A peptic ulcer is an open sore in the lining of the stomach (a gastric ulcer) or in the first part of the small intestine (a duodenal ulcer). Ulcers form when the layer of mucus that protects the lining from stomach acid wears down.
The two most common causes are infection with a bacterium called Helicobacter pylori and regular use of pain relievers known as NSAIDs, such as ibuprofen, naproxen, and aspirin. Contrary to old belief, stress and spicy food do not cause ulcers, though they can aggravate symptoms.
Common symptoms
The most common symptom is a burning or gnawing pain in the upper abdomen, often between meals or during the night, that may ease for a while with food or antacids. Other symptoms include bloating, feeling full quickly, nausea, and loss of appetite. Some ulcers — especially those caused by NSAIDs — produce no pain at all and first show themselves with bleeding.
How ulcers are diagnosed
Your gastroenterologist may test for H. pylori with a breath, stool, or blood test. The most direct way to confirm an ulcer is an upper endoscopy: while you are sedated, a thin, flexible camera examines the esophagus, stomach, and duodenum. Biopsies taken during the exam can confirm the infection and make sure a stomach ulcer is not hiding anything more serious.
Treatment approaches
Most ulcers heal with a course of acid-reducing medicine, usually a proton pump inhibitor, which lowers acid so the lining can repair itself. If H. pylori is present, it is treated with a combination of antibiotics plus acid reduction, and follow-up testing confirms the infection is gone.
If NSAIDs caused the ulcer, your doctor will help you stop them or find a safer alternative. Stomach ulcers are often rechecked with a follow-up endoscopy to confirm they have healed completely.
When to contact a gastroenterologist
Make an appointment for upper abdominal pain that keeps returning, especially if you take NSAIDs regularly. Seek emergency care for vomiting blood or material that looks like coffee grounds, black or tarry stools, sudden severe abdominal pain, or lightheadedness along with stomach symptoms — these can signal a bleeding or perforated ulcer.
Take-home information sheet
A printable version from our office is on the way. In the meantime, this page has the same information — or ask at the front desk.
Questions about your care?
This page is general education, not personal medical advice. Your care team is happy to talk through what it means for you.