Peptic ulcers: what are the symptoms?
The symptoms of peptic ulcers, which comprise gastric (or stomach) ulcers and duodenal ulcers, can vary from person to person and with the location of the ulcer. You may have an ulcer without experiencing any symptoms, have obvious symptoms, or experience a complication, such as bleeding or perforation. However, doctors recognise the following symptoms as being the most common ones associated with peptic ulcers.
Common symptoms of peptic ulcers
Burning or gnawing abdominal pain
Abdominal pain or discomfort is a typical symptom of peptic ulcers (both gastric and duodenal). The pain tends to come and go, and is often worse at night. It usually occurs when the stomach is empty. You may feel the pain anywhere in the area between your navel and your breastbone. The pain may last from between a few minutes to several hours, and can often be relieved by eating, drinking milk or taking antacid medicines.
Nausea and vomiting
Sometimes you might experience nausea or vomiting. These symptoms are not as common as abdominal pain.
Loss of appetite and weight
Again these symptoms are less common than abdominal pain, but people with peptic ulcers may suffer from loss of appetite and so lose weight.
Stomach and duodenum showing peptic ulcers
More serious symptoms
If you have an ulcer it is possible you may experience complications from it which can be serious and require further medical or hospital treatment. Painkillers called non-steroidal anti-inflammatory drugs (NSAIDs), for example aspirin and ibuprofen, can cause peptic ulcers. If you are taking an NSAID long-term, it is possible that you may have developed an ulcer but not know it because the pain-relieving effect of the NSAID may mask the pain you would otherwise feel from the ulcer. Most ulcers, however, are caused by a bacterium known as Helicobacter pylori (H. pylori).
Sometimes people are not aware they have an ulcer until they experience a serious complication, and some of these may include the following.
As an ulcer corrodes the lining of the stomach or duodenum, it may extend into the stomach muscles or duodenal wall. In these cases, blood vessels can also be damaged, which causes bleeding. If these blood vessels are small, the blood may slowly seep into the digestive tract, leading to the development of anaemia over time. This may make you feel weak, dizzy or tired.
If the blood vessels that become damaged are larger, however, the bleeding will occur much more rapidly. This is a more dangerous situation. You may feel weak when you stand up, or you may faint or vomit blood. Your stools may be a black or dark red colour (from the blood) and ‘tar-like’ in consistency.
If you have any of these symptoms you should seek medical attention immediately, as you may need surgery to stop the bleeding.
Although this occurs rarely, ulcers can develop to such an extent that they completely penetrate through the stomach or duodenal wall. This causes gastric contents, including partially digested food, to leak through this opening into the abdominal cavity (the peritoneum), resulting in peritonitis (inflammation of the abdominal cavity). This can cause sudden, severe abdominal pain that is worsened by any kind of movement. Perforation is a medical emergency that needs immediate surgery in a hospital.
Narrowing and obstruction
If your ulcer is located at the end of the stomach where it attaches to the duodenum, the scarring it causes may eventually narrow the opening to the duodenum. This will prevent food from leaving your stomach and moving into the small intestine. If this happens you may experience vomiting, as well as worsening abdominal pain and bloating.
You should always check with your doctor if you feel any change in the symptoms you associate with your ulcer.
2. MayoClinic.com. Peptic ulcer (updated 6 Jan 2011). http://www.mayoclinic.com/health/peptic-ulcer/DS00242 (accessed Jul 2013).
3. National Digestive Diseases Information Clearinghouse (NDDIC). H. pylori and peptic ulcers (updated 30 Apr 2012). http://digestive.niddk.nih.gov/ddiseases/pubs/hpylori/ (accessed Jul 2013).