Stomach ulcers are open sores that develop on the lining of the stomach, or other areas of the small intestine (in which case they're called duodenal ulcers). Around one in 10 people in the UK will get a stomach ulcer at some point in their lives. Although they can affect people of any age, including children, most people who get them are over the age of 60.
Most people with stomach ulcers experience a burning or gnawing pain in the middle of their abdomen. The pain isn't always located in the tummy area alone – it can also travel up to your neck, your navel or be felt in your back. The pain, which is often triggered by stomach acid coming into contact with the ulcer, can last anywhere from a few minutes to several hours.
Many people experience a burning sensation soon after eating. If the ulcer is located in your small intestine (duodenal ulcer), the pain may occur a few hours after eating a meal, and may disturb your sleep at night. Taking indigestion tablets (antacids) can help relieve the pain of a duodenal ulcer, but will not usually help if the ulcer is located in your stomach.
Though less common, stomach ulcers can also cause the following symptoms: indigestion, heartburn, loss of appetite and vomiting. Many people do not experience symptoms, and may be unaware that they have a stomach ulcer until it bleeds.
What causes stomach ulcers?
There are two main causes of stomach ulcers: Helicobacter pylori (H. pylori) bacteria, which can irritate the stomach or upper intestine lining, causing an ulcer to form and non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin, which can have a similar effect.
Helicobacter pylori (H. pylori) infections are common, and it's possible to be infected without realising it because the infection doesn't usually cause symptoms. Some people, for reasons unknown, are more vulnerable to the effects of H. pylori when the majority of people are not. However, smoking seems to increase the risk. Stomach ulcers are also known to run in families, so genetics may make certain people more sensitive to H. pylori.
It was previously thought that lifestyle factors, such as stress, smoking, alcohol and spicy foods, caused stomach ulcers. Experts now believe that such lifestyle factors make the symptoms worse, but are not the main cause of ulcers developing.
Your doctor will first determine the underlying cause of your stomach ulcer. Once this is addressed and treatment given, they usually clear up. If the underlying cause isn't addressed, new ulcers can sometimes form.
Depending on the cause of the problem, you may be given medication (known as a proton pump inhibitor) to reduce the amount of acid in your digestive system, which allows the ulcer to heal. If the problem is caused by an H. pylori infection, your doctor may prescribe antibiotics to kill the bacteria, which should prevent the ulcer coming back.
If the ulcers are related to the use of NSAIDs, your doctor will usually suggest you stop taking them and prescribe proton pump inhibitors. In the case of aspirin-induced ulcers the aspirin sometimes needs to be continued, depending on why it is being given.
Complications of stomach ulcers
Around one in 50 people will experience complications of a stomach ulcer, such as bleeding at the site of the ulcer, the stomach lining at the site of the ulcer splits open – known as perforation, or the ulcer blocking the movement of food through the digestive system, known as gastric obstruction.
Some complications are regarded as medical emergencies, though are rarely life-threatening. Those aged over 70 are most at risk of experiencing a fatal complication of a stomach ulcer.
When to see your doctor
If you are concerned that you have a stomach ulcer, see your GP. If you vomit blood, pass black tar-like stools or get a sudden, sharp pain in your stomach that gets worse and does not improve, seek medical advice urgently. If your GP is unavailable, contact your local out-of-hours service or call 111.