Causes of Stomach Ulcer

The two main causes of ulcers of the stomach and small intestine are:
Helicobacter pylori bacteria
A class of painkillers called nonsteroidal anti-inflammatories, (NSAIDs)

Less common causes of stomach ulcers include:
Excess stomach acidity (hyperacidity) – this can occur for a range of reasons, including genetics, smoking, stress, and some foods
Zollinger-Ellison – a disease that causes an excess of stomach acid to be produced (rare)

Symptoms of Ulcer

You may not have any. If you do, they may include:
A gnawing or burning pain in your stomach between meals or at night
Bloating
Heartburn
Nausea or vomiting
Loss of appetite

In severe cases, symptoms can include:
Dark or black stool
Vomiting blood or material that can look like coffee grounds
Weight loss
Severe pain in your belly
Diagnosis and test

Doctors follow the symptoms of a stomach ulcer by asking questions about how the pain feels, where and when it happens, and how frequent and long-lasting it has been.

This process helps to narrow down whether there is a stomach ulcer or not. Your doctor may also ask for a stool test or a breath test to find out whether the stomach ulcer is from Helicobacter pylori bacteria.

Endoscopy picture shows ulcer region

If there are more serious symptoms such as bleeding the doctor may require further testing, which may include:

Endoscopy – A camera to look at the gut lining; a biopsy (tissue sample) may be taken

Barium enema – A thick liquid that allows X-rays to be taken of the gut
Treatment and medications

If the doctor thinks there is a stomach ulcer, they may try to remove the cause by:
If the cause is thought to be NSAIDs, they may change the type of painkiller being taken
Trying the “test-and-treat” approach if the cause is thought to be H. pylori bacteria
Once the cause has been removed, the symptoms of stomach ulcers can be treated by

protecting the ulcer from acid while it heals. Drugs a doctor could prescribe include:
A proton pump inhibitor (PPI) – blocks acid producing cells
H2-receptor antagonist – prevents stomach from producing excess acid
OTC antacids or alginate
Drugs that protect the stomach lining – Pepto-Bismol, for instance

Symptoms often subside quickly following treatment. However, the treatment should be continued, especially if the ulcer is due to an H. pylori infection. It is also important to avoid drinking alcohol, smoking tobacco, and any trigger foods during treatment.
Surgical treatments

In certain cases, surgery may be an option. For instance, if the ulcer continues to return, won’t heal, bleeds, or prevents food from leaving the stomach.

Surgery can include:

Removing the ulcer
Tying off bleeding blood vessels
Sewing tissue from another site onto the ulcer
Cutting the nerve that controls stomach acid production

Complications from stomach ulcers such as bleeding or perforation are rare. Either of these complications requires urgent medical attention.