Peptic Ulcer

A peptic ulcer is an open sore in the stomach or first part of the small intestine.

Ulcers form when the protective lining is damaged and digestive acid can irritate the tissue beneath it. Some cause no obvious symptoms, while others cause discomfort, bleeding or complications. Stomach ulcers and duodenal ulcers are both included under the term peptic ulcer.

Upper abdominal burning, gnawing or aching may come and go and may relate to meals. Indigestion, heartburn, nausea, reduced appetite and chest pain can occur. Abdominal pain, black stools and indigestion are very common presentations of peptic ulcer; chest pain, heartburn, loss of appetite and nausea are common presentations. Vomiting blood, black tar-like stools, fainting, severe sudden abdominal pain or worsening weakness need urgent medical care.

Helicobacter pylori infection is a frequent cause because it can inflame and weaken the stomach lining. Regular use of anti-inflammatory pain medicines can also damage that protection. Smoking, alcohol, severe physical illness and some medicines may increase irritation or make healing harder. A clinician can review the likely cause in the context of your medicines and health history.

An ulcer may heal when its cause is treated and acid irritation is reduced. If the cause remains, symptoms can return or the sore can deepen. Bleeding may be gradual and lead to tiredness, or it may be sudden. A hole through the stomach or intestinal wall is uncommon but requires emergency treatment.

Risk is higher with H. pylori infection, anti-inflammatory medicines, prior ulcers and combinations of medicines that irritate the stomach or affect bleeding. Smoking and heavy alcohol use can interfere with healing. Do not stop prescribed medicine abruptly; ask the prescriber or pharmacist how it should be reviewed safely.

A clinician will ask about pain, meals, bleeding symptoms, weight change and medicines. Testing for H. pylori may use a breath test, stool test or a sample taken during an endoscopy. An endoscopy uses a flexible camera passed through the mouth to examine the upper digestive tract and can help clarify the cause of concerning symptoms.

Treatment may include medicine that lowers stomach acid, stopping or changing an ulcer-causing medicine under clinical advice, and antibiotics if H. pylori is found. Complete the prescribed course and attend any follow-up testing offered to check that the infection has cleared. The choice and timing of treatment depends on symptoms, cause and whether there has been bleeding.

Take medicines as directed and tell your clinician if pain persists, changes or returns. Avoid smoking and limit alcohol because both can irritate the digestive tract. Choose meals that are comfortable for you; a particular food does not cause every ulcer, but keeping notes can reveal personal triggers for indigestion or heartburn.

Ulcers can bleed, which may cause black stools, vomiting blood, fatigue or iron-deficiency anaemia. An ulcer can also obstruct the passage of food or perforate the wall of the stomach or intestine. These complications need urgent assessment and may need hospital treatment.

If you need anti-inflammatory pain relief, discuss the lowest suitable exposure and whether stomach protection is appropriate for you. Taking H. pylori treatment exactly as prescribed, avoiding smoking and seeking review of recurring symptoms can reduce ongoing irritation and support healing.

A GP can review symptoms and medicines, arrange initial testing and decide whether specialist assessment is needed. A gastroenterology team may be involved when symptoms are persistent, bleeding is suspected, or an endoscopy is required. Take details of all prescribed, over-the-counter and herbal products to the appointment.