A stomach ulcer is an open sore that forms on the inner surface of the stomach, usually caused by stomach acid. Medically known as a peptic ulcer, this condition can occur in the stomach or duodenum. The most common location is the inner lining of the stomach.
How does an ulcer form?
The stomach lining has a natural barrier to protect it from stomach acid. However, when this barrier weakens, the acid damages the stomach wall, leading to the formation of an ulcer. The most common causes include:
- Helicobacter pylori (H. pylori) infection,
- Long-term use of non-steroidal anti-inflammatory drugs (NSAIDs) (e.g., aspirin, ibuprofen),
- Excessive alcohol consumption and smoking.
Who is at risk?
Certain groups are at higher risk of developing stomach ulcers:
- Chronic NSAID users
- Individuals with H. pylori infection
- Those under intense stress
- Heavy smokers and alcohol consumers
- Individuals with a genetic predisposition
When Do Stomach Ulcer Symptoms Become Dangerous?
Persistent, worsening pain
The most prominent symptom of a stomach ulcer is pain that occurs especially when hungry and worsens when the stomach is empty. The pain is typically felt in the upper abdomen, between the sternum and the navel. This pain may be burning or gnawing. Pain that becomes persistent or wakes you up at night is a sign that the ulcer is progressing.
Bloody vomiting or stool
In advanced stages of ulcers, stomach bleeding may occur. The following symptoms indicate serious complications of stomach ulcers:
- Brown or bloody vomiting
- Tar-colored, foul-smelling stool (melena)
- Sudden dizziness or fainting
These symptoms may indicate a life-threatening condition such as stomach bleeding and require immediate medical attention.
Conditions requiring immediate medical attention
In the following situations, you should seek medical attention without delay:
- Severe and sudden onset of abdominal pain
- Vomiting blood or blood in stool
- Fainting, weakness, cold sweats
These symptoms may indicate that the stomach ulcer has developed serious complications such as perforation or bleeding.
Can the symptoms be confused with reflux or gastritis?
Common symptoms with reflux and gastritis
Stomach ulcer symptoms are often confused with reflux (gastroesophageal reflux disease) and gastritis. This is because all three conditions are affected by stomach acid and cause similar complaints. Common symptoms include:
- Heartburn
- Indigestion
- Bloating
- Burning sensation in the stomach
etc.
Distinguishing Features
The most important difference between ulcers, reflux, and gastritis is related to the type and timing of the pain:
| Symptoms | Ulcer | Reflux | Gastritis |
| Time of pain | Worsens when hungry | Increases after eating | Can occur both when hungry and full |
| Location of pain | Upper abdomen | Center of chest, upward | Widespread abdominal pain |
| Other symptoms | Bleeding, weight loss | Bitter taste in mouth | Nausea, loss of appetite |
Diagnostic methods
The most reliable method for diagnosing stomach ulcers is endoscopy. Endoscopy allows direct visualization of the stomach and confirmation of the presence of ulcers. In addition, a biopsy can be taken to test for H. pylori infection.
Additionally:
- Urea breath test
- H. pylori antigen test in stool
- Blood tests
can assist in the diagnostic process.
10 Common Symptoms of Stomach Ulcers
- Burning Pain in the Upper Abdomen
This is a gnawing pain that increases with hunger. - Heartburn and Acid Reflux
Stomach acid escaping into the esophagus can cause a burning sensation. - Indigestion and Early Satiety
Inability to consume sufficient amounts of food may be a sign of stomach ulcer. - Loss of Appetite and Weight Loss
Avoiding eating due to pain can lead to weight loss. - Nausea and Vomiting
Nausea, especially in the morning, may be a sign of a stomach ulcer. - Abdominal Bloating and Gas
Imbalances in the digestive system can cause bloating. - Bloody Vomiting (hematemesis)
This occurs when there is bleeding in the stomach wall. - Tarry Stools (melena)
Stools containing digested blood indicate ulcer bleeding. - Weakness and Fatigue
Chronic blood loss can cause anemia. - Metallic Taste in the Mouth
A metallic taste in the mouth may be felt in cases of hidden stomach bleeding.
What causes stomach ulcers?
- H. pylori infection: Weakens the stomach lining.
- NSAID use: Risk increases, especially in older individuals.
- Smoking and alcohol: Irritates the lining.
- Stress and irregular eating habits: Disrupts acid balance.
- Genetic factors: Risk is higher in individuals with a family history.
How to Prevent Stomach Ulcers?
- Get tested for H. pylori
- Limit your use of NSAIDs
- Avoid acidic and spicy foods
- Eat a regular and balanced diet
- Quit smoking and drinking alcohol
- Manage your stress
Risk of Gastric Ulcers After Bariatric Surgery
The risk of gastric ulcers may increase after bariatric surgeries such as sleeve gastrectomy or gastric bypass. Especially:
- Use of NSAIDs
- Continuing to smoke
- Protein deficiency
- Inadequate fluid intake
can facilitate ulcer development. Therefore, it is of great importance to be under the supervision of a dietitian and physician during the post-surgical period.
