Stomach Ulcer Symptoms, Cause, Diagnosis & Treatment

Stomach ulcer or gastric ulcer is a type of peptic ulcer disease. An ulcer is a breach in the continuity of epithelium. Epithelium acts as the layer of cells on the outer surface of organs and blood vessels throughout our body. The stomach has four layers, and the innermost is known as mucosa which consists of this epithelium, and when this layer gets eroded away, it causes stomach ulcer.

The stomach secretes various enzymes to break down the food we eat. It produces and maintains an acidic pH to ensure the necessary environment for the breakdown of nutrients.


The mucus barrier covering the inner lining of the stomach guards your stomach against the acidic juices, and whenever there is an imbalance between the safeguarding effect of mucus and acid environment, stomach ulcer happens. Let’s see stomach ulcer symptoms, causes, diagnosis and treatment options.

What causes stomach ulcer?

There are a vast number of items and activities that we include in our lives without even realising their deleterious effects! A few of them include:


NSAIDs (Non-steroidal anti-inflammatory drugs) like Aspirin & Ibuprofen are popular painkillers. But the main side effect of these drugs on a long-term use is the peptic ulcer.

These medicines block the production of significantly essential prostaglandins which help in the creation of the critical mucus barrier. There are a few other drugs like corticosteroids, etc. which are prescribed in many autoimmune and allergic conditions, cause stomach ulcers.

Bacterial infection of Helicobacter pylori

Pylori, a common type of bacteria, can grow into the digestive tract. It enters the mucosa and produces damaging and destructive enzymes which breaks down the anatomical structure of the stomach and causing inflammatory damage.

A medical review (1) suggests that H. Pylori infection is prevalent among more than half of the total world’s population.


This is one of the commonest reasons for peptic ulcer as liquor reduces the mucus barrier and thus the acid of the stomach slowly abrades the tissue. This usually occurs with long-term and heavy alcohol consumption.


According to recent research (2), smoking causes various alterations in the acid-mucus dynamics. It also causes damage to the blood vessels supplying the stomach thus affecting healing and recovery.

Zollinger-Ellison syndrome

This is a rare syndrome which can cause stomach and intestinal ulcers by increasing the production of acid inside the body. However, it is a rare disease and can cause less than 1% of total case of peptic ulcers.

Duodenal and gastric ulcer – Difference

Duodenal and gastric ulcers are two kinds of peptic ulcers which are characterised depending on the affected anatomical region of the body. Gastric ulcers happen in the stomach lining. Whereas, duodenal ulcer happens in the upper part of the small intestine.

Stomach ulcer symptoms

The prognosis, treatment and healing vary. So, it is essential to visit your doctor as soon as you experience these symptoms.

  • Burning sensation or pain in your stomach
  • Vomiting
  • Altered stool colour (dark)
  • Bloating
  • Acid refluxes
  • Heartburn
  • Weight loss
  • Tiredness and shortness of breath
  • Diarrhoea

If undiagnosed, peptic ulcers can cause dangerous complications such as bleeding or even perforation of the ulcer. It can cause sudden and sharp searing pain in the abdominal region between your chest and the belly button. The pain doesn’t go away and only worsens.

A perforation could lead to the spreading of the infection and contents throughout the abdomen – a condition known as Peritonitis.

How is a stomach ulcer is diagnosed?

The severity of your stomach ulcer will decide the diagnosis and treatment plan. The doctor may ask your medical history, symptoms, etc.

You might go through tests such as stool, blood and breath for ruling out H. Pylori bacterium. Other stomach ulcer tests include endoscopy, barium swallow and endoscopic biopsy.

What are the treatment options and Diet Changes?

By now you must have understood that stomach ulcer varies in severity level. Even its treatment plan changes based on its severity level.

With the use of drugs

Treatment usually begins with giving a combination of antacids which antagonise the acidity of the stomach and provide some relief. One of the most commonly used drugs now is a Proton Pump Inhibitor (PPI), which is remarkably effective.

This drug acts by decreasing the production of acid altogether and thus helps in the healing of the ulcer. In case of an acute bleeding ulcer, they are given intravenously. Otherwise, just tablets for 4-6 weeks are prescribed.

In case of an infectious peptic ulcer, as caused by H. Pylori, there is a combination of medications, including an antibiotic targeted explicitly towards killing it along with a PPI to aid in the healing. Unfortunately, sometimes recurrences occur, this known as Refractory Peptic Ulcer.

Natural ways to treat stomach ulcer

The stomach is the organ which passes everything that we eat. So, it’s important to watch what we eat or drink. Even a positive change can at least prevent the chance of peptic ulcer.

A Diet Reshuffle which would help alleviate the pain

You can add healthy foods to your diet plans such as green leafy vegetables, olive oil, different kinds of berries, and certain probiotic-rich foods like yoghurt, kimchi, fruits, etc. All these items have high levels of anti-oxidants which help ward off the damage caused by the ulcer. Spicy foods must be prohibited.

External Supplementation to maintain gut health

Due to the broad-spectrum antibiotics used to treat H. Pylori, probiotics are encouraged to maintain the level of healthy and helpful bacteria in the gut. Lactobacillus, Bifidobacterium, and Saccharomyces have been noted to help patients with H. pylori ulcers

Limiting Coffee Consumption

Coffee used to be strongly correlated with peptic ulcer, but now, a recent study shows (3) that coffee doesn’t CAUSE a peptic ulcer, but it aggravates an existing one.  A few constituents of caffeine like catechol and N-alkanoyl-5-hydroxytryptamides act together and stimulate increased gastric acid secretion.

An alternative would be trying decaffeinated substitutes and herbal teas along with a chicory root extract for coffee feel.


Extra Precautions regarding painkiller intake

Avoidance of use of NSAIDs is advised, as much as possible as it can aggravate a healing ulcer and may even cause recurrence. Also, there are many gastric friendly alternatives to painkillers as well. You can also take them along with antacids and meals to reduce excess production.

Lifestyle changes

Smoking has adverse effects on almost every disease & when diagnosed with the peptic ulcer, smoking would have to be stopped to ensure survival and healing. Alcohol consumption must also be cut down to ensure that the mucous barrier remains to continue its protective action.

Final words on stomach ulcer

With the advent of modern medicine, so many things are curable, if only caught at the right time. There might have been a time where a peptic ulcer would be deemed incurable, but now with positive diet changes and new drug therapy regimens, the treatment is very plausible. With the right information and the right doctor, stomach ulcer can be completely curable.


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