Symptoms such as pain and indigestion, felt where food sits in the stomach, might lead to worries about an ulcer.
What is a stomach ulcer?
When a small area of the surface on the inside of the stomach is damaged in a certain way, this is a stomach ulcer.
Ulcers can happen just past the stomach, too – slightly lower down the gut, in the first few centimeters of the small intestine.
The cause of stomach ulcer is damage from the acid contents of the stomach. The stomach is where food first sits after passing down from the mouth.
Stomach acid and churning help with digesting food. The acid also helps protect against harm from microbes. The stomach protects itself from the acid it secretes. If this surface protection is harmed, the acid can cause damage. This damage is what results in an ulcer.
Mouth ulcers and stomach ulcers are both shallow holes in the surface of the moist tissue in these areas.
Stomach ulcer symptoms
The classic symptom of a stomach ulcer is indigestion. Doctors also call this symptom dyspepsia. Indigestion causes pain or discomfort in the stomach area. Not all stomach ulcers show this symptom.
This main symptom may feel like it is just below the chest and can be mistaken for another problem in the gut known as heartburn. Heartburn is more of a burning sensation and can occur at the same time as ulcer pain.
Heartburn can be caused by acid reflux . It occurs slightly higher up from the stomach and is felt in the lower part of the chest. In some cases, heartburn can be felt even higher.
Stomach ulcer symptoms tend to be more distinct than heartburn, but symptoms can still be vague. An ulcer tends to:
- Produce a burning pain, but often a precise sensation in the stomach area
- This pain is also described as a sort of “biting” or “gnawing” pain
- Many people have symptoms that are not clear or typical like the above two
- Some people describe a hungry sensation
Ulcers in the stomach tend to show slightly different symptoms and signs than those in the small intestine:
- Stomach ulcers tend to show less clear symptoms, with the pain being less consistent. Sometimes the pain is worse after eating food.
- Small intestine ulcers are more likely to produce a consistent pain. The pain can wake many in the middle of the night but is not there first thing in the morning. When the pain appears later in the day, eating food tends to reduce it.
The difference may be of interest to doctors, who may want to ensure nighttime acid is treated for small intestine ulcers.
Some stomach ulcers go unnoticed and show no typical indigestion-type pains. These ulcers are less common and tend to be diagnosed after the ulcer has started bleeding. Some ulcers can develop into the more serious problem of a hole in the stomach wall. This is known as perforation.
Stomach ulcer symptoms can change over time. However, it can be difficult to the spot the signs and symptoms of a stomach ulcer, let alone whether they have progressed.
When to see a doctor about stomach ulcer
Anyone who thinks they may have an ulcer in their stomach should consult their doctor. Any stomach symptoms that last for more than a few days or keep happening need evaluation and treatment.
It is not common, but it is especially important to get medical attention if there could have been a complication of an ulcer.
A slow-bleeding ulcer can be signaled by feeling anemic, such as being tired and breathless. More serious bleeding is an urgent medical problem, and can be signaled if blood is vomited up, or stools are black and sticky.
Perforation – a hole in the stomach – is also an emergency. Without quick treatment, the wall of the stomach can get infected. Sudden belly pain that gets worse can signal perforation, and any signs of being very unwell with infection need treatment as soon as possible.
Causes of stomach ulcers
The two main causes of ulcers of the stomach and small intestine, just past the stomach, are:
- acteria called Helicobacter pylori
- A class of painkillers called nonsteroidal anti-inflammatories
Anyone can get a stomach ulcer, but they are much less common in children. The risk in children is higher if their parents smoke or have a stomach ulcer themselves. One of the other risk factors for young people getting stomach ulcers is drinking alcohol.
Diagnosis and treatment of stomach ulcers
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.
If there are more serious symptoms such as bleeding, doctors may send for further testing.