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Stomach Ulcer Symptoms – Causes & Treatment

Stomach ulcer symptoms include burning upper abdominal pain, nausea, and bloating. Learn which warning signs require immediate medical attention.

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Things worth knowing about "Stomach Ulcer Symptoms"

Stomach ulcer symptoms include burning upper abdominal pain, nausea, and bloating. Learn which warning signs require immediate medical attention.

What Is a Stomach Ulcer?

A stomach ulcer (medically known as ulcus ventriculi or gastric ulcer) is an open sore that forms in the lining of the stomach. It develops when the protective mucous layer of the stomach is damaged, allowing stomach acid to erode the underlying tissue. Stomach ulcers can cause both acute and chronic symptoms and should always be evaluated by a doctor.

Common Symptoms of a Stomach Ulcer

The symptoms of a stomach ulcer can vary depending on severity and the individual. The most common complaints include:

Burning or stabbing pain in the upper abdomen: This is the hallmark symptom. The pain is typically felt in the pit of the stomach and may radiate to the back.
Pain related to meals: With gastric ulcers, pain often worsens shortly after eating, as food stimulates the production of stomach acid.
Nausea and vomiting: Many patients experience persistent nausea, sometimes accompanied by vomiting.
Bloating and a feeling of fullness: An uncomfortable pressure in the upper abdomen along with bloating are frequent accompanying symptoms.
Loss of appetite: Due to pain and general discomfort, many patients lose their appetite.
Unintentional weight loss: Prolonged loss of appetite can lead to noticeable weight loss.
Acid reflux and heartburn: Backflow of stomach acid into the esophagus can cause a burning sensation in the chest.

Warning Signs – When to Seek Immediate Medical Help

Certain symptoms may indicate serious complications of a stomach ulcer and require emergency medical care:

Tarry or black stools: This can be a sign of bleeding in the gastrointestinal tract.
Vomiting blood: Vomiting blood or material that resembles coffee grounds is a medical emergency.
Sudden, severe abdominal pain: This may indicate a perforation (rupture) of the stomach wall.
Pale skin, dizziness, and weakness: These can be signs of internal bleeding.

Causes and Risk Factors

The most common causes of a stomach ulcer include:

Helicobacter pylori infection: The bacterium Helicobacter pylori is the leading cause and damages the stomach lining.
Long-term use of pain medications: Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or aspirin can damage the stomach lining.
Chronic stress: Prolonged stress can increase stomach acid production and weaken the protective mucous layer.
Smoking and alcohol: Both factors contribute to the development of stomach ulcers.
Unhealthy diet: Heavily spiced or fatty foods can worsen existing symptoms.

Diagnosis

To diagnose a stomach ulcer, doctors use the following methods:

Gastroscopy (endoscopy): The most reliable method for directly examining the stomach lining and taking tissue samples for biopsy.
Helicobacter pylori testing: Can be performed via breath test, blood test, or stool test.
Ultrasound and blood tests: Used to assess complications and the patient's general condition.

Treatment

Treatment of a stomach ulcer depends on the underlying cause:

Proton pump inhibitors (PPIs): Medications such as omeprazole reduce stomach acid production and support healing of the stomach lining.
Antibiotic therapy: If a Helicobacter pylori infection is confirmed, a combination of antibiotics and PPIs is used (eradication therapy).
Discontinuing NSAIDs: Where possible, stomach-irritating pain medications should be stopped or replaced with more stomach-friendly alternatives.
Lifestyle changes: Quitting smoking and alcohol, reducing stress, and adjusting dietary habits all support the healing process.

References

German Society for Gastroenterology, Digestive and Metabolic Diseases (DGVS): S2k Guideline on Helicobacter pylori and Gastroduodenal Ulcer Disease (2022).
Herold, G. et al.: Internal Medicine. Self-published, Cologne (2023).
World Health Organization (WHO): Helicobacter pylori – Fact Sheet. Available at: https://www.who.int (2023).

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