Peptic Ulcer (Stomach Ulcer)
A peptic ulcer is an open sore in the lining of the stomach or the first part of the small bowel (the duodenum). The two main causes are infection with the bacterium Helicobacter pylori and regular use of anti-inflammatory painkillers such as ibuprofen, diclofenac and aspirin. In Nigeria 'ulcer' is used for almost any upper abdominal pain, and many people take antacids for years without a test, when H. pylori can be found with a simple test and cleared with a two-week course of treatment. Pepper and skipping meals do not cause ulcers, though they can make indigestion feel worse.
Find a Gastroenterology SpecialistMedically reviewed by Dr Debo Odulana, Founder and Chief Executive, Mezo. Last reviewed . This page is general information, not a diagnosis. Care is decided with you after an examination.
Symptoms
- Burning or gnawing pain in the upper middle abdomen
- Pain that comes on when hungry or at night, or soon after eating
- Bloating and belching
- Nausea
- Loss of appetite and weight loss
- Vomiting blood or material like coffee grounds
- Black, tarry stools
When to See a Doctor
See a doctor if upper abdominal pain or indigestion lasts more than a few weeks or keeps returning, so you can be tested for H. pylori. See a doctor promptly if you are over 45 with new symptoms, or have weight loss, difficulty swallowing, persistent vomiting or anaemia, as these need an endoscopy. Go to an emergency department immediately if you vomit blood or coffee-ground material, pass black stools, or have sudden severe abdominal pain, which can mean a bleeding or perforated ulcer.
Treatment options
- Testing for H. pylori by stool antigen or breath test
- Eradication therapy: a two-week course of two antibiotics and an acid-reducing medicine
- Proton pump inhibitors such as omeprazole to heal the ulcer
- Stopping or replacing anti-inflammatory painkillers where possible
- Upper GI endoscopy for warning signs or ulcers that do not heal
- Endoscopic or surgical treatment for bleeding or perforation
Common Questions
Does pepper cause ulcer?
No. Spicy food does not cause peptic ulcers, though it can worsen discomfort in some people. The main causes are H. pylori infection and painkillers such as ibuprofen and diclofenac.
Can an ulcer be cured?
Yes. When H. pylori is the cause, clearing it heals most ulcers and greatly reduces the chance of them coming back. A test after treatment confirms it has gone.
Is my pain an ulcer or something else?
Upper abdominal pain can come from indigestion, reflux, gallstones, the pancreas and, less often, the heart or stomach cancer. If antacids are not working or the pain is unusual for you, it needs a proper assessment rather than more antacids.
Can I take painkillers if I have an ulcer?
Paracetamol is usually safe. Anti-inflammatory painkillers such as ibuprofen, diclofenac and aspirin can cause or worsen ulcers and should be avoided unless your doctor advises otherwise, with stomach protection.
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