Stomach ulcers, which are also known as gastric ulcers, are painful sores in the stomach lining. Stomach ulcers are a type of peptic ulcer disease. Peptic ulcers are any ulcers that affect both the stomach and small intestines.
Stomach ulcers occur when the thick layer of mucus that protects your stomach from digestive juices is reduced. This allows the digestive acids to eat away at the tissues that line the stomach, causing an ulcer.
Stomach ulcers may be easily cured, but they can become severe without proper treatment.
Stomach ulcers are almost always caused by one of the following:
- an infection with the bacterium Helicobacter pylori (H. pylori)
- long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, or naproxen
Rarely, a condition known as Zollinger-Ellison syndrome can cause stomach and intestinal ulcers by increasing the body’s production of acid. This syndrome is suspected to cause less than 1 percent of all peptic 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
- weight loss
- not wanting to eat because of pain
- nausea or vomiting
- feeling easily full
- burping or acid reflux
- 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 that’s 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 aren’t treated. Bleeding ulcers can become life-threatening.
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’re taking.
To rule out H. pylori infection, a blood, stool, or breath test may be ordered. With a breath test, you’ll 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:
- Barium swallow: You drink a thick white liquid (barium) that coats your upper gastrointestinal tract and helps your doctor see your stomach and small intestine on X-rays.
- Endoscopy (EGD): A thin, lighted tube is inserted through your mouth and into the stomach and the first part of the small intestine. This test is used to look for ulcers, bleeding, and any tissue that looks abnormal.
- Endoscopic biopsy: A piece of stomach tissue is removed so it can be analyzed in a lab.
Explore the interactive 3-D diagram below to learn more about stomach ulcers.
Treatment will vary depending on the cause of your ulcer. Most ulcers can be treated with a prescription from your doctor, but in rare cases, surgery may be required.
It’s important to promptly treat an ulcer. Talk to your doctor to discuss a treatment plan. If you have an actively bleeding ulcer, you’ll likely be hospitalized for intensive treatment with endoscopy and IV ulcer medications. You may also require a blood transfusion.
In addition to these treatments, your doctor may also recommend:
- H2 receptor blockers (drugs that also block acid production)
- stopping use of all NSAIDs
- follow-up endoscopy
- probiotics (useful bacteria that may have a role in killing off H. pylori)
- bismuth supplement
Symptoms of an ulcer may subside quickly with treatment. But even if your symptoms disappear, you should continue to take any medication prescribed by your doctor. This is especially important with H. pylori infections, to make sure that all bacteria are eliminated.
Side effects of medications used to treat stomach ulcers can include:
These side effects are typically temporary. If any of these side effects cause extreme discomfort, talk to your doctor about changing your medication.
In very rare cases, a complicated stomach ulcer will require surgery. This may be the case for ulcers that:
- continue to return
- don’t heal
- tear through the stomach
- 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 patching it over the ulcer site
- tying off a bleeding artery
- cutting off the nerve supply to the stomach to reduce the production of stomach acid
In the past, it was thought that diet could cause ulcers. We know now this isn’t true. We also know that while the foods you eat won’t cause or cure a stomach ulcer, eating a healthful diet can benefit your intestinal tract and overall health.
In general, it’s a good idea to eat a diet with lots of fruits, vegetables, and fiber.
That said, it’s possible that some foods play a role in eliminating H. pylori. Foods that may help fight off H. pylori or boost the body’s own healthy bacteria include:
- broccoli, cauliflower, cabbage, and radishes
- leafy greens, such as spinach and kale
- probiotic-rich foods, such as sauerkraut, miso, kombucha, yogurt (especially with lactobacillus and Sacharomyces)
- blueberries, raspberries, strawberries, and blackberries
- olive oil
Additionally, since people with stomach ulcers may have accompanying acid reflux disease, it is a good idea to stay away from spicy and sour foods while an ulcer is healing.
In addition to eating healthy foods, the following items may help reduce the effects of H. pylori, the bacteria responsible for many stomach ulcers. However, these supplements are not intended to replace prescription medication or your current treatment plan. They include:
Your doctor may also have suggestions for things you can do at home to relieve discomfort from your ulcer. Consider talking to your doctor about these natural and home remedies for ulcers.
If you think you have a stomach ulcer, call your doctor. Together you can discuss your symptoms and treatment options. It’s important to get a stomach ulcer taken care of because without treatment, ulcers and H. pylori can cause:
- bleeding from the ulcer site that can become life-threatening
- penetration, which occurs when the ulcer goes through the wall of the digestive tract and into another organ, such as the pancreas
- perforation, which occurs when the ulcer creates a hole in the wall of the digestive tract
- obstruction (blockage) in the digestive tract, which is due to swelling of inflamed tissues
- stomach cancer, specifically
Symptoms of these complications can include those listed below. If you have any of these symptoms, be sure to call you doctor right away:
To prevent the spread of bacteria that might cause a stomach ulcer, wash your hands with soap and water on a regular basis. Also, be sure to properly clean all of your food and to cook it thoroughly as needed.
To prevent ulcers caused by NSAIDs, stop using these medications (if possible) or limit their use. If you need to take NSAIDs, be sure to follow the recommended dosage and avoid alcohol while taking these medications. And always take these medications with food and adequate liquids.