Peptic Ulcer – Symptoms and Causes

ByJanis Updated

Overview

Peptic ulcers are open sores that develop on the inner lining of the stomach and upper small intestine. They come in two main types: gastric ulcers (found in the stomach) and duodenal ulcers (located in the duodenum, the first part of the small intestine).

The primary symptom of peptic ulcers is stomach pain. Despite common misconceptions, these ulcers aren’t caused by stress or spicy foods, though these factors may worsen existing symptoms.

The two leading causes of peptic ulcers are:

  • H. pylori infection – a bacterial infection of the stomach lining.
  • Regular NSAID use – including common pain relievers like ibuprofen and naproxen sodium.

Understanding these causes is important for proper treatment. Most peptic ulcers can be successfully treated when the underlying cause is addressed.

Signs and Symptoms

People with peptic ulcers may not always notice symptoms. When symptoms do appear, they might include:

  • Stomach pain that feels dull or burning
  • Bloating or feeling too full
  • Frequent burping
  • Burning sensation in the chest
  • Feeling sick to your stomach

The pain might be worse at night or between meals for some people. Others may feel more discomfort after eating.

Sometimes peptic ulcers can bleed. If this happens, you might notice:

  • Throwing up blood (which may look red or black)
  • Dark blood in your bowel movements
  • Black or tar-like stools
  • Feeling lightheaded or fainting

When You Should Get Medical Help

Contact your healthcare provider right away if you vomit blood, have black stools, or feel dizzy. You should also make an appointment if over-the-counter medicines like antacids help at first, but your pain keeps coming back.

Causes

Peptic ulcers occur when stomach acid harms the digestive tract lining, leading to open sores in the stomach or small intestine. Normally, a layer of mucus protects these organs from acid damage.

When this protection fails—either due to increased acid or decreased mucus—ulcers can develop.

Two main factors contribute to most peptic ulcers:

  • Bacterial infection: Helicobacter pylori bacteria commonly live in the protective mucous layer of the digestive tract. While often harmless, these bacteria can cause inflammation in the stomach lining, leading to ulcers. Transmission of this infection likely occurs through:

    • Close person-to-person contact
    • Contaminated food
    • Contaminated water

  • Pain medications: Regular use of certain pain relievers can damage the digestive tract lining.

Risk Factors

    Several factors can raise your chances of developing peptic ulcers when taking NSAIDs (non-steroidal anti-inflammatory drugs):

    • Age over 60: Older adults face higher risk levels.
    • History of ulcers: If you’ve had a peptic ulcer before, you’re more likely to develop another one.
    • NSAID usage patterns: Your risk increases when you:
      • Take high doses of NSAIDs
      • Use multiple NSAIDs at once
      • Combine NSAIDs with other medications like:
        • Other pain relievers
        • Steroids
        • Blood thinners
        • SSRI antidepressants
        • Osteoporosis medications (such as alendronate and risedronate)

    While these factors don’t directly cause ulcers, they can worsen existing ones.

    • Smoking: May increase ulcer risk in people with H. pylori infection.
    • Alcohol consumption: Irritates stomach lining and increases acid production.
    • Untreated stress: Can aggravate ulcer symptoms.
    • Spicy foods: May worsen discomfort from existing ulcers.

    Understanding these risk factors can help you take appropriate precautions if you need to use NSAIDs regularly.

    Health Problems from Untreated Ulcers

    Peptic ulcers left without treatment can lead to several serious health issues. One common problem is bleeding in the stomach or small intestine.

    This bleeding might happen slowly, causing anemia (low red blood cell count), or quickly, requiring hospital care. Severe cases may cause black or bloody vomit or stools.

    A dangerous complication is perforation—when an ulcer creates a hole through the stomach or intestinal wall. This allows stomach contents to leak into the abdomen, causing a serious infection called peritonitis.

    Ulcers can also create blockages in the digestive tract. When this happens, food cannot move through properly. People with blockages often:

    • Feel full after eating very little
    • Vomit frequently
    • Lose weight unintentionally

    Research shows that people infected with H. pylori bacteria (a common cause of ulcers) face a higher risk of developing stomach cancer over time.

    Prevention

    Taking steps to prevent peptic ulcers can save you from pain and complications. Here are some key strategies to protect your stomach.

    Managing Pain Relievers

    Pain medications called NSAIDs can increase your risk of developing ulcers. If you need to take these medicines regularly:

    • Take them with food, not on an empty stomach
    • Work with your doctor to find the lowest effective dose
    • Avoid drinking alcohol while using pain relievers
    • Ask about protective medications, like antacids or proton pump inhibitors

    Some doctors might recommend COX-2 inhibitors, which may cause fewer ulcers. However, these medications might increase heart attack risk, so discuss the benefits and risks with your healthcare provider.

    Quit Smoking

    Smoking harms the protective lining of your stomach and can make ulcers more likely to develop. It also slows healing if you already have an ulcer.

    Talk to your healthcare provider about smoking cessation programs and medications that might help you quit.

    Other Preventive Measures

    • Limit alcohol consumption. Excessive alcohol can irritate and damage your stomach lining, making it more vulnerable to ulcers.
    • Manage stress. While stress doesn’t cause ulcers directly, it can make symptoms worse. Try relaxation techniques like deep breathing, meditation, or regular exercise.
    • Get tested for H. pylori. If you have risk factors or a family history of ulcers, your doctor might recommend testing for this bacterium. Early treatment can prevent ulcer development.
    • Practice good hygiene. Washing hands thoroughly, especially before eating, may help reduce the risk of H. pylori infection.
    • Watch for medication interactions. Some medications can increase ulcer risk when taken together. Always tell your doctor about all medicines you take, including over-the-counter products.

    Health Writer

    Janis's areas of expertise include nutrition, exercise, stress management, and mental health. She is passionate about educating and empowering people to take control of their health and make positive changes that can last a lifetime. Janis believes that small, sustainable changes are the key to long-term success, and she works with her clients to develop personalized plans that fit their individual needs and lifestyles.