A peptic ulcer is a sore on the inner lining of the stomach or the first part of the small intestine. The two leading causes are Helicobacter pylori (H. pylori) infection and regular use of certain painkillers called NSAIDs.
When to seek emergency care: Seek emergency care now for vomiting blood or material that resembles coffee grounds, black tar-like stool, red blood in stool, sudden severe abdominal pain that does not settle, a hard tender abdomen, fainting, rapid pulse or signs of shock. These can indicate bleeding or a perforated ulcer. Call 1122.
What an ulcer may feel like
The typical symptom is dull or burning pain in the upper abdomen. It may come and go, occur when the stomach is empty or at night, or sometimes feel worse after food. Other symptoms include early fullness, uncomfortable fullness after eating, bloating, belching, nausea or vomiting. Some ulcers cause no noticeable pain until a complication develops.
"Gas," acidity and ulcer can feel similar, but they are not interchangeable. Symptoms alone cannot prove that a sore is present.
Why ulcers happen
H. pylori weakens the protective lining and is treatable with a specific combination of antibiotics and acid-suppressing medicine. NSAID painkillers — including medicines commonly used for headache, joint pain or fever — can also injure the lining, particularly with frequent use, higher doses, older age, blood thinners or previous ulcers.
Spicy food and everyday stress do not usually create peptic ulcers by themselves, although either can make symptoms feel worse. Smoking can slow healing and increase recurrence. Herbal powders are not automatically safe; some contain undisclosed steroids or painkillers.
Testing and treatment
A clinician may test for H. pylori using a breath or stool test. Some patients need upper-GI endoscopy, especially with bleeding, anaemia, weight loss, swallowing difficulty, repeated vomiting or persistent symptoms. Treatment usually reduces stomach acid. Confirmed H. pylori requires a prescribed antibiotic regimen, completed exactly as directed, followed by a test to confirm eradication when advised.
Do not self-start leftover antibiotics. Incorrect combinations contribute to resistance and treatment failure. Ask before continuing ibuprofen, diclofenac, naproxen or aspirin; prescribed low-dose aspirin should not be stopped without the clinician who recommended it.
What can help while arranging care
Avoid smoking and alcohol, note which medicines you take, and eat tolerable balanced meals rather than prolonged fasting. Smaller portions may reduce discomfort for some people. Food changes can ease symptoms, but diet alone cannot eradicate H. pylori or heal a serious complication.
Which doctor should you see?
A family physician or internal-medicine doctor can start evaluation and H. pylori testing. A gastroenterologist is appropriate for alarm symptoms, recurrence, anaemia, suspected bleeding, uncertain diagnosis or a need for endoscopy.
Which specialist to see
SehatGPT helps you book gastroenterology for persistent upper-abdominal pain or suspected H. pylori, and directs you to emergency care for bleeding signs.
Frequently asked questions
Does milk heal an ulcer?
No. It may briefly soothe discomfort but does not treat H. pylori or the underlying injury.
Can an ulcer become cancer?
Most duodenal ulcers are not cancer. Some stomach ulcers require endoscopy and biopsy to confirm the diagnosis.
Can I take painkillers?
Ask a clinician or pharmacist. NSAIDs can cause or worsen ulcers; the safest alternative depends on your health history.