Peptic Ulcer Guide: Causes, Symptoms, and Treatment

Overview

Peptic ulcers are open sores that develop on the inner lining of your stomach (called gastric ulcers) or the upper part of your small intestine (called duodenal ulcers). They form when stomach acid damages the protective mucus layer that lines these areas, and they are a very common, treatable digestive condition.

Signs & Symptoms

Many people with peptic ulcers have no symptoms at all, especially in the early stages. When symptoms do occur, they can vary depending on where the ulcer is located and how severe it is.

• Burning or gnawing stomach pain, often worse when your stomach is empty or at night
• Bloating and feeling overly full after eating small amounts of food
• Heartburn or indigestion
• Nausea or vomiting
• Unexplained weight loss
• Dark, tarry, or bloody stools (a sign of bleeding in the digestive tract)
• Vomiting blood or material that looks like coffee grounds

Causes & Risk Factors

Most peptic ulcers are caused by two main factors: infection with the Helicobacter pylori (H. pylori) bacteria, or long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, and aspirin. Other factors can increase your risk of developing an ulcer or make existing ulcers worse.

Diagnosis

To diagnose a peptic ulcer, your doctor will start by asking about your medical history, symptoms, and any medications you take regularly. They may also recommend one or more of the following tests: an endoscopy (a thin, flexible tube with a camera inserted through your throat to view your digestive tract), a breath, blood, or stool test to check for H. pylori infection, or an upper GI series (barium swallow) where you drink a contrast liquid and get X-rays of your digestive tract.

Treatment & Management

Treatment for peptic ulcers depends on the underlying cause. If your ulcer is caused by H. pylori, your doctor will prescribe a combination of antibiotics to eliminate the infection, plus medications to reduce stomach acid and protect the digestive tract lining. If your ulcer is caused by NSAID use, you will be advised to stop taking the NSAID, and may be given acid-reducing medications and protective drugs to support healing. Antacids can help relieve mild pain, but they do not heal the ulcer itself.

• Antibiotic therapy to eliminate H. pylori infection (if present)
• Proton pump inhibitors (PPIs) or H2 blockers to reduce stomach acid production
• Cytoprotective medications to protect the stomach and small intestine lining
• Stopping use of NSAID pain relievers, or switching to safer alternatives (like acetaminophen) if needed
• Rarely, surgery for severe ulcers that do not respond to medication or cause life-threatening complications

Living With It

With proper treatment and lifestyle adjustments, most people with peptic ulcers heal completely and can prevent recurrence. Key steps include avoiding trigger foods that irritate your digestive tract, not smoking, limiting alcohol intake, managing stress, eating smaller meals, and avoiding eating 2–3 hours before bedtime to reduce nighttime acid production.