Stomach Ulcer: Symptoms, Causes and Treatment

stomach ulcer

Broadly speaking, stomach ulcers are breaks in the mucous membrane which makes up the lining of the stomach. They manifest as sores that shed and expunge necrotic tissue, which can make them extremely painful and uncomfortable. Even though curing them is relatively easy, they are dangerous if left untreated. So if you suspect that you may be suffering from stomach ulcers, read on to find out whether your fears are justified.

Stomach Ulcer Types and Terminology

What we commonly refer to as “stomach ulcers” does not necessarily affect only the stomach. They can also form in the duodenum or the lower esophagus. Since there are several terms that are used interchangeably when talking about stomach ulcers, we will try to clear up the confusion before delving any deeper.

Peptic Ulcer

‘Peptic ulcer’ is the umbrella term that encompasses both the gastric and duodenal ulcer. Peptic ulcer disease or PUD is the medical term for the condition. The adjective “peptic” refers to the acidity and the digestive function of the stomach and duodenum.

Gastric Ulcer

Gastric ulcers are ulcers that develop on the lining of the stomach itself.

Duodenal Ulcer

Duodenal ulcers are ulcers affecting the duodenum, the first part of the small intestine. In the western world, they are more common than gastric ulcers.

Stomach Ulcer Symptoms

There are several broad and prevalent symptoms that can point towards peptic ulcer (be it gastric or duodenal). These symptoms include:

  • abdominal pain
  • pain relieved by antacids
  • a feeling of fullness
  • bloating
  • gastroesophageal reflux disease (GERD)
  • loss of appetite
  • weight loss, in severe cases
  • nausea and vomiting

Gastric Ulcer Symptoms

Pain that gets worse after eating is symptomatic of gastric ulcers. Most patients describe the pain as a burning or gnawing pain affecting the middle or upper abdomen. Other telltale signs include indigestion and nausea.

Duodenal Ulcer Symptoms

The symptoms of duodenal ulcer are significantly clearer and more consistent than the symptoms of gastric ulcer. Waking up at night with pain in the upper abdomen is one of the most common signs of duodenal ulcer. Another clear sign is persistent upper abdominal pain later in the day that gets better with eating. In cases when pain appears after eating, it takes about three hours for the pain to start.

Bleeding Ulcer Symptoms

When the early signs of stomach ulcer are ignored, the following symptoms may appear:

  • Melena, the medical term for tarry, black stool associated with internal bleeding in the upper gastrointestinal tract.
  • Hematemesis, the vomiting of blood.

These are signs of a serious complication, which means that if you experience one of these symptoms, you should seek medical attention immediately.

Stomach Ulcer Causes

helicobacter pylori

Helicobacter pylori

Infections with Helicobacter pylori account for approximately 60% of gastric ulcers and up to 75% of duodenal ulcers. More than half of the world’s population carry H. pylori in their stomach, but less than 20% of infections are symptomatic, leading to stomach ulcers. Helicobacter pylori penetrates and harms the stomach lining by producing toxic ammonia.


Stress is a common risk factor that contributes to ulcer formation. Although more research is needed into the precise mechanisms behind it, reducing stress levels is one way to decrease your chances of getting the disease.


To put it simply, smoking is bad for the stomach, and in more than one way. First of all, toxins found in cigarettes interfere with the production of natural substances that protect the lining of the stomach against stomach acid. It also increases the acidity of the duodenum and reduces blood flow in the stomach by constricting small blood vessels, which slows down healing.

Non-Steroid Anti-Inflammatory Drugs (NSAIDs)

NSAIDs, the most common among them being ibuprofen and aspirin, inhibit the function of cyclooxygenase, an enzyme that is essential for the production of several active lipid compounds which make up the protective layer of mucus in the stomach. That is why taking aspirin and other medications for every minor headache is a bad idea.

Hereditary Factors

There is insufficient evidence to support the claim that stomach ulcers are hereditary, but some underlying conditions that cause ulcers may run in families, for example, increased gastric secretion and higher-than-average acidity.

Stomach Ulcer Complications

When left untreated, stomach ulcers can cause one or more of the following complications:

  • Bleeding: the most common complication. If it happens slowly and over time, it can lead to anemia (paired with fatigue, loss of breath, heart palpitations). It can also be copious and intense, making you vomit blood and pass sticky, tarry stools (see above).
  • Penetration: the medical term used when stomach ulcer spreads to other nearby organs (the liver, spleen, etc.). It is rare but dangerous.
  • Perforation: happens when stomach ulcer eats through the stomach wall. If they spill into the abdominal cavity, the contents of the stomach (bacteria, enzymes, half-digested food) can easily cause peritonitis, inflammation of the abdomen’s lining with potentially fatal consequences.
  • Obstruction: when a swollen ulcer blocks the normal passage of food through the digestive system. Constant vomiting and a feeling of fullness are common telltale signs.
  • Stomach cancer: due to Helicobacter pylori, chronic ulcers are a risk factor in the development of gastric cancer.

Stomach Ulcer Treatment

Depending on the cause, stomach ulcers can be treated in one or more of the following ways:

  • antibiotics to treat Helicobacter pylori infection
  • proton pump inhibitors, medications that reduce stomach acid
  • upper endoscopy to treat bleeding ulcers
  • surgery in cases of perforation

Natural Remedies for Stomach Ulcers

camomile tea

In addition to medical treatment, there are several proven natural remedies that can relieve the symptoms of stomach ulcers and help you on your way to recovery. Experts advise switching to a healthy diet and eating smaller portions, preferably several meals a day instead of the traditional three.

Stomach Ulcer Diet

  • flavonoids, found in legumes, soybeans, broccoli, kale, green tea, apples and berries
  • leafy greens, primarily cabbage, which contains vitamin K to speed up the healing process
  • bananas (contain antibacterial compounds and reduce acidity)
  • honey, with its antibacterial properties
  • licorice root, but without the sweet flavor (helps produce more protective mucus)
  • garlic, which contains allicin and kills H. pylori
  • probiotics, increasing the levels of good bacteria to keep H. Pylori in check
  • chamomile, apart from its anti-inflammatory properties, helps to relieve stress

Foods to Avoid

  • milk – although it soothes the stomach lining at first, its high-protein content stimulates the stomach to produce more acid
  • coffee – increases the amount and concentration of stomach acid
  • spicy foods – irritate the stomach
  • alcohol – damages the mucous lining of the stomach
  • deep fried and processed foods – stress for the stomach
  • red meats – high protein level, take long to digest, can be fatty
  • carbonated beverages – increase acid production, irritate stomach lining

Stomach ulcers are a very common and perfectly treatable affliction. But before you let it get to the point where you find yourself lying on your side, struggling to swallow a thick plastic tube, remember that an ounce of prevention is worth a pound of cure. And while there is very little you can do to avoid some of the causes, you can at least try to worry less and eat better. Your stomach will thank you for it.

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