Gastric ulcer

Overview

A gastric ulcer is a sore that forms on the lining of your stomach. It happens when the protective layer of your stomach is damaged, allowing acid to irritate the tissue underneath.

Yes, gastric ulcers are fairly common. They affect millions of people worldwide each year.

Gastric ulcers can occur at any age, but they are most common in adults over 60. They affect both men and women, though men may have a slightly higher risk.

Symptoms

Common symptoms

• A burning or gnawing pain in the middle of the upper abdomen, often between meals or at night
• Bloating or feeling full quickly after eating
• Heartburn or indigestion
• Nausea or vomiting
• Loss of appetite or weight loss

Symptoms in children

• Vague stomach aches, often around the belly button
• Poor appetite or refusing to eat
• Weight loss or slow growth
• Vomiting, sometimes with blood (red or dark like coffee grounds)

Symptoms in older adults

• Less noticeable pain – may feel only a dull ache or no pain at all
• Unexplained fatigue or weakness due to anemia (low red blood cells)
• Black, tarry stools (sign of bleeding)
• Vomiting blood

Causes

Main causes

• Infection with Helicobacter pylori (H. pylori) bacteria – this weakens the stomach's protective lining
• Long‑term use of non‑steroidal anti‑inflammatory drugs (NSAIDs) like ibuprofen, naproxen, or aspirin (discuss with your doctor before stopping any prescribed medication)
• Excess stomach acid production (rare, e.g., in Zollinger‑Ellison syndrome)

Risk factors

• Smoking – slows healing and increases acid production
• Drinking too much alcohol – irritates the stomach lining
• Chronic stress – may worsen symptoms, though it is not a direct cause
• A family history of peptic ulcers
• Being over 60 years old

When to see a doctor

See a doctor urgently if:

• If you have any of the emergency symptoms listed above (vomiting blood, black stools, severe abdominal pain, fainting) – call your local emergency number immediately.
• If your stomach pain is severe or has come on suddenly.

Book a routine appointment if:

• If you have persistent or recurrent abdominal pain, bloating, or heartburn that does not go away with simple measures
• If you are losing weight without trying
• If you have been taking NSAIDs regularly and develop stomach symptoms

Diagnosis

Your doctor will start by asking about your symptoms, medical history, and any medications you take. They may press on your stomach to check for tenderness. If an ulcer is suspected, they will likely recommend one or more tests.

Tests that may be done

• Breath test or stool test – to check for H. pylori infection
• Endoscopy – a thin, flexible tube with a camera is passed through your mouth into your stomach to see the ulcer directly and take a small tissue sample (biopsy)
• Barium swallow – you drink a chalky liquid and X‑rays are taken to outline your stomach (less common now)

What to expect at your appointment

If you have an endoscopy, you will be given a sedative to help you relax. The test usually takes about 15–30 minutes and is not painful. Your doctor will discuss the results with you soon after, or when the biopsy (if taken) results come back.

Treatment

Treatment depends on the cause. Most gastric ulcers heal with a combination of medications and lifestyle changes. The goal is to reduce stomach acid, treat any infection, and protect the stomach lining.

Self-care at home

• Stop smoking – ask your doctor or local health service for support
• Limit alcohol – if you drink, keep within recommended limits (ask your doctor what is safe for you)
• Avoid NSAIDs – talk to your doctor about safer alternatives for pain relief
• Eat smaller, more frequent meals – this can help reduce acid irritation
• Avoid foods that trigger your symptoms (e.g., spicy or fatty foods, caffeine)

Medical treatments

Your doctor may prescribe medications that reduce stomach acid production, such as proton pump inhibitors (PPIs) or H2 receptor antagonists. If you have H. pylori infection, you will be given a course of antibiotics (usually two different ones) along with an acid‑reducing medicine to clear the bacteria. Treatment typically lasts several weeks. Do not take any over‑the‑counter or prescription medicines without your doctor's advice.

When is surgery considered?

Surgery is rarely needed today. It may be considered if the ulcer does not heal with medicine, if it causes severe bleeding that cannot be controlled during an endoscopy, or if it has perforated (made a hole in the stomach wall).

Living with this condition

Most people recover fully from a gastric ulcer within a few weeks of starting treatment. Take all prescribed medications exactly as directed, even if you start feeling better. Keep follow‑up appointments so your doctor can check that the ulcer has healed and, if needed, re‑test for H. pylori.

Lifestyle tips

• Eat a balanced diet with plenty of fruits, vegetables, and whole grains
• Avoid eating large meals close to bedtime
• Manage stress with relaxation techniques, gentle exercise, or talking to someone you trust
• If you smoke, quitting is one of the best things you can do for your stomach health

Diet and exercise

There is no special diet that cures ulcers, but eating regular, small meals can help. Avoid foods that seem to worsen your symptoms. Gentle exercise like walking can aid digestion and reduce stress. Stay hydrated with water. Most people can eat a normal diet once the ulcer heals.

Mental health and emotional wellbeing

Living with chronic pain or worrying about a serious condition can be stressful. It is natural to feel anxious or low. Talk to your doctor if your mood is affecting your daily life. Connecting with friends, family, or support groups can also help.

Prevention

You can lower your risk of developing a gastric ulcer by avoiding NSAIDs unless prescribed, treating H. pylori infection promptly, limiting alcohol, not smoking, and managing stress. If you must take NSAIDs, ask your doctor about taking them with a protective medication.

Screening programmes

Routine screening for gastric ulcers is not recommended for the general public. However, if you have risk factors (e.g., family history, long‑term NSAID use), talk to your doctor about whether you should be tested for H. pylori.

Complications

If left untreated

• Bleeding – the ulcer can bleed into the stomach, leading to anemia or, in severe cases, shock
• Perforation – the ulcer can create a hole in the stomach wall, causing a medical emergency
• Gastric outlet obstruction – swelling or scarring can block the passage of food from the stomach to the small intestine

Long-term outlook

With proper treatment, the outlook for gastric ulcers is very good. Most ulcers heal completely within a few weeks to months. Even if complications occur, timely medical care can usually manage them effectively. Following your doctor's advice and attending follow‑up appointments greatly reduces the chance of recurrence.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.