Stomach ulcers are painful sores that can be found in the stomach lining or small intestine. Stomach ulcers are the most visible sign of peptic ulcer disease. They occur when the thick layer of mucus that protects your stomach from digestive juices is reduced, thus enabling the digestive acids to eat away at the lining tissues of the stomach. Stomach ulcers are easily cured, but they can become severe without proper treatment.
Stomach ulcers aren’t necessarily caused by one single factor. The decrease in the stomach’s mucus lining that leads to an ulcer is usually caused by one of the following:
- an infection with the bacterium Helicobacter pylori(H. pylori)
- long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen
- excess acid (hyperacidity) in the stomach, which may be related to genetics, lifestyle (stress, smoking), and certain foods
- Zollinger-Ellison syndrome, a rare disease that makes the body produce excess stomach acid
Certain factors and behaviors can put you at higher risk for developing stomach ulcers:
- frequent use of steroids (such as those for treating asthma)
- hypercalcemia (overproduction of calcium)
- family history of stomach ulcers
- being over 50 years old
- excessive consumption of alcohol
Symptoms of Stomach Ulcers
A number of symptoms are associated with stomach ulcers. The severity of the symptoms depends on the severity of the ulcer.
The most common symptom is a burning sensation or pain in the area between your chest and belly button. Normally, the pain will be more intense when your stomach is empty and it can last for a few minutes or several hours.
Other common symptoms include:
- dull pain in the stomach
- weight loss
- not wanting to eat because of pain
- nausea or vomiting
- burping or acid reflux
- heartburn (burning sensation in the chest)
- pain improves when you eat, drink, or take antacids
Talk to your doctor if you experience symptoms of a stomach ulcer. Even though discomfort may be mild, ulcers can worsen if they aren’t treated.
How Are Stomach Ulcers Diagnosed?
Diagnosis and treatment will depend on your symptoms and the severity of your ulcer. To diagnose a stomach ulcer, your doctor will review your medical history along with your symptoms and any prescription or over-the-counter medications you’re taking.
To rule out H. pylori infection, a blood, stool, or breath test may be ordered. In a breath test, you’ll be instructed to drink a clear liquid and breathe into a bag, which is then sealed. If H. pylori is present, the breath sample will contain higher-than-normal levels of carbon dioxide.
Other tests and procedures used to diagnose stomach ulcers include:
- barium X-ray: a thick white liquid (barium) that you drink helps the stomach and small intestine show up on X-rays
- endoscopy: a thin, lighted tube is inserted through the mouth and into the stomach to look for the presence of an ulcer
- endoscopic biopsy: a piece of stomach tissue is removed so it can be analyzed
Treating Stomach Ulcers
If your stomach ulcer is the result of H. pylori, you’ll need antibiotics. For mild to moderate stomach ulcers, your doctor will usually prescribe the following medications:
- H2 blockers: to prevent your stomach from making too much acid
- proton pump inhibitors: blocks the cells that produce acid
- over-the-counter antacids: to help neutralize stomach acid
- cytoprotective agents: to protect the lining of the stomach and small intestine, such as Pepto-Bismol
In very rare cases, a complicated stomach ulcer will require surgery. These include ulcers that:
- continue to return
- don’t heal
- tear the stomach or small intestine
- keep food from flowing out of the stomach into the small intestine
Surgery may include:
removal of the entire ulcer
taking tissue from another part of the intestines and sewing it over the ulcer site
tying off a bleeding artery
cutting off nerve supply to the stomach to reduce the production of stomach acid