Stomach Ulcer: Symptoms, Causes, Treatment & Complications

A stomach ulcer is a wound that forms in the tissue that lines the stomach. It can be caused by several factors, but it is more common due to poor eating habits, prolonged use of oral anti-inflammatory medication or infection by Helicobacter pylori (H. pylori) bacteria.

The presence of a stomach ulcer can lead to symptoms such as abdominal pain, nausea, and vomiting, especially after eating. It is also often referred to as a gastric or peptic ulcer. 

Usually, this condition isn't serious but it needs to be treated as soon as possible, to prevent the ulcer from increasing in size, which can worsen symptoms and increase the risk of complications such as bleeding or gastric perforation.

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Main symptoms

The main symptoms of gastric ulcers are:

  • Strong abdominal pain, like a stabbing pain
  • Heartburn
  • Nausea
  • Vomiting
  • Loss of appetite
  • Bloating
  • Weight loss

Symptoms of gastric ulcer sometimes get worse after eating.

In addition to a gastric ulcer, a duodenal ulcer may also form. This type of ulcer is located in the first portion of the intestines, and it causes symptoms during periods of fasting or during the night. 

Read more about stomach ulcer symptoms and how they can present.

Diagnosis for stomach ulcers

Diagnosis is usually done by a gastroenterologist or a family doctor. The ulcer is first suspected based on the presenting symptoms, and then testing can be ordered to confirm it. Tests like an endoscopy can help the doctor look inside the stomach, while a urea breath test can identifies the presence of H. Pylori infection.

Learn more about H. Pylori infection, its symptoms and treatment options.

Common causes

The main causes of gastric ulcers are:

  • H. pylori infection, which is a bacteria that multiplies in the stomach and weakens the protective barrier of the stomach lining 
  • Use of non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, aspirin or diclofenac
  • Excessive production of gastric juice, which can occur with conditions like Zollinger-Ellison syndrome
  • Chronic diseases
  • Chemotherapy and/or radiation therapy
  • Stomach cancer

In these cases, gastric ulcers tend to develop due to an imbalance between the stomach's defenses against gastric acid and its production, resulting in the formation of a wound.

Furthermore, gastric ulcers are more common in people with a history of alcohol abuse, smoking, long periods of fasting and drug abuse.

Treatment options

The main treatment options for gastric ulcers are:

1. Antibiotics

A gastric ulcer caused by the H. pylori bacteria can be treated with antibiotics such as amoxicillin, clarithromycin or metronidazole.

2. Proton pump inhibitors

Proton pump inhibitors, such as omeprazole, pantoprazole or esomeprazole, work by blocking acid production in the stomach, which allows the gastric ulcer to heal. Treatment with these medications normally lasts around 8 weeks.

3. Antacids

Antacids, such as aluminum hydroxide, magnesium hydroxide, or sodium bicarbonate, can help neutralize stomach acid and alleviate symptoms in some cases. They should only be used if prescribed by a doctor, because they do not cure stomach inflammation and excessive use can cause rebound acidity.

4. Painkillers

Analgesics, like acetaminophen, may be prescribed by the doctor to relieve pain as necessary.

5. Lifestyle changes

You should avoid smoking and drinking while treating a stomach ulcer. You should also maintain a healthy diet, which will help to relieve symptoms and contribute to stomach wall healing. Learn more about how to start a gastritis and ulcer diet and which foods you should avoid.

6. Home remedies

One home remedy for gastric ulcers is pure potato juice, which acts as a natural antacid. It should be taken, preferably, on an empty stomach and immediately after preparing. However, its use should not replace treatment recommended by your doctor.

Also recommended: Home Remedies for Gastritis: 10 Natural & Proven Recipes

7. Surgery

Surgery is the last treatment option for gastric ulcers, and is indicated in cases where it is not possible to achieve a cure through the use of medication or when complications such as bleeding, gastric obstruction or perforation arise. Read more about ulcer surgery and how it is performed.

Possible complications

Ulcers that are left untreated can lead to complications such as:

  • Bleeding, which can result in anemia and, consequently, excessive fatigue, weakness, palpitations and paleness
  • Ulcer perforation, which causes inflammation and pain in the abdomen, also known as peritonitis.
  • Intestinal obstruction, causing vomiting and weight loss.

Symptoms such as dark, sticky stools, bloody vomit or severe abdominal pain that does not go away should be assessed urgently in a hospital.