Stomach ulcers

What is a stomach ulcer?

A stomach ulcer (also called a peptic ulcer or gastric ulcer) is caused when the sticky layer of mucus that protects the stomach's lining breaks down over time. 

When this happens, the acid produced by the stomach to digest food and kill bacteria can start to damage the tissue that lines your stomach. This causes tiny open sores to form, which can become inflamed and painful.

What are the symptoms of stomach ulcers?

Common stomach ulcer symptoms are:

• Sudden burning pain in the centre of the abdomen which happens a few hours after eating or during the night

• Indigestion

• Feeling sick

• Retching

• Heartburn

• Bloating

• Loss of appetite

• Weight loss

• Feeling extremely 'full' after a meal

If you experience any of the following gastric ulcer symptoms, you should get urgent medical advice as they could be signs of internal bleeding:

• Poos that are dark, sticky and tar-like

• Vomiting blood. This can be either bright red or dark like coffee

• Sharp pain in the abdomen that starts suddenly and steadily gets worse

What causes stomach ulcers?

Stomach ulcers are usually caused when the mucus layer protecting the stomach lining from stomach acid is broken down by bacteria.

On occasion, an infection with a bug called Helicobacter pylori can cause stomach ulcers. About 15% of people in the UK are infected with H pylori but it doesn't always cause problems. 

Another common cause of stomach ulcers is taking high or regular doses of pain relievers like ibuprofen or aspirin (known as NSAIDs) over a long time. Also, if you have Crohn's disease, then stomach ulcers can also be a complication of this condition.

How can you reduce your risk of stomach ulcers?

Certain lifestyle factors may increase your risk of stomach ulcers although the evidence is not overwhelming. However, lifestyle changes can improve symptoms. Simple changes include:

• Avoiding spicy foods and fatty foods

• Reducing stress

• Reducing your alcohol intake

• Giving up smoking

• Losing weight

• Eating smaller meals

• Eating no later than 4 hours before going to bed

How are stomach ulcers diagnosed?

The risk factors you can't control that increase your chance of having a stomach ulcer are:

• Age – being over the age of 60

• Gender – men are more commonly diagnosed with stomach ulcers than women

If you've got stomach ulcer symptoms, you should go and see a GP. Some tests they might recommend:

• A test for a bacteria in your stomach called Helicobacter pylori. This can be done by collecting a poo sample, or by a breath test where you'll be asked to drink a chemical that's broken down by the bacteria in your stomach and then breath into a tube or straw

• A poo sample to check for any internal bleeding

• A blood test to check that your liver and pancreas are working properly and that you have not become anaemic due to any internal bleeding

• A gastroscopy – a thin, flexible tube with a camera at one end is passed into your mouth to examine your stomach. The doctor may also take a small sample of your stomach lining to test it (this is called a biopsy)

How are stomach ulcers treated?

The treatment you have will depend on the type of stomach ulcer, how it was caused and how severe it is. 

Treatment options include:

• A course of antibiotics that you may need to take for up to 2 weeks if you are found to have H pylori

• Antacids to neutralise stomach acid and provide immediate relief of your symptoms

• A proton pump inhibitor (PPI) that will allow your ulcer to naturally heal by reducing the amount of stomach acid that you have

In most cases, stomach ulcers will heal within a month or two of having treatment. The GP may also recommend that you have a gastroscopy a few weeks after you have finished your treatment to check the stomach ulcer has properly healed. 

Are there any complications of stomach ulcers?

In rare cases, stomach ulcer complications can occur. They can be potentially life-threatening if left untreated. 

Complications may include:

• Internal bleeding

• The movement of food through the digestive system becomes blocked. This is called a gastric outlet obstruction and causes frequent severe vomiting or feeling too full to eat

• Perforation of the stomach lining, which could result in bacteria infecting the lining of your abdomen (peritonitis) and potentially leading to a blood infection (sepsis)

If you experience sudden abdominal pain that gets steadily worse, then you should seek urgent medical advice by calling NHS 111, as you may require hospital treatment.

How can Livi help?

A Livi doctor will make an individual assessment based on your symptoms. You may then be given treatment or referred for specialist care.