Stomach ulcers

Stomach ulcers are open, inflamed sores in the lining of your stomach. They are also known as gastric ulcers. Ulcers can also occur in the upper part of the small intestine — these are known as duodenal ulcers. Together, stomach ulcers and duodenal ulcers are known as peptic ulcers.

The most common symptom is pain in the upper abdomen (tummy area). It may be worse before meals and get better after eating or taking antacids. Sometimes, it may get worse after eating. The pain may even wake you from sleep.

Other less common symptoms include:

• nausea
• heartburn
• vomiting

Stomach ulcers can be caused by a type of bacteria called Helicobacter pylori (H. pylori). There is a greater risk of H. pylori in people who:

• are over 65 years of age
• are migrants
• live in an aged care or other residential facility
• have low income
• have family members with H. pylori
• have a family history of peptic ulcer disease

Non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen can also cause stomach ulcers. Some things can increase the risk of developing a stomach ulcer while using NSAIDs, for example, being older than 65 years, smoking, or using medicine such as anticoagulants or antiplatelets.

Seek medical attention immediately if you have:

• a sudden, severe pain in the abdomen
• bloody or black bowel motions (poo)
• vomit that looks like coffee grounds with red blood
• light-headedness
• nausea or changes to your appetite
• unexplained weight loss

Stomach ulcers are usually diagnosed by endoscopy — a flexible tube with a tiny camera that is passed into the mouth and down to the stomach. This procedure allows your doctor to see your stomach and check for ulcers. It is usually done under general anaesthetic so you won't be awake.

If you have an ulcer, your doctor may recommend a test for H. pylori infection. This can be done with a:

• breath test
• blood test
• stool test
• biopsy sample collected during an endoscopy

If you have a stomach ulcer, your doctor may prescribe a combination of:

• antibiotic medicines to fight the H. pylori bacteria
• medicines that reduce the amount of acid in your stomach, known as proton pump inhibitors (PPIs)

You will only need surgery if you have severe bleeding or a perforation (hole) in your stomach or small intestine.

To help manage symptoms, you can also:

• stop smoking
• reduce the amount of alcohol you drink
• avoid foods that may make symptoms worse (such as spicy foods, coffee or fizzy drinks)
• lose weight, if you are above a healthy weight range

There are 2 main complications of stomach ulcers — these can both be emergencies:

• Bleeding from the ulcer — this might be a slow trickle or a significant, life-threatening bleed.
• Perforation — the ulcer may go all the way through the wall of the stomach, causing a hole so food and acid leak into the abdominal cavity.

If you have a H. pylori infection, your doctor may prescribe antibiotics to treat the infection and prevent you from getting another ulcer. If H. pylori is found before you develop an ulcer, treatment can stop you from getting an ulcer in the first place.

You can prevent stomach ulcers caused by medicines such as NSAIDs by taking the lowest effective dose and for the shortest possible time. Your doctor may recommend also taking a medicine that lowers stomach acid while you take NSAIDs.

Visit the Gastroenterological Society of Australia for:

• information about endoscopy (Opens in new tab)
• information about Helicobacter pylori (Opens in new tab)

Call the Quitline Interpreter Service (Opens in new tab) — if you prefer a language other than English call 13 7848 and ask for an interpreter. They will call you back with an interpreter in your language.

Find an Aboriginal Community Controlled Health Organisation (ACCHO) or Affiliate (Opens in new tab) near you.