Stomach ulcers are open sores that develop when the lining of the stomach has become damaged. Stomach ulcers are also called gastric ulcers.
How common is it?
It's not known exactly how common stomach ulcers are. They have become much less common since the 1980s because of much more effective treatments. So people with stomach ulcers now usually get better much more quickly.
The term 'peptic ulcer' is used to describe ulcers that are caused by too much acid in the stomach. This includes stomach ulcers and also ulcers in the first part of the gut (small intestine) known as the duodenum. Stomach ulcers are less common than duodenal ulcers.
What are the causes?
The acid in your stomach can damage the stomach lining but this is usually prevented by a protective layer over the lining of your stomach. Sometimes this protective layer doesn't work properly and this allows a stomach ulcer to develop.
- We now know that a germ (bacterium) called Helicobacter pylori (H. pylori) is often the cause of a stomach ulcer.
- Non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen and diclofenac can allow the stomach acid to cause an ulcer.
- Most stomach ulcers are not cancerous (that means they are benign) but a few stomach ulcers are caused by stomach (gastric) cancer.
Read more about the causes of stomach ulcers.
What are the symptoms?
The main symptom caused by a stomach ulcer is having a pain in the upper tummy (abdomen). Other symptoms may include:
- Bloating. This means your tummy swells because your stomach is full of gas or air.
- Retching. Also known as 'heaving'. This means sounding and looking as though you're about to be sick (vomit) but not actually vomiting.
- Feeling sick (nausea).
- Feeling very 'full' after a meal.
A stomach ulcer may cause bleeding into the stomach, which may cause blood in your vomit (called haematemesis). Blood may also pass through your gut (bowel) and make your stools (faeces) very dark in colour or black (melaena).
A stomach ulcer may also cause a hole to form through the whole wall of the stomach (this is called a perforation) but this is rare. Food and acid can then leak out of the stomach and cause severe pain and make you very unwell. This is a medical emergency and needs hospital treatment as soon as possible.
Find out more about the symptoms of stomach ulcers.
What tests may be done?
Your doctor will arrange blood tests, including to see if any bleeding from the ulcer has made you anaemic. You will also have a blood test, stool (faeces) test or a breath test to see if you have the H. pylori germ (bacterium).
To confirm whether or not you have a stomach ulcer, you will usually be referred to a specialist to have a gastroscopy (endoscopy). This involves having a thin, flexible telescope passed down your gullet (oesophagus) to look for any inflammation or ulcers in the stomach. Samples (biopsies) of the stomach wall are also taken to check for any cancer in the stomach ulcer.
Read more about the tests for a stomach ulcer.
What are the treatments?
- The initial treatment for a stomach ulcer is a 4- to 8-week course of a medicine to reduce the amount of acid in your stomach. This will help to heal the ulcer.
- If it is found that you are infected with H. pylori, you will need a course of treatment with medicines to clear this infection. This usually involves treatment with two different antibiotics and a medicine to reduce the amount of acid in your stomach.
- If your ulcer was caused by an anti-inflammatory medicine then the best option is to stop taking the medicine and use a different type of medicine if needed.
- Surgery is now usually only needed if a complication of a stomach ulcer develops, such as severe bleeding or a hole (perforation) in the stomach wall.
Learn more about the treatments for a stomach ulcer.
What is the outlook?
For most people with a stomach ulcer, the outlook (prognosis) is excellent. Depending on the cause of the stomach ulcer, treatment of H. pylori infection or avoiding non-steroidal anti-inflammatory medicines greatly reduces the risk of having any more stomach ulcers in the future.
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Further reading & references
- Dyspepsia and gastro‑oesophageal reflux disease: Investigation and management of dyspepsia - symptoms suggestive of gastro‑oesophageal reflux disease - or both; NICE Clinical Guideline (Sept 2014)
- Dyspepsia - proven peptic ulcer; NICE CKS, July 2015 (UK access only)
- Cai S, Garcia Rodriguez LA, Masso-Gonzalez EL, et al; Uncomplicated peptic ulcer in the UK: trends from 1997 to 2005. Aliment Pharmacol Ther. 2009 Nov 15 30(10):1039-48. Epub 2009 Aug 26.
- Sachs G, Scott DR, Wen Y; Gastric infection by Helicobacter pylori. Curr Gastroenterol Rep. 2011 Dec 13(6):540-6. doi: 10.1007/s11894-011-0226-4.
- Niv Y; H. pylori/NSAID--negative peptic ulcer - the mucin theory. Med Hypotheses. 2010 Nov 75(5):433-5. Epub 2010 May 4.
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