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Overview

What Is a Peptic Ulcer?

A peptic ulcer is an open sore in the protective lining of the stomach or duodenum, the first part of the small intestine. A stomach ulcer is also called a gastric ulcer, while an ulcer in the duodenum is called a duodenal ulcer. Together, these conditions are known as peptic ulcer disease. Adults of different ages can develop an ulcer of the stomach and duodenum, although certain infections and medicines increase the risk.

Symptoms

Peptic Ulcer Symptoms

  • Burning or aching pain in the upper abdomen
  • Nausea
  • Vomiting
  • Bloating
  • Belching
  • Feeling full quickly
  • Pain that changes in relation to meals
  • Indigestion or discomfort after eating

Seek urgent care

Warning signs of a serious ulcer

Black or tarry stools, vomiting blood or material that looks like coffee grounds, sudden severe abdominal pain, fainting, or unusual weakness may indicate bleeding or a perforation. Seek urgent medical attention rather than waiting for a routine appointment.

Causes

Causes of Peptic Ulcers

Ulcers form when stomach acid and digestive enzymes damage a protective lining that has been weakened. The most common causes are Helicobacter pylori (H. pylori) infection and regular use of nonsteroidal anti-inflammatory drugs (NSAIDs). Other health problems can also weaken the stomach’s defenses. Spicy foods and everyday stress do not usually cause ulcers, although they may worsen symptoms for some people.

INFECTION

H. pylori infection: This bacterium can cause ongoing inflammation and weaken the stomach lining, making it more vulnerable to acid and digestive enzymes.

MEDICINES

NSAID-related injury: Medicines such as ibuprofen, naproxen, and aspirin can reduce chemicals that help protect the stomach lining, allowing irritation and ulcers to develop.

Risk Factors

Peptic Ulcer Risk Factors

  • Exposure to H. pylori infection
  • Regular use of NSAIDs or aspirin
  • Older age
  • A personal history of peptic ulcers
  • Smoking
  • Heavy alcohol use
  • A serious illness or major physical stress
  • Medicines that increase bleeding risk, especially when combined with NSAIDs

Complications

Peptic Ulcer Complications

  • Gastrointestinal bleeding can cause blood in vomit or stools and may become severe.
  • Ongoing or hidden bleeding can lead to anemia, causing tiredness, weakness, or shortness of breath.
  • Perforation occurs when an ulcer creates a hole through the stomach or intestinal wall.
  • Penetration occurs when an ulcer extends into a nearby organ, such as the pancreas.
  • Gastric outlet obstruction can block food from leaving the stomach and cause repeated vomiting or early fullness.

Emergency symptoms

Do not delay emergency care

Vomiting blood, passing black stools, fainting, or developing sudden severe abdominal pain can signal dangerous bleeding or perforation. These symptoms require emergency medical care and should not wait for a routine appointment.

Diagnosis

How Peptic Ulcers Are Diagnosed

Diagnosis begins with a review of your medical history, symptom pattern, medicines, and a physical examination. A clinician may then choose tests based on your age, symptoms, H. pylori risk, and the possibility of complications. The evaluation may include noninvasive testing or an examination of the upper digestive tract.

  • A breath test or stool test can look for H. pylori infection.
  • Blood testing may help assess anemia or other concerns when clinically relevant.
  • Upper endoscopy allows a clinician to view the esophagus, stomach, and duodenum.
  • A biopsy taken during endoscopy can check for H. pylori or other tissue changes.
  • Imaging or laboratory tests may be used when bleeding, perforation, or another complication is suspected.

Treatment & Management

Peptic Ulcer Treatment and Management

INFECTION TREATMENT

Treat H. pylori: When testing confirms infection, a clinician prescribes a combination of antibiotics and acid-suppressing medicine. Take the full course exactly as directed.

ACID CONTROL

Reduce acid and protect healing: Proton pump inhibitors and other appropriate acid-suppressing medicines reduce irritation and give the ulcer time to heal.

MEDICINE REVIEW

Review medicines: NSAIDs or aspirin may need adjustment, substitution, or protective treatment. Do not stop prescribed aspirin or another medicine without medical guidance.

Supportive steps include avoiding smoking, limiting alcohol, and identifying foods that clearly worsen your symptoms. Take medicines exactly as prescribed, but do not rely on a special diet as a cure for an ulcer. A healthcare professional can help balance symptom relief with the treatment of the underlying cause.

Complicated ulcers

When hospital treatment is needed

Ulcers with severe bleeding, perforation, or obstruction may require hospital care. Treatment can include endoscopic therapy, blood replacement, an interventional procedure, or surgery, depending on the complication.

Prevention

Can Peptic Ulcers Be Prevented?

  • Use NSAIDs only as directed and discuss safer options if they cause stomach symptoms.
  • Ask whether stomach-protective medicine is appropriate when long-term NSAIDs are necessary.
  • Get confirmed H. pylori infection treated and complete the prescribed therapy.
  • Avoid smoking.
  • Limit alcohol.
  • Complete prescribed treatment and follow-up testing to reduce the chance of recurrence.

Outlook and Prognosis

Peptic Ulcer Outlook and Prognosis

Most peptic ulcers heal when the underlying cause is treated and acid suppression is used appropriately. Healing time and the chance of recurrence vary according to the cause, ongoing medicine exposure, smoking, and whether complications are present. Without treatment, an ulcer can return or lead to bleeding, perforation, or blockage.

  • Complete every prescribed treatment, including antibiotics for H. pylori.
  • Confirm that H. pylori has cleared when your clinician recommends follow-up testing.
  • Review whether ongoing NSAID use is necessary and how to use it more safely.
  • Report persistent, returning, or worsening symptoms for reassessment.
  • Follow recommendations for repeat endoscopy or other testing.

When Should You See a Doctor

When Should You See a Doctor for Ulcer Symptoms?

Call emergency services

Get emergency help now

Seek emergency care for vomiting blood or coffee-ground material, black or bloody stools, sudden severe abdominal pain, fainting, confusion, a rapid heartbeat, or signs of shock. These may indicate serious bleeding or a perforated ulcer.

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