Stomach Ulcers Explained: Causes, Symptoms, And Treatments

Pain between the belly button and breastbone is the most common symptom of peptic ulcers, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). This pain might feel dull or burning, and will be felt on and off for days or even longer periods. When the pain comes, it usually stays for minutes to hours. Medscape notes that stomach ulcer pain may start soon after meals, while duodenal ulcer pain may start 2-3 hours after meals. Eating or taking antacids relieves the pain of duodenal ulcers but may offer little relief for stomach ulcers.

Healthline outlines other symptoms of stomach ulcers: heartburn, acid reflux, bloating, nausea, vomit that may be bloody, blackish poop, fear of eating, weight loss, and anemia. Stomach ulcer and gastritis (another gut problem) have similar symptoms, but you can tell stomach ulcers apart since you will likely feel a stomach ulcer pain from one spot, says the Cleveland Clinic. You can also differentiate a stomach ulcer pain from heartburn because heartburn is usually felt in the chest. However, the only way to be certain that you have a stomach ulcer is to have your doctor diagnose it.

There are some things that make ulcer symptoms worse. It's worth knowing what they are even if everyone responds to them differently. If you have an ulcer, you may have noticed that some foods make ulcers flare up. WebMD reports that fatty foods, acidic foods like citrus and tomatoes, chocolate, spicy foods, alcohol, and caffeine worsen ulcers in some people. Livestrong notes that how coffee affects ulcers depends on your tolerance and the type of coffee you drink. According to the American Addiction Centers, drinking alcohol increases your risk of developing peptic ulcers and worsens ulcers. They advise that you cut down on drinking too much if you have a peptic ulcer. 

According to a research review published in the International Journal of Molecular Medicine, smoking increases your risk of getting a H. pylori infection. Smoking also reduces mucus production, increases stomach acid, causes reflux from the duodenum, and makes ulcers difficult to heal. 

Stress is often associated with ulcer flare-ups. When the body responds to stress, it increases the stomach's acid, as gastroenterologist Christine Lee told the Cleveland Clinic. Stress also increases the urge to drink and smoke, and people who are stressed are more likely to use NSAIDs to treat aches or pain, Dr. Lee notes. Further, stress reduces the body's healing abilities, according to gastroenterologist Dr. Tara Menon, speaking to the U.S. News & World Report. She adds that managing stress may help to reduce ulcer symptoms like heartburn or reflux, as well as to improve health generally.

To get a diagnosis of stomach ulcer, you need to visit your doctor. Your doctor will ask you to describe your symptoms, including how often you feel them and when they happen (via Medical News Today). To confirm if you have an ulcer, the type of ulcer, and its cause, your doctor will run further tests.

One of these tests is a barium swallow. You will need to drink liquid barium, which will coat the organs of your gut so they can be seen by an X-ray (via Johns Hopkins Medicine). Another test is an upper endoscopy. An endoscope with a camera is inserted in your mouth and is directed through your digestive tract to your duodenum to check for ulcers. A tissue sample can also be taken for a H. pylori lab test using this method.

In addition to getting tissue samples through endoscopy, the Mayo Clinic points out that stool and breath tests can be used to check for H. pylori infection. Stool tests are used to check for H. pylori or its antigen. To perform a breath test, you will swallow tagged carbon molecules — if these encounter H. pylori in your gut, it will cause carbon to be released into your body, which will then need to be breathed out. You will exhale into a bag, and a device will detect the amount of tagged carbon molecules your breath contains. 

According to Harvard Health Publishing, most stomach ulcers that are not complicated take two to three months to heal completely. The NIDDK recommends that you take any prescription drugs, especially antibiotics, as your doctor instructs. Your ulcer could reoccur if an H. pylori infection is not completely treated. If the ulcer was caused by NSAID use, you should discontinue taking it until your ulcer heals.

Sometimes, peptic ulcers don't heal even after treatment. Ulcers that don't heal after eight to 12 weeks of treatment are described as refractory, according to a paper published in Clinical Endoscopy. Refractory ulcers are treated by increasing the dose of drugs or by using different drugs. According to the Mayo Clinic, refractory ulcers are caused by smoking, continuing the use of NSAIDs, not taking ulcer medications properly, or if H. pylori is resistant to antibiotics. Less common causes of refractory ulcers are Zollinger-Ellison syndrome, another infection apart from that of H. pylori, and diseases like stomach cancer and Crohn's disease (per Clinical Endoscopy).

According to a research review from the Brazilian Archives of Digestive Surgery, eating fiber-rich foods like apples, oatmeal, granola seeds, flaxseed, pears, and whole grains helps food pass through the digestive system fast, and reduces bloating and abdominal pain from eating. Additionally, Healthline notes that foods like cabbage and honey have antioxidant abilities that help prevent and heal ulcers; dried licorice (not licorice-flavored candies) and honey help increase mucus; and garlic and mastic have antibacterial properties that can help fight against H. pylori infection.

Apart from food, other natural remedies are also effective to some extent. Sepalika identifies five essential oils effective against H. pylori infection based on a study published in Antimicrobial Agents and Chemotherapy. They include lemon grass, carrot seed, clove, cinnamon bark and manuka essential oils. Also, Dr. Samuel Meyers told Prevention that water dilutes stomach acid, so drinking a full glass of water can help ease discomfort.  

According to the National Center for Complementary and Integrative Health, supplements and herbs may affect drugs you are taking and may be compromised during their manufacture. So, you should discuss any remedy you want to use with your doctor.

Stomach ulcers may take several weeks to heal, so they may be an inconvenience during this time (via Familydoctor.org). One thing stomach ulcers can affect is your eating habits, and it can be frustrating to find that your favorite meal triggers your ulcer. News Medical advises that you keep a food journal to document potential trigger foods and the symptoms you feel. They also advise that you eat more smaller meals, eat at a slower pace, sit upright as you eat and after eating, and don't eat within two hours of bedtime.

Ulcer irritations can interrupt your sleep. According to Medscape, 30–40% of stomach ulcer patients wake up with ulcer pains at night. V Cure notes that gravity and pressure on your gut while you sleep can make ulcers feel worse at night. They advise that you avoid lying on your stomach, and instead lie on your back or left side  to move acid away from your ulcer.

There are many myths surrounding ulcers. The most common myth is that peptic ulcers are caused by stress. According to Famous Scientists, ulcers were believed to be caused by stress up to the 1980s. Prior to this time, scientists commonly believed that bacteria could not the culprit behind ulcers, because they thought stomach acids would kill harmful pathogens — a misconception proven wrong by scientists Barry Marshall and Robin Warren, who found that ulcers could be caused by Helicobacter pylori. To prove the point, Marshall chugged a beaker full of H. pylori and was diagnosed with peptic ulcer. It's now acknowledged that everyday mental and psychological stress only worsens ulcer symptoms, and cannot itself cause an ulcer (via Healthline).

Ulcers have also been linked to food. But The American College of Gastroenterology says that spicy foods don't cause ulcers, and may only irritate them. They add that you also don't need to follow a bland diet to manage ulcers. Another myth is that taking milk eases ulcer pain. But the Cleveland Clinic states that drinking milk only soothes ulcer pain for a while, and might ultimately make pain worse by provoking an increase in stomach acid. Finally, peptic ulcer isn't a lifetime disease. In the past, ulcers couldn't be treated and people suffered for months or a lifetime. But that's not the case anymore, as ulcers can be treated and cured (via Nemours KidsHealth).