How Do You Know if You Have a Stomach Ulcer?

Stomach pain is usually a telltale sign.

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There are a quite few stomach problems a person can have, including cramps, stomach flu, acid reflux, and stomach ulcers. Stomach ulcers, or peptic ulcers, are sores on the stomach lining says the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). One of the ways you can tell that you might have a stomach ulcer is if you feel dull or burning pain in your stomach. It's also possible to feel that pain between your belly button and breastbone.

We asked our contributing medical editor, gastroenterologist Roshini Rajapaksa, MD, for the need-to-know facts on stomach ulcers.

How Do Stomach Ulcers Happen—And What Causes Them?

The crater-like sores form when acid in the digestive tract eats away at the lining of the stomach or the duodenum (the first section of the small intestine), said Dr. Rajapaksa: "They're potentially very dangerous if left untreated."

That depends on how deep the ulcer goes into your stomach lining. "If the ulcer erodes deep enough into the lining of your stomach, two things can happen," said Dr. Rajapaksa. "It can erode into a blood vessel, which then can start bleeding very profusely. Or, it can actually erode a hole all the way through your stomach, and stomach contents can then leak into the abdominal cavity"—a rare but potentially deadly scenario.

The primary cause is a bacteria known as Helicobacter pylori (H. pylori). "Many people have the bacteria in their bodies, but may not realize it until later in life, if and when they develop gastritis, which is inflammation of the stomach, or an actual stomach ulcer," said Dr. Rajapaksa.

Another possible cause of stomach ulcers is the long-term use of nonsteroidal anti-inflammatories, or NSAIDs, like ibuprofen and aspirin, added Dr. Rajapaksa.

Symptoms of Stomach Ulcers

You may not know you have a stomach ulcer if the sore is just opening and you're symptom-free, said Dr. Rajapaksa. But when an ulcer forms and deepens into the stomach lining, you'll feel it, added Dr. Rajapaksa.

Common symptoms include burning pain and nausea, even vomiting in some cases. "You may also feel a gnawing feeling of hunger," said Dr. Rajapaksa. Some people with ulcers may feel a little bit better after they eat because food helps coat the stomach, added Dr. Rajapaksa.

If you notice these signs, Dr. Rajapaksa recommended seeing a healthcare provider as soon as possible.

"Certainly, if you're vomiting blood, I would hope that everyone knows to immediately go to the hospital," said Dr. Rajapaksa. "But even if you're having other symptoms at home and you suspect you have an ulcer, I would suggest you get it diagnosed instead of trying to wait it out or seeing if the pain goes away."

Diagnosing Stomach Ulcers

Medical history, a physical examination, and different tests can help a healthcare provider with the diagnosis and cause of stomach ulcers.

When it comes to medical history, healthcare providers will want to know about any symptoms you're experiencing, your general medical history, and the medications you are taking. They'll especially want to know if you've taken any NSAIDs and other OTC medicines.

Also, the physical exam for stomach ulcers primarily involves an assessment of your abdominal area. A healthcare provider will check for bloating, tenderness, or pain, as well as listen to stomach sounds with a stethoscope.

Furthermore, a healthcare provider uses lab tests to help diagnose a stomach ulcer. They can check if you have an H. pylori infection by testing your blood, breath, or stool.

The provider also may look inside your stomach and duodenum by doing an x-ray or an endoscopy (a non-surgical procedure that involves inserting a flexible tube with a light and mini camera through your mouth to look inside your digestive tract).

Other tests might include a biopsy for examining tissue from the lining of your esophagus or a CT scan for diagnosing any holes in your stomach or small intestinal walls.

Treatment for Stomach Ulcers

The treatment for a stomach ulcer will depend on the cause of the ulcer, but treatment typically includes medicines. Healthcare providers might prescribe medicines such as:

  • Proton pump inhibitors (PPIs): Reduce stomach acid and protect the stomach lining
  • Histamine receptor blockers: Block the chemical histamine to stop it from sending signals to the stomach to produce acid
  • Protectants: Coat and protect ulcers
  • Antibiotics: Kill H. pylori
  • Bismuth subsalicylates: Works with antibiotics to destroy H. pylori bacteria

Specifically for H. pylori-induced ulcers, healthcare providers may prescribe a combination of any of the medicines above for one to two weeks.

How Can You Prevent Stomach Ulcers?

For NSAID-induced ulcers, preventing stomach ulcers may mean you stop taking NSAIDs, reducing your use, or switching to another medicine that won't lead to ulcers.

Since H. pylori can cause peptic ulcers, you may be able to prevent this type of ulcer by steering clear of the bacteria that cause the stomach infection. There are a few precautions you can take that may prevent getting H. pylori:

  • Washing your hands after restroom visits and before eating
  • Eating food that has been prepared the right way
  • Drinking clean water

Some people believe that avoiding spicy foods can help, or that stress triggers stomach ulcers—but those are myths, said Dr. Rajapaksa. However, avoiding alcohol and not smoking may be beneficial.

The key is to get checked out early, said Dr. Rajapaksa. "As soon as the ulcer is diagnosed, you can take an acid-blocking medication that will treat the erosion and prevent it from getting any worse in most cases. In more extreme cases, surgery may be required to repair the damage."

A Quick Review

Stomach ulcers, also known as peptic ulcers, are sores on the stomach lining that can occur due to H. pylori bacteria in the body or from prolonged NSAID use. These sores cause dull or burning pain, and a diagnosis of stomach ulcers may include a physical exam, tests, and information about a person's medical history.

Additionally, stomach ulcers can be prevented. However, if you end up with stomach ulcers, they can be treated with different medicines depending on the cause.

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  1. National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms & causes of peptic ulcers (stomach ulcers).

  2. MedlinePlus. Helicobacter pylori infections.

  3. National Institute of Diabetes and Digestive and Kidney Diseases. Diagnosis of peptic ulcers (stomach ulcers).

  4. MedlinePlus. Peptic ulcer.

  5. MedlinePlus. Endoscopy.

  6. National Institute of Diabetes and Digestive and Kidney Diseases. Treatment for peptic ulcers (stomach ulcers).

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