Gastric ulcers do not always cause symptoms. Symptoms may come and go and can occur at any time. Having an empty stomach may make them worse. Symptoms may include:

Gnawing pain:
- May awaken you from sleep
- May change when you eat
- May last for a few minutes or several hours
- Feels like unusually strong hunger pangs
- May be relieved by taking antacids
Nausea
Vomiting
Loss of appetite
Bloating
Burping
Weight loss

Ulcers can worsen. This can lead to serious problems and severe belly pain such as bleeding. Bleeding symptoms may include:

Bloody or black, tarry stools
Vomit that looks like coffee grounds or blood
Weakness
Lightheadedness

An ulcer can break through the wall of the stomach. It is called a perforated ulcer. It causes sudden and severe pain.

Diagnosis

Your doctor will ask about your symptoms and past health. A physical exam will be done.

An upper endoscopy will confirm an ulcer. Other tests may be done to look for a cause.

Treatment

Treatment options may include one or more of the following:

Medication

Medicine may help to treat cause or ease symptoms. Choices include:

Antibiotics—if an infection is present or possible
Over-the-counter antacids
Proton pump inhibitors
H2 blockers
Medicine to coat ulcer
Medicine to protect stomach against NSAIDs

Lifestyle Changes

Changes in everyday habits may help. They may ease symptoms and help the ulcer heal. Helpful steps are:

Quit smoking. Smoking worsens symptoms and slows healing.
Limit alcohol intake.
Avoid NSAIDs. This includes common over-the-counter drugs like aspirin and ibuprofen.

Surgery and Endoscopy

Procedures may be needed for:

An ulcer that will not heal
Ulcers that keep coming back
A bleeding ulcer
An ulcer that has spread through stomach wall
Ulcers that make it hard for food to pass out of stomach

Endoscopy

An upper GI endoscopy may be done to stop bleeding. A tube is passed down the throat into the stomach. Heat, electricity, medicine, or a special glue will be used to stop bleeding.

Surgery

Surgery for gastric ulcers is rare. It may be done to remove the ulcer or stop bleeding. Tissue from somewhere else on the body may also be used to patch the ulcer.

Prevention

Not all ulcers can be prevented. To help reduce the chances of H. pylori infection:

Wash your hands often. This is very important after using the bathroom and before you eat or make meals.
Drink water from a safe source.
Do not smoke. Smoking increases the chances of getting an ulcer.

To help reduce the chances of a gastric ulcer from NSAIDs:

Use other drugs when possible for managing pain.
Take the lowest possible dose.
Do not take drugs longer than needed.
Do not drink alcohol while taking the drugs.
If you regularly take NSAIDs
- Ask your doctor if there is another treatment.
- Ask about medicine to protect your stomach.

RESOURCES:

American College of Gastroenterology
http://patients.gi.org

American Gastroenterological Association
http://www.gastro.org

CANADIAN RESOURCES

Canadian Association of Gastroenterology
https://www.cag-acg.org

Canadian Digestive Health Foundation
http://www.cdhf.ca

References:

Fashner J, Gitu AC. Diagnosis and treatment of peptic ulcer disease and H. pylori infection. Am Fam Physician. 2015;91(4):236-242.

Peptic ulcer disease. American College of Gastroenterology website. Available at:
...(Click grey area to select URL)
Accessed January 13, 2020.

Peptic ulcer disease. EBSCO DynaMed Plus website. Available at: http://www.dynamed... . Updated April 2, 2018. Accessed January 13, 2020.

Peptic ulcers (stomach ulcers). National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/peptic-ulcers-stomach-ulcers. Accessed January 13, 2020.

Last reviewed September 2019 by EBSCO Medical Review Board Daus Mahnke, MD
Last Updated: 1/13/2020

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