Stomach ulcers are small sores that form in the lining of the stomach. They are often caused by the bacterium Helicobacter pylori. Stomach ulcers can also result from frequent or long-term use of nonsteroidal antiinflammatory drugs, or NSAIDs, a group of medications that help reduce pain and inflammation. Both of these disrupt the delicate lining of the stomach, making it more vulnerable to the damaging effects of stomach acid. The most common symptom of a stomach ulcer is burning pain in the abdomen that improves with food. Other signs or symptoms, such as bleeding, nausea, vomiting and weight loss, may also occur.
When the stomach lining is damaged, it is exposed to acidic stomach juices that normally digest food. As a result, ulcers form, causing burning or gnawing pain. Pain from an ulcer usually occurs in the upper abdomen and lasts for a few minutes to hours. The pain often occurs 2 to 5 hours after eating, and it can awaken a person at night. It may improve by taking an antacid, which neutralizes acid in the stomach. For some people, eating or drinking also improves the pain, by coating the ulcer. For others, food may irritate the ulcer and worsen the pain. Very severe pain could indicate that the ulcer has perforated through the stomach lining.
A stomach ulcer may bleed when it forms near a blood vessel in the stomach and damages it. The symptoms of a bleeding ulcer depend on the amount of bleeding and how fast a person is losing the blood. Symptoms of acute bleeding include vomiting fresh red blood or a substance that looks like coffee grounds. Black, tarry stools or blood in the stools may be noticed. If bleeding is rapid and severe, there will likely be signs of shock, such as a fast heart rate and low blood pressure. If an ulcer bleeds slowly over time, the only signs or symptoms may be fatigue or paleness due to anemia -- a deficiency of red blood cells.
Other Signs and Symptoms
While pain is a typical symptom of stomach ulcers, some people -- especially those who are older -- have no pain. Instead, they may notice nausea, vomiting, bloating, a loss of appetite, belching, intolerance of fatty foods or heartburn. Weight loss -- triggered by a fear of food intake causing pain -- is another potential sign of stomach ulcers, according to an October 2007 article in "American Family Physician." Weight loss can also occur from obstruction -- in which swelling or scarring from the ulcer physically blocks the flow of food through the stomach. This causes less food to pass into the intestines, where it is broken down and absorbed into the body.
When to Seek Medical Attention
Seek emergent medical attention if you have severe pain in the abdominal area, if you notice blood in your stool or black tarry stools, or if you are vomiting blood. Also call your doctor if you are losing weight, have persistent nausea or vomiting, or pain with eating. Consult with your doctor about risk factors for stomach ulcers including smoking, excessive alcohol use, a family history of stomach ulcers or long-term use of NSAIDs.
- American Family Physician: Peptic Ulcer Disease
- American Gastroenterological Association: Understanding Peptic Ulcer Disease
- Primary Care: Clinics in Office Practice: Peptic Ulcer Disease
- Merck Manual Professional Version: Peptic Ulcer Disease
- World Journal of Emergency Medicine: Management of Upper Gastrointestinal Bleeding Emergencies: Evidence-Based Medicine and Practical Considerations