Symptoms & Causes of Peptic Ulcers (Stomach or Duodenal Ulcers)

What are the symptoms of a peptic ulcer?

Peptic ulcers may cause symptoms of indigestion. Common symptoms include

• pain or discomfort in the upper part of your abdomen, anywhere between your belly button and breastbone
• feeling full too soon while eating a meal
• feeling uncomfortably full after eating a meal
• nausea and vomiting
• bloating
• belching

Abdominal pain is the most common symptom of a peptic ulcer.

Abdominal pain is the most common symptom of a peptic ulcer. The pain may be dull or burning and may come and go over time. For some people, the pain may occur when the stomach is empty or at night, and it may go away for a short time after they eat. For other people, eating may make the pain worse.

Many people who have peptic ulcers don’t have any symptoms. They may not develop symptoms until an ulcer leads to complications.

You should call or see your doctor right away if you have symptoms that could be caused by a complication. These symptoms include

• black or tarry stool, or red or maroon blood mixed with your stool
• red blood in your vomit or vomit that looks like coffee grounds
• sudden, sharp, or severe abdominal pain that doesn’t go away
• feeling dizzy or fainting
• a rapid pulse or other symptoms of shock
• a change in or worsening of your peptic ulcer symptoms

What causes peptic ulcers?

The most common causes of peptic ulcers are Helicobacter pylori (H. pylori) infection and nonsteroidal anti-inflammatory drugs (NSAIDs). Other causes of peptic ulcers are uncommon or rare.

People with certain risk factors are more likely to develop ulcers.

H. pylori

H. pylori infection is a common cause of peptic ulcers. Researchers are still studying how people become infected with H. pylori bacteria. The bacteria may spread from person to person through contact with an infected person’s vomit, stool, or saliva. Food or water contaminated with an infected person’s vomit, stool, or saliva may also spread the bacteria from person to person.

NSAIDs

Taking NSAIDs—such as aspirin, ibuprofen, and naproxen—is another common cause of peptic ulcers. NSAIDs relieve pain, but they also make the stomach lining more prone to damage and ulcers. Some types of NSAIDs are more likely to cause ulcers than others.

You have a higher chance of developing a peptic ulcer due to NSAIDs if you take

• NSAIDs for a long time
• a type of NSAID that is more likely to cause an ulcer
• high doses of an NSAID or more than one NSAID
• NSAIDs along with other medicines that increase the risk for ulcers
• NSAIDs and you are also infected with H. pylori

Other causes

Less common causes of peptic ulcers include

• infections caused by certain viruses, fungi, or bacteria other than H. pylori
• medicines that increase the risk of developing ulcers, including corticosteroids, medicines used to treat low bone mass, and some antidepressants, especially when you take these medicines with NSAIDs
• surgery or medical procedures that affect the stomach or duodenum

Less common causes of peptic ulcers also include certain diseases and health conditions, such as

• diseases that can affect the stomach, such as cancer or Crohn’s disease
• injury, blockage, or lack of blood flow that affects the stomach or duodenum
• life-threatening health conditions that require critical care
• severe chronic diseases, such as cirrhosis or chronic obstructive pulmonary disease
• Zollinger-Ellison syndrome, a condition that occurs when one or more tumors—called gastrinomas—cause your stomach to make too much acid

In rare cases, doctors can’t find the cause of peptic ulcers. Doctors may call ulcers with unknown causes idiopathic peptic ulcers.