A stomach ulcer (or gastric ulcer) is an open sore in your stomach lining. It is a common cause of focal stomach pain — pain that you can feel coming from a particular spot — often with a burning or gnawing quality. But not all stomach ulcers cause noticeable symptoms.

 

Stomach ulcers are common and treatable, but they can become serious if they go too long without treatment. Some ulcers bleed continuously, which can lead to significant blood loss over time. Some can continue to erode through your stomach wall until there is a hole.

 

Sometimes, a stomach ulcer is called a peptic ulcer. Stomach ulcers are one type of peptic ulcer disease.

 

In the U.S., healthcare providers treat about 4 million stomach ulcers every year. Ulcers are common in our society because their main causes are also common. These include use of over-the-counter (OTC) pain medications and a widespread bacterial infection called H. pylori.

 

What are the symptoms of stomach ulcers?

A stomach ulcer feels like a sore spot in your stomach, which is located in your upper abdomen, between your breastbone and your belly button, a little to the left.

 

Typical ulcer pain feels like an acid burn in your stomach, or like something is eating it. This feeling is not an illusion. Stomach acids, enzymes and other chemicals are eating away at the wound.

 

Many people experience indigestion with stomach ulcers, which means burning stomach pain together with a feeling of fullness. You might feel full shortly after you have started eating and/or long after you ate.

 

People also report:

 

These symptoms are related to the conditions that caused your stomach ulcer.

 

Some people do not feel their stomach ulcers at all. These are called silent ulcers. You might not experience any symptoms until you develop complications, like bleeding or a perforation (hole).

 

These symptoms might include:

 

If you develop any of these symptoms, see a healthcare provider right away.

 

How serious are stomach ulcer complications?

Bleeding ulcers: Active bleeding from a stomach ulcer can be mild to severe and can affect you a little or a lot. Moderate blood loss can lead to anemia, while severe blood loss can lead to shock.

 

Perforated ulcers: An ulcer that erodes all the way through your stomach wall is rare, but it is an emergency. Stomach acids and bacteria that leak from the hole into your abdominal cavity can cause an infection. Infection in your abdominal cavity can easily spread to your bloodstream and lead to sepsis.

 

The two most common causes of stomach ulcers are the H. pylori bacterial infection and overuse of nonsteroidal anti-inflammatory drugs (NSAIDs). These two causes together account for about 99% of the stomach ulcers U.S. healthcare providers treat.

 

H. pylori is a very common bacterial infection that affects up to half of people worldwide. It primarily lives in your stomach. In many people, it does not seem to cause any problems. But sometimes, it overgrows and takes over. As the bacteria continue to multiply, they eat into your stomach lining, causing chronic inflammation that leads to gastric ulcers.

 

NSAIDs (nonsteroidal anti-inflammatory drugs) are common over-the-counter pain relievers, like ibuprofen, naproxen and aspirin. These medications irritate your stomach lining on contact, and they also inhibit some of the chemicals that defend and repair it.

 

Your stomach lining is designed to recover from these minor insults. But if you take too many NSAIDs too often, eventually it will not be able to keep up with repairs. The more the protective lining wears away, the fewer resources it has to recover.

 

Less common causes of stomach ulcers include:

 

Other infections. Rarely, other bacterial, viral or fungal infections can take over in your stomach and cause erosive gastritis.

Zollinger-Ellison syndrome. This is a rare condition that causes your stomach to produce too much gastric acid, which erodes the lining.

Severe physiological stress. You may develop a stress ulcer if your body is struggling to recover from a life-threatening illness or injury. Severe physiological stress changes your pH balance, making your stomach more acidic.

 

Normal lifestyle factors, like your day-to-day stress levels and what you eat and drink, do not cause stomach ulcers. But they can make your symptoms worse if you have one. Anything that makes your stomach more acidic can irritate the wound, including:

 

How is a stomach ulcer diagnosed?

Your healthcare provider will begin by asking you about your symptoms and medical history. They will want to know if you frequently use NSAIDs or have a history of H. pylori infection. If signs point to an ulcer, they will take a look inside your stomach to find it.

 

Your healthcare provider will want to check for H. pylori infection, then look for the ulcer itself inside your stomach. They can do these things in a few different ways. One common method is an upper endoscopy exam, which can accomplish both at once.

 

An upper endoscopy (EGD test) goes inside your stomach with a tiny camera on a long, thin tube (endoscope). The tube goes down your throat while you are under sedation. Through the tube, a healthcare provider can pass long, narrow tools.

 

Your provider can use these tools to take a tissue sample (biopsy) and test it for H. pylori. They can also use tools to treat a stomach ulcer on sight. This is especially helpful if your provider suspects complications like bleeding.