Stomach Ulcer: Causes, Symptoms and Treatments

by David Chiedozie

Imagine being at work and having a productive day. Then, suddenly you begin to feel a burning sensation originating from your stomach. This sensation renders you useless for the rest of the day and makes it difficult for you to get any work done. 

Guess what? These kinds of painful sensations are mostly caused by a stomach ulcer. A stomach ulcer is a very common health condition that affects millions of people worldwide. It occurs when painful sores develop in the protective linings along the gastrointestinal tract. 

A peptic ulcer, commonly known as a stomach ulcer, is a sore that forms on the inner lining of your stomach or duodenum—the upper portion of the small intestine located right below the stomach. According to the National Institute of Diabetes, Digestive and Kidney Diseases, a peptic ulcer may occasionally appear in the oesophagus, which is located directly above the stomach.

In this guide, we’ll be walking you through everything you need to know about a stomach ulcer, its causes, symptoms and recommended treatments.

Types of Peptic Ulcers

The most common types of peptic ulcers are named based on the location where they occur, and they include:

  • Stomach Ulcer: This is a very common type of peptic ulcer. It occurs inside the stomach.
  • Duodenal Ulcer: This sore is found in the duodenum, which is the top portion of the small intestine.
  • Esophageal Ulcer: This kind of ulceration occurs in the oesophagus. The oesophagus is the tube that transports food from your throat to your stomach.

Note that you can have more than one type of peptic ulcer at the same time.

What is a Stomach Ulcer?

A stomach ulcer, also known as gastric ulcer is a painful sore in the lining of the stomach. It is a subtype of peptic ulcers which affects both the stomach and the small intestine.

To aid food digestion and ward off microorganisms, the stomach secretes a potent acid called hydrochloric acid. Additionally, the stomach secretes a thick coating of mucus to help shield the body tissues from this acid it produces.

Acids can harm the stomach tissue, leading to ulcers, if the mucus layer becomes worn down and ceases to function properly. The small intestine or stomach ulcer is speculated to affect 1 in 10 people in most countries at some point in their life.

Even though gastric ulcers are usually treatable. They can however be problematic when left untreated.

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What Causes a Stomach Ulcer?

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Stomach ulcer.

When the digestive juices produced begin to harm the lining of the stomach or small intestine, ulcers develop. Your gut will feel more pain if the mucus layer becomes too thin or if your stomach produces too much digestive acid. 

Below are four possible causes of a stomach ulcer:

  1. Bacteria (H. pylori)

H. pylori, often known as Helicobacter pylori, is a bacterium that many humans carry in their stomachs. Although most H. pylori carriers do not develop ulcers. However, in some people, this bacteria may increase the level of acid, degrade the mucus layer which serves as protection against gastric ulcers, and irritate the digestive tract.

Up till now, how the H. pylori virus spreads remains a mystery to medical practitioners. However, they speculated that it might spread through intimate contact, such as a kiss between individuals. It can also be spread via contaminated food and water.

  1. Certain Analgesics

A stomach ulcer is more likely to develop if you take Aspirin often and for a long period. Taking other nonsteroidal anti-inflammatory medications (NSAIDs) such as Naproxen and Ibuprofen can also trigger stomach ulcers. 

NSAIDs prevent the body from producing a substance that aids in securing the stomach and small intestine’s inner walls against stomach acid. Painkillers such as Acetaminophen, however, don’t cause peptic ulcers.

  1. Alcohol and Cigarette

Alcohol consumption and cigarette smoking can both increase your risk of developing a stomach ulcer. On the other hand, many people believed that eating a lot of spicy foods causes ulcers but this isn’t true. These foods can only make ulcers worse and more difficult to treat.

  1. Zollinger-Ellison Syndrome (ZES)

In rare cases, the Zollinger-Ellison syndrome, which causes the body to produce more acid, can cause stomach and intestine ulcers. Note that only less than 1% of gastric ulcer cases are induced by this syndrome.

Common Symptoms of a Stomach Ulcer

Some people with gastric ulcers do not experience any form of symptoms but this is not true for everybody. Several symptoms are associated with stomach ulcers. The severity of the symptoms would depend on the severity of the ulcer and how much it has advanced. 

The most typical symptom is a burning sensation or pain between your belly button and chest area. The pain can persist for a few minutes to many hours and becomes worse when your stomach is empty.

Some common signs and symptoms of a stomach ulcer include:

  • Mild pain in the stomach.
  • Unexplained weight loss.
  • Loss of appetite due to pain.
  • Nausea or vomiting.
  • Bloating.
  • Feeling easily full.
  • Burping or acid reflux.
  • Heartburn (a burning sensation in the chest).
  • Anaemia, with symptoms such as tiredness, shortness of breath, paler skin, and dark or tarry stools.
  • Fatigue, etc.

Certain forms of stomach ulcers are not easily discovered since they don’t cause the typical indigestion-type discomfort. These ulcers are less frequent, and doctors only treat them after they result in bleeding.

Moreover, stomach wall holes can develop because of some ulcers. This severe disease is referred to by medical professionals as perforation.

In addition to changing over time, stomach ulcer symptoms might be challenging to identify.

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Ways to Diagnose Stomach Ulcers 

The diagnosis of a stomach ulcer could be made by your healthcare professional after speaking with you about your symptoms. If you don’t use NSAIDs when you notice an ulcer, then H. pylori infection is probably to blame. 

Either way, you’ll need one of the following tests to confirm the diagnosis:

  1. Endoscopy

To identify whether you have a stomach ulcer, your doctor may recommend an upper endoscopy test if you are experiencing significant symptoms. In this treatment, the doctor looks for anomalies by passing an endoscope (a thin, illuminated tube with a tiny camera) through your throat, into your stomach.

  1. Testing for H. Pylori

H. pylori tests are now often utilized in testing for a stomach ulcer, and your doctor will customize your treatment to ease your symptoms and eradicate the bug. The quickest and easiest method to find H. pylori is by taking a urea breath test. Additionally, your healthcare professional may do a blood test or stool microscopy, culture and sensitivity or collect a sample during an upper endoscopy to check for it.

  1. Imaging test

Imaging techniques like X-rays and CT scans are utilized to find stomach ulcers less commonly. You’ll be required to consume a special liquid that covers the digestive tract and increases the visibility of ulcers on imaging devices.

Possible Side Effects of a Stomach Ulcer

Complications from gastric ulcers can occasionally occur and frequently need extra care. 

The three most serious complications of stomach ulcers include:

  • Internal Bleeding: Blood spurts out directly from the site of the ulcer.
  • Bowel Obstruction: This occurs when the stomach ulcer blocks the movement of food through the digestive tract.
  • Peritonitis: This condition is characterized by inflammation and infection of the abdominal cavity due to perforation.

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Effective Treatments for Stomach Ulcers

Depending on what caused your stomach ulcer, your treatment options will differ. Most stomach ulcers can be cured with a doctor’s prescription. But in serious cases, surgery may be necessary.

It’s important to treat an ulcer right away. Thus, consult your physician for treatment as soon as possible. If your ulcer is actively bleeding, you’ll probably need to stay in the hospital for intensive endoscopic and IV ulcer medicine therapy. Additionally, you might need a blood transfusion.

Let’s take a look at different treatment approaches for peptic ulcers.

  1. Non-Surgical Treatment

Doctors may recommend the following medicines for stomach ulcer cases that don’t require surgery.

  • Proton Pump Inhibitors (PPI): These medicines stop the production of acid by acid-producing cells. Such drugs include Esomeprazole (Nexium), Lansoprazole (Prevacid), Omeprazole (Prilosec, Zegerid), Pantoprazole (Protonix) and Rabeprazole (Aciphex).
  • H2 Receptor Antagonists: They prevent the stomach from releasing too much acid. These drugs include Cimetidine (Tagamet), Famotidine (Pepcid), Nizatidine (Axid) and Ranitidine (Zantac).
  • Antacids: Over-the-counter antacids (Gecrol, Jawasil, Gestid, etc), or medications like Pepto-Bismol, which protects the stomach lining and the small intestines.
  • Probiotics: Dietary supplements that contain useful bacteria may have a role in eliminating H. pylori.

Stomach ulcers’ symptoms usually go away shortly after treatment. However, it’s crucial to abstain from trigger foods, alcohol, and smoking while receiving treatment.

  1. Surgical Treatment

Surgery might be an option in some situations. Especially when the stomach ulcer keeps coming back, won’t heal, bleeds, or keeps food from leaving the stomach.

An ulcer surgery may involve:

  • removing the gastric ulcer and tying off bleeding blood vessels or
  • sewing up the affected tissue from a different area to the ulcer and severing the nerve that controls the generation of gastric acid.
  1. Healthy Diet

It was once believed that diet could cause a stomach ulcer but research has shown that this is not so true. A healthy diet can improve your digestive tract and overall health, even though it can’t prevent or treat a stomach ulcer.

Eating a diet rich in fruits, vegetables, and fibre is a good idea. Certain foods are said to help in the destruction of H. Pylori. 

Foods that may aid in the elimination of H. pylori or the growth of the body’s beneficial bacteria include leafy greens like spinach and kale, broccoli, cauliflower, cabbage, and radishes. Probiotic-rich meals like yoghurt (particularly with lactobacillus and Sacharomy) can also hinder the growth of H. pylori.

More importantly, avoid hot and sour meals while an ulcer is healing to prevent acid reflux.

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How to Prevent a Stomach Ulcer

You can reduce your chances of getting stomach ulcers by making certain lifestyle and behavioural decisions which include:

  • Limit your intake of alcoholic drinks to one or two times per day. Also, avoid taking alcohol with prescription drugs.
  • Wash your hands often to prevent illnesses that might arise from dirt.
  • Ibuprofen, Aspirin, and Naproxen (Aleve) usage should be limited.
  • Give up on tobacco usage and adopt a balanced diet high in fruits, vegetables, and whole grains.


Stomach ulcer affects a lot of people in our society and are oftentimes asymptomatic until they have progressed a great deal. It is therefore important to take preventive measures and also visit a doctor when you suspect any symptoms of a stomach ulcer.

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About Author

Avatar of David Chiedozie
David Chiedozie
David Chiedozie Ndeokwelu is a graduate of Microbiology, who holds a Masters degree in public health. He is currently a medical student at the University of Ilorin and is passionate about fields of career, public health, entrepreneurship and career building.

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