What Is a Peptic Ulcer?

A peptic ulcer is an open sore that forms in the lining of the stomach or the upper part of the small intestine. When the sore develops in the stomach, it is called a gastric ulcer. When it forms in the small intestine, it is called a duodenal ulcer.

Ulcers happen when stomach acid damages the protective lining of the digestive tract. Most ulcers are linked to an H. pylori bacterial infection or long-term use of certain pain medicines.

The most common causes of peptic ulcers are:

• H. pylori infection
• Frequent or long-term use of NSAID medicines such as ibuprofen or aspirin

Other factors that may increase irritation or slow healing include smoking, alcohol use, and excess caffeine.

Symptoms

Symptoms can range from mild discomfort to severe pain. Some people may not notice symptoms until complications occur.

Common symptoms include:

• Burning or gnawing stomach pain
• Pain between meals or during the night
• Bloating
• Burping
• Nausea
• Feeling full quickly
• Loss of appetite
• Unexplained weight loss

More serious symptoms may include:

• Black or bloody stools
• Vomiting blood
• Sudden severe abdominal pain

How Is It Diagnosed?

Healthcare providers diagnose peptic ulcers using a combination of medical history, physical examination, and testing.

Tests may include:

• Upper endoscopy
• H. pylori testing through breath, stool, or blood tests
• Imaging studies such as an upper GI series

An endoscopy allows providers to look directly at the stomach and small intestine and may also include a biopsy if needed.

How Is It Treated?

Most peptic ulcers improve with medicine and lifestyle changes. Treatment focuses on reducing stomach acid, helping the ulcer heal, and treating the underlying cause.

Treatment may include:

• Antibiotics for H. pylori infection
• Proton pump inhibitors (PPIs)
• Acid-reducing medications
• Antacids
• Avoiding NSAID medicines when possible
• Limiting alcohol and smoking

Surgery is rarely needed but may be recommended if an ulcer causes severe bleeding, perforation, or blockage.

With proper treatment, many people recover fully and experience significant symptom relief within a few weeks.