The most common stomach ulcer symptoms are a burning or gnawing pain in the upper middle abdomen, bloating, burping, nausea, loss of appetite and feeling full after small meals. Pain from a duodenal ulcer typically comes 2–3 hours after eating or at night and may ease with food, while stomach (gastric) ulcer pain may worsen soon after eating. Some ulcers cause no pain until they bleed, showing up as black stools or vomiting blood, which is an emergency.
Key points
- H. pylori and pain-killers (NSAIDs) cause the vast majority of ulcers.
- Pain-killer ulcers are often painless until they bleed.
- Endoscopy confirms an ulcer and checks for H. pylori and cancer.
- Most ulcers heal in 4–8 weeks with treatment.
Table of Contents
- Common Stomach Ulcer Symptoms
- Gastric vs Duodenal Ulcer Pain
- Silent Ulcers
- Symptoms of Complications
- What Causes Stomach Ulcers?
- How to Know If You Have an Ulcer
- Treatment
- Foods to Avoid and Eat
- Frequently Asked Questions
Common Stomach Ulcer Symptoms
- Burning, gnawing or aching pain between the breastbone and navel
- Pain on an empty stomach or at night, sometimes relieved by food or antacids
- Bloating and burping
- Nausea, sometimes vomiting
- Feeling full quickly; loss of appetite
- Unintentional weight loss
- Tiredness from iron-deficiency anaemia
Gastric vs Duodenal Ulcer Pain
| Gastric (stomach) ulcer | Duodenal ulcer | |
|---|---|---|
| Pain timing | Often soon after eating | 2–3 hours after meals and at night |
| Effect of food | May worsen pain | Often relieves pain |
| Weight | Weight loss more common | Weight may be stable |
| Biopsy | Needed to rule out cancer | Usually benign |
These patterns overlap a lot, so they cannot replace an endoscopy.
Silent Ulcers
Older adults and people taking pain-killers (ibuprofen, diclofenac, naproxen, aspirin), steroids or blood thinners may have ulcers without pain. The first sign may be anaemia, black stools or sudden bleeding. Anyone on regular pain-killers with stomach symptoms should be assessed.
Symptoms of Complications
| Complication | Warning symptoms |
|---|---|
| Bleeding | Vomiting blood or coffee-ground material, black tarry stools, dizziness, fainting |
| Perforation | Sudden severe abdominal pain, rigid belly, fever |
| Obstruction | Repeated vomiting of undigested food, swelling of the upper abdomen |
All of these need emergency care. See our page on GI bleeding.
What Causes Stomach Ulcers?
- H. pylori infection, very common in Pakistan; see H. pylori symptoms
- NSAID pain-killers and aspirin
- Smoking, naswar and alcohol
- Severe physical stress (major illness or surgery)
- Rarely, acid-producing tumours or stomach cancer
Our article what causes a peptic ulcer to form explains each cause in detail.
How to Know If You Have an Ulcer
- Upper GI endoscopy: the definitive test; allows biopsy and H. pylori testing
- H. pylori stool or breath test
- Blood count for anaemia
Endoscopy is especially important if you are over 45 or have weight loss, vomiting, difficulty swallowing, anaemia or black stools.
Treatment
- Proton pump inhibitors for 4–8 weeks to heal the ulcer
- H. pylori eradication therapy, followed by a test to confirm cure
- Stopping or replacing NSAIDs, or adding stomach protection if they are essential
- Stopping smoking and naswar
- Repeat endoscopy for gastric ulcers to confirm healing
- Endoscopic treatment (injection, clips or heat) for bleeding ulcers
Dr. Omer Hassaan Aftab Ahmad diagnoses and treats ulcers, including bleeding ulcers, at G-8 Markaz, Islamabad. See the peptic ulcer treatment page.
Foods to Avoid and Eat
No food causes or cures an ulcer, but while it heals: limit very spicy and fried food, strong tea and coffee (especially on an empty stomach), cola and alcohol; eat regular smaller meals; and include yogurt, fruit, vegetables, oats and lean protein. Have dinner 3–4 hours before bed.
Urdu Mein Khulasa
معدے کے السر کی عام علامات میں پیٹ کے اوپر جلن یا کاٹنے والا درد، اپھارہ، ڈکار، متلی، بھوک کم لگنا اور جلدی پیٹ بھر جانا شامل ہیں۔ چھوٹی آنت کے السر کا درد اکثر کھانے کے دو تین گھنٹے بعد یا رات کو ہوتا ہے۔ درد کی گولیاں کھانے والوں میں السر بغیر درد کے بھی ہو سکتا ہے اور پہلی علامت کالا پاخانہ ہو سکتی ہے۔ اینڈوسکوپی سے تشخیص ہوتی ہے اور دوا سے زیادہ تر السر ٹھیک ہو جاتے ہیں۔ خون کی الٹی یا کالا پاخانہ ہو تو فوراً ہسپتال جائیں۔
Frequently Asked Questions
How do I know if I have a stomach ulcer?
Burning upper stomach pain related to meals or night-time, with bloating and nausea, suggests an ulcer. An endoscopy confirms it.
What does ulcer pain feel like?
A burning, gnawing or hunger-like ache in the upper middle abdomen, sometimes spreading to the back.
What is the best treatment for stomach ulcers?
Acid-reducing medicine for 4–8 weeks, H. pylori eradication if present, and stopping pain-killers that harm the stomach.
Can stress cause an ulcer?
Everyday stress does not cause ulcers on its own, but it can worsen symptoms. Severe physical stress, such as major illness, can.
How long does an ulcer take to heal?
Most ulcers heal within 4–8 weeks of proper treatment.
Conclusion
Recognising stomach ulcer symptoms early, and getting an endoscopy when needed, prevents bleeding and other complications. For ulcer diagnosis and treatment in Islamabad, consult Dr. Omer Hassaan Aftab Ahmad on 0336 5993116.
