Stomach ulcers (also called peptic and duodenal ulcers)

What is an ulcer?
An ulcer is a raw inflamed area in the lining of your stomach (gastric ulcer) or the duodenum - an area where the upper intestine joins the stomach, (duodenal ulcer).

How does it develop?
The digestive juices formed in your stomach contain acid and enzymes, which break down food. The stomach and the duodenum have a protective lining but if your stomach produces too much of these acidic digestive juices, the stomach lining can become broken.

Why does it happen?
There are some known contributing factors to the development of duodenal ulcers. Your stomach may be infected by a bacterium called Helicobacter pylori. This infection can significantly contribute to the development of peptic ulcers.

Men are more at risk of ulcers than women. Aspirin and some anti-inflammatory drugs for pain or arthritis are commonly associated with ulcers.

Elderly people and patients with a family history of stomach ulceration are more likely to develop ulcers.

What are the symptoms of an ulcer?
Discomfort or pain at the top of the abdomen, just below the breast bone. Pain may be relieved by eating, but it can also get worse after food. It can be worse at night.

What can you do to prevent ulcers developing?
Reduce your alcohol intake, donít smoke and avoid aspirin and anti-inflammatory painkillers.

Stress can probably make the symptoms worse as the stomach produces more acid in response to stress.

How do you find out if you have an ulcer?
Your doctor will take your history and examine you.

Sometimes further investigations may be necessary such as endoscopy. A flexible tube is passed into your stomach to see and take a sample of the lining for analysis. Sometimes you may need a barium meal, which involves swallowing a special contrasting liquid that will show up on an X-ray.

What is the treatment for ulcers?
Treatment aims to:

  • Eliminate or reduce contributing factors such as anti-inflammatory drugs, excess of alcohol and smoking.
  • Eradicate Helicobacter infection if present.
  • Reduce the production of stomach acid by taking acid inhibitors (Proton Pump Inhibitors or PPIs) or special antihistamines (ranitidine, cimetidine and others)
With effective modern drug treatments operations for stomach or duodenal ulcers are increasingly rare and usually deal with emergency complications of ulcers such as bleeding, or now less common, stomach perforation. Diet is believed to be less important than was thought in the past and the emphasis is on a balanced diet trying to avoid those foods which caused indigestion in the past.

What is the prognosis?
Stomach ulcers can recur and in some cases require repeated courses of treatment.

If the ulcer was caused by Helicobacter infection, eradication of the infection should provide a long-term cure.

Further information

This article published on
28 November 2005

Next review date 11/1/2013


Areaof the body

Stomach and digestion

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