What is a stomach ulcer?

Stomach ulcers are open, inflamed sores in the lining of your stomach. They are also known as gastric ulcers. Ulcers can also occur in the upper part of the small intestine — these are known as duodenal ulcers. Together, stomach ulcers and duodenal ulcers are known as peptic ulcers.

What causes stomach ulcers?

The most common causes of stomach ulcers are:

• Helicobacter pylori ( H. pylori) — a type of bacteria
• non-steroidal anti-inflammatory medicines (NSAIDs), such as aspirin and ibuprofen

What are the symptoms of a stomach ulcer?

The most common symptom is pain in the upper abdomen (tummy area) just below the breastbone (sternum). It usually comes and goes. It may be worse before meals and get better after eating or taking antacids. Sometimes, it will get worse after eating. The pain may wake you from sleep.

Other less common symptoms include:

• bloating
• feeling sick
• feeling very full after eating
• retching

When should I see my doctor?

Seek medical attention immediately if you experience:

• a sudden, severe pain in the belly
• bloody or black bowel motions (poo)
• vomit that looks like coffee grounds with red blood in it
• light-headedness
• nausea or changes to your appetite
• unexplained weight loss

How are stomach ulcers diagnosed?

Stomach ulcers are usually diagnosed by endoscopy — a flexible tube with a tiny camera that is passed into the mouth and down to the stomach. This procedure allows your doctor to see your stomach and check if there are any ulcers. It is usually done under general anaesthetic.

If you have an ulcer, you may be tested for helicobacter pylori (H. pylori) infection. This can be done with a breath test, a blood test, a stool test or a via a biopsy sample collected from the stomach lining during an endoscopy.

How are stomach ulcers treated?

If you have a stomach ulcer, your doctor may prescribe a combination of:

• antibiotic medicines to remove the H. pyloribacteria if it is present
• medicines that reduce the amount of acid the stomach produces, known as proton pump inhibitors (PPIs)

You will only need surgery if you have severe bleeding or a perforation (hole) in your stomach or small intestine.

To help manage symptoms, you can also:

• stop smoking
• reduce the amount of alcohol you drink
• eat smaller meals than usual
• eat no later than 3 to 4 hours before going to bed
• avoid foods that may make symptoms worse, such as fatty foods, tomatoes, spicy foods, coffee or chocolate
• lose weight, if you are above a healthy weight range

Can stomach ulcers be prevented?

If you have a helicobacter pylori infection, your doctor will prescribe antibiotics to treat the infection and prevent you from getting another ulcer. If H. pylori is found before you develop an ulcer, treatment can stop you from getting an ulcer in the first place.

You can prevent stomach ulcers caused by NSAID medicines by taking the lowest effective dose of NSAIDs and taking them for the shortest possible amount of time. Your doctor may recommend also taking a medicine that lowers stomach acid while you take NSAIDs.

Complications of stomach ulcers

There are 2 main complications of stomach ulcers — these can both be emergencies:

• Bleeding from the ulcer — This might be a slow trickle or a significant, life-threatening bleed.
• Perforation — The ulcer may go all the way through the wall of the stomach causing a hole,so food and acid leak into the abdominal cavity.

Resources and support

Visit the Gastroenterological Society of Australia for:

• information about endoscopy
• information about helicobacter pylori