About duodenal ulcers
Ulcers can also occur in part of the intestine just beyond the stomach. These are known as duodenal ulcers.
Both stomach and duodenal ulcers are sometimes known as peptic ulcers.
On this page the term ’stomach ulcer’ is used, although the information is the same for duodenal ulcers.
Signs and symptoms
The most common symptom of a stomach ulcer is a burning or gnawing pain that develops in your abdomen (tummy). Some stomach ulcers aren't painful and are only noticed when a complication of a stomach ulcer develops, such as bleeding from the ulcer.
The pain caused by a stomach ulcer can travel out from the middle of your tummy up to your neck, down to your belly button, or through to your back.
It can last from a few minutes to a few hours. It often starts within a few hours of eating. You may also wake up in pain during the night.
Taking antacids (indigestion medication) may relieve the pain temporarily, but it will keep coming back if the ulcer isn't treated.
Less common symptoms of a stomach ulcer can include:
Some people also find they burp or become bloated after eating fatty foods.
When to seek medical advice
Visit your GP if you experience persistent symptoms of a stomach (or duodenal) ulcer.
Contact your GP or GP out of hours service immediately, or go to your nearest emergency department, if you develop signs of a serious complication, including:
- vomiting blood – the blood can appear bright red or have a dark brown, grainy appearance, similar to coffee grounds
- passing dark, sticky, tar-like stools
- a sudden, sharp pain in your tummy that gets steadily worse
These could be a sign of a serious complication, such as internal bleeding (see possible complications below).
Causes of stomach ulcers
Stomach ulcers occur when the layer that protects the stomach lining from stomach acid breaks down. This means the stomach lining becomes damaged.
This is usually (but not always) a result of:
- an infection with Helicobacter pylori (H. pylori) bacteria
- taking non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin – particularly if they're taken for a long time or at high doses
It used to be thought that stress or certain foods might cause stomach ulcers, but there's little evidence to suggest this is the case.
Who is affected
Between one and three people in every 1000 in the population will develop peptic ulcer disease every year. This varies with age and sex.
The incidence of duodenal ulcers peaks at 45–64 years of age. It is twice as common in men as in women. The incidence of gastric ulcers increases with age, and is similar in men and women.
How stomach ulcers are treated
With treatment, most stomach ulcers will heal within a month or two. The treatment recommended for you will depend on what caused the ulcer.
Stomach ulcers can come back after treatment, although this is less likely to happen if the underlying cause is addressed.
Complications of stomach ulcers are quite uncommon, but they can be very serious and potentially life-threatening.
The main complications include:
- bleeding at the site of the ulcer
- the stomach lining at the site of the ulcer splitting open – known as perforation
- the ulcer blocking the movement of food through the digestive system – known as gastric obstruction