Abdominal pain is the most common symptom of a peptic ulcer.
Abdominal pain is the most common symptom of a peptic ulcer. The pain may be dull or burning and may come and go over time. For some people, the pain may occur when the stomach is empty or at night, and it may go away for a short time after they eat. For other people, eating may make the pain worse.
Many people who have peptic ulcers don’t have any symptoms. They may not develop symptoms until an ulcer leads to complications.
You should call or see your doctor right away if you have symptoms that could be caused by a complication. These symptoms include
- black or tarry stool, or red or maroon blood mixed with your stool
- red blood in your vomit or vomit that looks like coffee grounds
- sudden, sharp, or severe abdominal pain that doesn’t go away
- feeling dizzy or fainting
- a rapid pulse or other symptoms of shock
- a change in or worsening of your peptic ulcer symptoms
What causes peptic ulcers?
The most common causes of peptic ulcers are Helicobacter pylori (H. pylori) infection and nonsteroidal anti-inflammatory drugs (NSAIDs). Other causes of peptic ulcers are uncommon or rare.
People with certain risk factors are more likely to develop ulcers.
H. pylori
H. pylori infection is a common cause of peptic ulcers. Researchers are still studying how people become infected with H. pylori bacteria. The bacteria may spread from person to person through contact with an infected person’s vomit, stool, or saliva. Food or water contaminated with an infected person’s vomit, stool, or saliva may also spread the bacteria from person to person.
NSAIDs
Taking NSAIDs—such as aspirin, ibuprofen, and naproxen—is another common cause of peptic ulcers. NSAIDs relieve pain, but they also make the stomach lining more prone to damage and ulcers. Some types of NSAIDs are more likely to cause ulcers than others.
You have a higher chance of developing a peptic ulcer due to NSAIDs if you take
- NSAIDs for a long time
- a type of NSAID that is more likely to cause an ulcer
- high doses of an NSAID or more than one NSAID
- NSAIDs along with other medicines that increase the risk for ulcers
- NSAIDs and you are also infected with H. pylori
Other causes
Less common causes of peptic ulcers include
- infections caused by certain viruses, fungi, or bacteria other than H. pylori
- medicines that increase the risk of developing ulcers, including corticosteroids, medicines used to treat low bone mass, and some antidepressants, especially when you take these medicines with NSAIDs
- surgery or medical procedures that affect the stomach or duodenum
Less common causes of peptic ulcers also include certain diseases and health conditions, such as
- diseases that can affect the stomach, such as cancer or Crohn’s disease
- injury, blockage, or lack of blood flow that affects the stomach or duodenum
- life-threatening health conditions that require critical care
- severe chronic diseases, such as cirrhosis or chronic obstructive pulmonary disease
- Zollinger-Ellison syndrome, a condition that occurs when one or more tumors—called gastrinomas—cause your stomach to make too much acid
In rare cases, doctors can’t find the cause of peptic ulcers. Doctors may call ulcers with unknown causes idiopathic peptic ulcers.
A peptic ulcer is a sore on the lining of your stomach, small intestine or esophagus. A peptic ulcer in the stomach is called a gastric ulcer. A duodenal ulcer is a peptic ulcer that develops in the first part of the small intestine (duodenum). An esophageal ulcer occurs in the lower part of your esophagus.
Peptic ulcers are open sores that develop on the inside lining of your stomach and the upper portion of your small intestine. The most common symptom of a peptic ulcer is stomach pain.
Peptic ulcers include:
- Gastric ulcers that occur on the inside of the stomach
- Duodenal ulcers that occur on the inside of the upper portion of your small intestine (duodenum)
The most common causes of peptic ulcers are infection with the bacterium Helicobacter pylori (H. pylori) and long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve). Stress and spicy foods do not cause peptic ulcers. However, they can make your symptoms worse.
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Symptoms
- Burning stomach pain
- Feeling of fullness, bloating or belching
- Intolerance to fatty foods
- Heartburn
- Nausea
The most common peptic ulcer symptom is burning stomach pain. Stomach acid makes the pain worse, as does having an empty stomach. The pain can often be relieved by eating certain foods that buffer stomach acid or by taking an acid-reducing medication, but then it may come back. The pain may be worse between meals and at night.
Many people with peptic ulcers don't even have symptoms.
Less often, ulcers may cause severe signs or symptoms such as:
- Vomiting or vomiting blood — which may appear red or black
- Dark blood in stools, or stools that are black or tarry
- Trouble breathing
- Feeling faint
- Nausea or vomiting
- Unexplained weight loss
- Appetite changes
When to see a doctor
See your doctor if you have the severe signs or symptoms listed above. Also see your doctor if over-the-counter antacids and acid blockers relieve your pain but the pain returns.
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