up on x-rays.
Most ulcers are caused by an infected stomach and can be treated with antibiotics. The most commonly used antibiotics are amoxicillin, clarithromycin and metronidazole. Some people also need to take antacids to counteract the effect of stomach acid on the ulcer and reduce their pain. Others need other medicines to help the ulcer heal, such as histamine receptor blockers and proton pump inhibitors.
Some peptic ulcers aren’t caused by bacteria, but by other things such as smoking or overuse of certain medications such as aspirin and other NSAIDs. If you have these types of ulcers, your doctor will suggest lifestyle changes and medicines to reduce the amount of acid your body makes. In some cases, surgery is needed to remove part of the stomach or to prevent a hole from developing in the esophagus.
Prevention
A peptic ulcer is a painful sore in the lining of your stomach or first part of your small intestine (duodenum). The most common cause of stomach ulcers is a bacterium called Helicobacter pylori. This infection can lead to a buildup of stomach acid that irritates the stomach lining and causes symptoms like gas, heartburn and nausea. Other factors that can cause ulcers include frequent use of over-the-counter pain relievers called NSAIDs, like ibuprofen, smoking and certain illnesses.
Stomach ulcers are most common in the duodenum, but can also form in the esophagus. They can be very uncomfortable, but they usually do not cause serious health problems. If a peptic ulcer is not treated, it can lead to a hole in your stomach or duodenum wall (perforation) and cause severe bleeding that needs immediate medical attention.
Bleeding from a peptic ulcer can cause low blood cell levels, or anemia. It can also cause black or bloody stools or vomit. If the bleeding is bad enough, it can be a medical emergency and may require hospitalization and a blood transfusion.
Other complications from peptic ulcers include stomach infections, which can be serious. A peptic ulcer can eat a hole in the stomach or duodenum walls, and it can make food pass too quickly through your digestive tract. This can lead to malnutrition and weight loss.
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Doctors can diagnose an ulcer by asking about your symptoms and doing tests. They will want to know if you have had an infection in the past and what medications you take. They will also want to know if you have family members with peptic ulcers. The most common way to diagnose a peptic ulcer is with an upper gastrointestinal series, which involves drinking a chalky white liquid called barium and having X-rays taken of your throat and stomach. The X-rays show the lining of your digestive tract and any ulcers.
You will probably be prescribed a combination of antibiotic drugs to kill the H. pylori bacteria and medications to reduce the amount of acid in your stomach. This will typically involve a pill called a proton pump inhibitor (PPI), such as Aciphex or Nexium, and antacid medication. You may also be given other medications, depending on what’s causing your ulcers.
