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How Do You Know if You Have an Ulcer?

Reviewed on 1/13/2021

What is an ulcer?

An ulcer is a sore that occurs in the inner lining of the stomach or upper small intestine. The most common symptom of a peptic ulcer is a dull or burning pain in your stomach, between the navel and breastbone.
An ulcer is a sore that occurs in the inner lining of the stomach or upper small intestine. The most common symptom of a peptic ulcer is a dull or burning pain in your stomach, between the navel and breastbone.

Your stomach has digestive juices that contain hydrochloric acid and other enzymes. The stomach lining is coated with mucus to withstand the acidity without being damaged. Sometimes the lining of your stomach wears down due to the action of bacteria and other factors. When this happens, the digestive juices damage the stomach lining causing a sore known as an ulcer. 

An ulcer is a sore that occurs in the inner lining of the stomach or upper small intestine, also called the duodenum. When it is in the stomach, it is a gastric ulcer. If it is in the duodenum, then it is called a duodenal ulcer. They are both types of peptic ulcer.

For many years, it was thought that ulcers were caused by stress, alcohol, or spicy food. However, modern research shows they are usually caused by a specific bacterial infection in the stomach and upper intestine, certain medicines, and smoking.

Signs and symptoms of ulcers

The most common symptom of a peptic ulcer is a dull or burning pain in your stomach, between the navel and breastbone. This pain may last from a few minutes to a few hours and may come and disappear for weeks. You may also experience:

Types of ulcers

There are two main types of peptic ulcers, duodenal and gastric. They have almost the same signs and symptoms. The most common way to distinguish between them is noticing what times you feel pain relative to your eating schedule. 

Duodenal ulcer

It forms in the upper small intestine. If you feel stomach pain several hours after eating, or a stomach ache that wakes you up in the middle of the night, it could be the result of a duodenal ulcer. The pain usually improves after you have eaten. 

Gastric ulcer

This one forms in the lining of the stomach. The most common symptom is pain that often occurs when food is still in the stomach, just after eating. 

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Causes of ulcers

Acid 

A stomach ulcer occurs when the mucous layer that protects your stomach and small intestine lining from acid breaks down. It happens when acid in the digestive tract eats away at this lining. This leads to the development of a sore. 

H. pylori infection

The Helicobacter pylori (H. pylori) bacteria was discovered in 1982 by two doctors, Barry Marshall and Robin Warren. Since then, doctors have confirmed that the H. pylori bacteria cause peptic ulcers in ninety percent of all people with the condition

However, it is important to note that many people who have H. pylori bacteria do not get ulcers.

Smoking

The nicotine contained in cigarettes is known to weaken the stomach lining, increasing the risk of someone developing a peptic ulcer.

Some medicines

There is a group of medicines that doctors call non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, and naproxen. These are known to increase the risk of someone developing peptic ulcers.

When to see the doctor for ulcers

If you think you have an ulcer, make a point of seeing the doctor. This is especially so if you vomit and notice blood in the vomit or the vomit looks like coffee grounds. Also, if your stool is bloody or has blackish material, it could be a sign of severe ulcers that need immediate medical attention.

Diagnosing ulcers

Once you visit the doctor, they will ask questions about your symptoms, and probably conduct a physical exam. Your doctor may also ask to conduct tests that check your blood and stool for H. pylori. 

The best way to know for sure that you have a peptic ulcer is by doing an endoscopy. This test involves using an endoscope, which is a thin, flexible, lighted viewing instrument, that allows a doctor to view the inside of your stomach. In this case, the doctor will pass the endoscope down your throat to examine the esophagus, stomach, and the upper part of your small intestine.

Treatments for ulcers

It is important to get an ulcer treated, even if your symptoms have gone. The most common treatments for stomach ulcers are:

Antibiotics

A two-week course of two different antibiotics are usually prescribed to kill H. pylori bacteria.

Antacids 

To reduce acid in the stomach, acid blockers and proton pump inhibitors are usually prescribed for about two months. This gives your stomach lining time to heal.

To help prevent recurrence of an ulcer, consider these prevention habits:

  • Try quitting or reducing smoking.
  • Limit your alcohol consumption.
  • Wash your hands regularly to kill bacteria.
  • Reduce or eliminate your use of NSAIDs.

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References
Annals of Clinical Microbiology and Antimicrobials: "23 years of the discovery of Helicobacter pylori: Is the debate over?"

Australian Prescriber: "Peptic ulcer disease and non-steroidal anti-inflammatory drugs."

Family Doctor: "Ulcers."

British Society of Gastroenterology: "Smoking and ulcer perforation."

Johns Hopkins Medicine: "Helicobacter Pylori."

Johns Hopkins Medicine: "Stomach and Duodenal Ulcers (Peptic Ulcers)."

Michigan Medicine: "Endoscopy."

Michigan Medicine: "Peptic Ulcer Disease."

Michigan Medicine: "Types of Peptic Ulcers."

National Institute of Diabetes and Digestive and Kidney Diseases: "Symptoms & Causes of Peptic Ulcers (Stomach Ulcers)."

TeensHealth: “Ulcers."

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