Peptic Ulcer

What is Peptic Ulcer?

A peptic ulcer is an open sore that develops on the inner lining of your stomach or the upper part of your small intestine. These painful sores occur when stomach acid damages the protective mucus layer that normally shields your digestive tract. The most common types are gastric ulcers, which form in the stomach, and duodenal ulcers, which develop in the first section of the small intestine.

Many people think peptic ulcers only come from stress or spicy foods. While these can make symptoms worse, the real culprits are usually bacterial infection or long-term medication use. Most ulcers are caused by a bacteria called Helicobacter pylori, or H. pylori for short. This bacteria weakens the protective mucus coating, letting acid reach the sensitive tissue underneath.

The good news is that peptic ulcers are treatable. With the right diagnosis and treatment plan, most ulcers heal within a few weeks. Blood testing can help identify the underlying cause, especially if H. pylori bacteria is involved. Catching and treating ulcers early prevents serious complications like bleeding or perforation, where the ulcer creates a hole in the stomach wall.

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Symptoms

Burning stomach pain that comes and goes, often between meals or at night
Feeling full quickly when eating or bloating after meals
Heartburn and acid reflux that moves up into your chest
Nausea or vomiting, sometimes with blood that looks like coffee grounds
Dark, tarry stools or bright red blood in stools, which signals bleeding
Unexplained weight loss without trying
Pain that temporarily improves after eating or taking antacids
Loss of appetite due to pain or discomfort

Some people with peptic ulcers have no symptoms at all, especially in the early stages. Others only notice mild discomfort that they mistake for indigestion. This is why testing is important if you have persistent stomach problems.

Causes and risk factors

The majority of peptic ulcers are caused by infection with H. pylori bacteria. This common bacteria lives in the stomach lining and triggers inflammation that breaks down the protective mucus layer. Long-term use of nonsteroidal anti-inflammatory drugs, or NSAIDs, is the second leading cause. Medications like ibuprofen, aspirin, and naproxen can irritate the stomach lining and prevent healing. These pain relievers are especially risky when taken daily for chronic pain or arthritis.

Other risk factors include smoking, which increases stomach acid and slows healing. Heavy alcohol use irritates and erodes the stomach lining. While stress and spicy foods do not cause ulcers, they can worsen symptoms. Rare causes include Zollinger-Ellison syndrome, a condition where tumors produce excess stomach acid. Age over 50 and having a family history of ulcers also increase your risk. People who take blood thinners or corticosteroids along with NSAIDs face higher ulcer risk.

How it's diagnosed

Doctors diagnose peptic ulcers through several methods. An endoscopy is the most common test, where a thin tube with a camera examines your stomach and small intestine directly. During this procedure, doctors can take tissue samples to test for H. pylori bacteria. Blood tests can also help identify the underlying cause of your symptoms and check for complications.

Rite Aid offers add-on testing that screens for H. pylori antigen, which confirms if this bacteria is causing your ulcer. We also test amylase and lipase levels, which can become elevated if an ulcer affects your pancreas or causes complications. Testing for H. pylori is especially helpful because knowing if you have this infection guides your treatment plan. Other diagnostic tools include breath tests for H. pylori and stool tests that check for blood or bacteria.

Treatment options

Proton pump inhibitors like omeprazole or esomeprazole reduce stomach acid and promote healing
H2 blockers such as famotidine decrease acid production with fewer side effects
Antibiotics including amoxicillin and clarithromycin kill H. pylori bacteria when present
Bismuth subsalicylate coats the ulcer and protects it from stomach acid
Stop taking NSAIDs or switch to alternative pain relief options
Eat smaller, more frequent meals to reduce stomach acid production
Avoid foods that trigger your symptoms, such as alcohol, caffeine, and spicy dishes
Quit smoking to speed healing and prevent ulcer recurrence
Manage stress through relaxation techniques, exercise, or counseling
Take probiotics to support gut health and reduce H. pylori bacteria

Frequently asked questions

Peptic ulcer pain typically feels like a burning or gnawing sensation in your upper abdomen. The pain often occurs between meals or during the night when your stomach is empty. Many people find temporary relief by eating food or taking antacids. The pain can last from a few minutes to several hours and may come and go over weeks or months.

Some small ulcers may heal without treatment, but most require medication to fully recover. Without proper treatment, ulcers often return or worsen over time. Untreated ulcers can lead to serious complications like bleeding, perforation, or blockages. Getting proper treatment helps ulcers heal faster and prevents them from coming back.

Most peptic ulcers heal within 4 to 8 weeks with proper treatment. Ulcers caused by H. pylori may take longer if antibiotic treatment is needed. Larger ulcers or those caused by NSAIDs might require 8 to 12 weeks to fully heal. Your doctor may recommend a follow-up endoscopy to confirm the ulcer has healed completely.

No, H. pylori causes about 60 to 80 percent of peptic ulcers, but not all of them. Long-term use of NSAIDs like ibuprofen and aspirin is the second most common cause. Rare causes include Zollinger-Ellison syndrome and severe physical stress from major illness or injury. Smoking and alcohol increase ulcer risk but typically do not cause ulcers on their own.

Avoid alcohol, coffee, and caffeinated drinks that increase stomach acid production. Spicy foods, citrus fruits, and tomatoes may irritate your ulcer and worsen symptoms. Chocolate, mint, and fatty foods can relax the valve between your stomach and esophagus, causing acid reflux. Focus on eating bland, easy-to-digest foods like bananas, oatmeal, and lean proteins while your ulcer heals.

Stress alone does not directly cause peptic ulcers. However, stress can increase stomach acid production and make existing symptoms worse. Chronic stress may also weaken your immune system, making it harder to fight off H. pylori infection. Managing stress through healthy habits can help your ulcer heal faster and prevent symptoms from flaring up.

Peptic ulcers themselves are not contagious, but H. pylori bacteria can spread from person to person. The bacteria may transfer through saliva, contaminated food or water, or close contact with an infected person. Good hygiene practices like washing hands regularly can reduce your risk of infection. Not everyone who gets H. pylori develops an ulcer, though.

Black, tarry stools or bright red blood in your stool signal bleeding from an ulcer. Vomiting blood or material that looks like coffee grounds is another serious warning sign. You may feel dizzy, lightheaded, or unusually tired if you are losing blood. Sudden, severe stomach pain can indicate a perforation, which requires emergency care immediately.

Antacids can provide temporary relief from peptic ulcer pain by neutralizing stomach acid. However, they do not heal the ulcer or address the underlying cause like H. pylori infection. Use antacids only for short-term symptom relief while pursuing proper treatment. Talk to your doctor about prescription medications that reduce acid production and promote healing.

If H. pylori is successfully eliminated, your ulcer is unlikely to return. Ulcers caused by NSAIDs can recur if you continue taking these medications regularly. About 10 to 15 percent of people experience a recurrence even after successful treatment. You can reduce recurrence risk by avoiding NSAIDs, not smoking, limiting alcohol, and managing stress effectively.