Peptic ulcer

Peptic ulcer is an ulcer in the lining of the stomach or duodenum. 


Symptoms may vary, but many suffer from upper abdominal pain. It is usually caused by Helicobacter pylori (H. pylori) bacteria or certain drugs and is treated with antibiotics or other medicines. Roughly one in ten adults suffers from stomach ulcers at some point in their lives.


If the mucous membrane is weakened in the stomach or duodenum, an ulcer can be formed. If there is not enough protective mucus, then the stomach acid together with the enzyme pepsin can create ulcers. Often this occurs due to an infection caused by H. pylori bacteria. But ulcers can also be caused by corticosteroids or non-steroidal anti-inflammatory drugs. Smoking also dramatically increases the risk of peptic ulcers. In some cases, there is no clear explanation.


A bleeding or perforated ulcer means that the wound has passed through the wall of the mucous membrane and there is a risk that the contents will leak into the abdomen.


Peptic ulcers can be felt in different ways and either cause diffuse symptoms that come and go or acute abdominal pain. In mild cases, you can have pain in the middle of your upper abdomen. Heartburn (acid reflux), nausea and vomiting are also common.


Weight loss and difficulty swallowing can also occur and need to be investigated. In the case of bleeding or a perforated ulcer, the process is rapid and the pain is intense. In this case you need to seek urgent care.


Acute symptoms of bleeding ulcer:


  • severe abdominal pain in the upper abdomen
  • bloody or “coffee ground” vomiting
  • black stools or blood in the stool
  • hard and tight stomach
  • fever and general weakness.


Remember that abdominal pain and nausea do not necessarily mean that you have an ulcer. Gastritis and IBS can cause similar symptoms, but often in a milder form. Peptic ulcers cause persistent symptoms that usually worsen over time or become acute.

Prevention and protection

At pharmacies you can purchase non-prescription drugs that reduce or neutralize stomach acid and relieve symptoms if you have heartburn and stomach pain. If the treatment does not help and you suspect that you have had a peptic ulcer, you need to consult a doctor.


Reduce the risk of stomach ulcers by avoiding:


  • smoking
  • alcohol
  • coffee
  • heavily spiced and deep fried food
  • anti-inflammatory drugs.


To diagnose a peptic ulcer, a medical examination is required. It involves an examination of the gastrointestinal tract with the help of esophagogastroduodenoscopy. Stomach ulcers caused by bacteria are treated with antibiotics and proton-pump inhibitors. If the stomach ulcer is caused by medicines, the doctor will change the treatment and often also prescribe proton-pump inhibitors.

When to consult a doctor

If you think you have a stomach ulcer, you should contact your health care provider. Consult a doctor if you have had peptic ulcer before and have new symptoms.


If you have difficulty swallowing or involuntarily lose weight, you should seek care. If you have acute pain in the upper abdomen, black stools, bloody or coffee ground vomiting, seek emergency help.

How APPOTEK can help

As long as symptoms do not require emergency care, APPOTEK can help you with peptic ulcers. A nurse or a doctor will make an individual assessment based on your symptoms during the care meeting. You can then be prescribed medicines or referred for further treatment. This type of abdominal pain usually requires a physical examination.


Valeria Chernikova, Neurologist, M.D.