Many people confuse ulcers and heartburn, but they are different conditions. They have some similar symptoms, but heartburn involves the esophagus, and ulcers include the stomach lining or top of the small intestine.

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Although heartburn and ulcers are both digestive conditions, they have different causes and don’t share all the same symptoms. Deciding which is causing your symptoms may be confusing.

Heartburn involves the esophagus, while ulcers are sores on your stomach lining or small intestine. While both conditions share similar symptoms, if you have an ulcer, you may have additional symptoms.

Read on to understand the different symptoms, causes, treatments, and outlooks of these conditions.

An ulcer is a sore or wound that can occur on the lining of your stomach or the upper portion of your small intestine. You can have either a stomach ulcer, a small intestine ulcer, or both types at once. About 1% to 6% of Americans have ulcers.

Most ulcers are caused by H. pylori bacteria, which can spread from person-to-person through direct contact with saliva and fecal matter, or water containing the bacteria. Ulcers can also be caused by NSAIDs (ibuprofen, naproxen, and aspirin), especially if you take these for extended periods of time.

Heartburn is a burning sensation in the upper part of your chest that occurs when regurgitated food or stomach acid moves up the esophagus. Heartburn is very common, affecting about 20% of Americans. People with severe or persistent heartburn may have gastroesophageal reflux disease (GERD), but not everyone with heartburn has GERD.

Heartburn occurs when the sphincter muscle at the top of your stomach becomes weakened, allowing the contents of your stomach to flow back up your esophagus. When the food and stomach juices come up, they cause your esophagus to become inflamed and irritated, resulting in the burning feeling known as heartburn.

Both ulcers and heartburn involve abdominal pain or discomfort and share other symptoms like indigestion and nausea. But the precise location of the pain usually varies.

If you have heartburn, the pain is usually felt in the upper chest and throat. If you have ulcers, on the other hand, the pain is often felt a bit lower, between your belly button and breastbone area.

Also, heartburn and ulcers are two completely different conditions affecting different parts of your digestive system:

  • Heartburn: Affecting the upper portion of your stomach and esophagus, heartburn occurs when the valve at the top of your stomach is weakened, allowing stomach contents to flow up your esophagus.
  • Ulcers: Affecting the lining of your stomach or the top of your small intestine, ulcers are actual wounds or sores.

While certain symptoms overlap, ulcers and heartburn have distinct symptoms. Let’s take a closer look at ulcer vs. heartburn symptoms.


People who have ulcers may experience no symptoms at all or have mild indigestion. Other possible symptoms of ulcers include:

In more severe cases, ulcers can cause bloody stool or blood in the vomit. Your vomit may take on the appearance of coffee grinds, and your stool may be bright red or black.


The primary symptom that people with heartburn describe is a burning sensation that radiates from the upper chest area and into the throat. Other symptoms may include:

Although some of the same medications may be prescribed for both symptoms, treatments for ulcers and heartburn are different because they are different conditions with different causes. Here’s what to know about the treatment for these two conditions.


There are two kinds of treatments for ulcers:

  • treatments that work to heal the ulcer
  • treatments to address what’s causing the ulcer

The most common treatment for healing ulcer sores is proton pump inhibitors (PPIs), such as omeprazole (Prilosec) and lansoprazole (Prevacid).

H2 receptor blockers are another treatment option and include medications like famotidine (Pepcid and Zantac360). Both PPIs and H2 blocks work by decreasing the production of stomach acid.

Treating ulcers also involves addressing the cause. If H. pylori bacteria cause your ulcer, you may be given antibiotics, PPIs, or a medication called bismuth subsalicylate. Usually, a combination of antibiotics and PPIs are prescribed.

If NSAIDs cause your ulcer, you need to either stop taking the particular NSAID medication that caused the ulcer, or stop taking NSAIDs altogether.


Treating heartburn involves a combination of lifestyle changes and medications.

Medications used to address heartburn include:

Lifestyle modifications for heartburn may include:

Certain risk factors may increase the chances that you will develop ulcers or heartburn. Here’s what to know:


Those at higher risk of developing an ulcer include:

  • people with H. pylori
  • people who frequently take NSAIDs
  • older people
  • people who smoke
  • people with a history of ulcers


Those at higher risk of experiencing heartburn may include:

  • people who have obesity/overweight
  • pregnant people
  • people who smoke or are exposed to secondhand smoke
  • people who have hiatal hernias

Both heartburn and ulcers are treatable conditions with generally positive outlooks.

For most people, heartburn is a symptom that can be managed with dietary and lifestyle medications and medications. The biggest issue with heartburn is usually the discomfort. Complications from heartburn are rare and usually only occur if a serious case of GERD is causing your symptoms.

Ulcers can be managed with treatment, especially once the cause of the ulcer is pinpointed and addressed. Perhaps the most serious complication of ulcers is that they have a high likelihood of recurring. But recurrences can also be successfully treated. Ulcers rarely cause death.

What kind of doctor treats heartburn and ulcers?

If you have symptoms of heartburn or ulcers, you can start by visiting your primary care provider, who can help determine what might be bothering you. It’s possible they will refer you to a gastroenterologist, which is the type of specialist who treats both ulcers and heartburn.

Are ulcers caused by stress or spicy foods?

It was thought that ulcers were caused by stress or by eating spicy food. But we now know that isn’t the case. If you have an ulcer, it may be best to avoid certain foods temporarily while it heals.

What is “Barrett’s esophagus”?

If you have GERD along with heartburn, you may develop a condition called “Barrett’s esophagus,” where there are changes to the mucous membranes that line the lower part of your esophagus. The condition may slightly raise your risk of esophagus cancer.

It’s common to experience upper abdominal pain and wonder if you have an ulcer or heartburn. But although both conditions involve the digestive system, they are different and require different treatments. That’s why it’s important to visit your physician for a correct diagnosis and to get the proper care that you need to feel better.