About one in 10 people will develop a peptic ulcer at some time in their lives, although many of them won’t know about it. This potentially serious condition tends to affect men more than women.


  • Upper abodominal pain. The usual symptom of an ulcer is pain in the upper part of the abdomen just below the breast bone. It is often a burning or ‘knife-like’ pain which goes through to the back. The pain generally occurs when the stomach is empty (a few hours after meals) and will often wake the sufferer at 2 or 3 o’clock in the morning. The pain is often relieved by food or antacid medication.
  • Vomiting blood. This is a more serious symptom that happens if the ulcer bleeds.
  • Passing blood in the bowel motions. Also a serious symptom as a result of the ulcer bleeding. If this happens the motions have a black, ‘tar-like’ appearance.
  • Perforation. On rare occasions an ulcer will perforate through the stomach or duodenal wall. This is a major emergency requiring surgery.


Ulcers are areas of damage to the lining of the stomach, as in gastric ulcer, or the upper part of the intestine (duodenal ulcer). They are caused by a number of factors, including prolonged use of aspirin or other anti-inflammatory drugs (often used to treat arthritis), smoking, alcohol and stress. Sometimes there is too much acid, produced by the stomach as part of the process of digestion, and this acid attacks the lining of the intestine.

stomach ulcers and duodenal ulcers

Research has shown that most people with ulcers have an infection in the stomach with a bacterium known as Helicobacter pylori. H. Pylori infection is particularly important in the development of duodenal ulcers.

Tests and diagnosis

Ulcers are diagnosed either by a special X-ray (barium meal) or, more commonly, by endoscopy, where a flexible telescopic tube is passed into the stomach allowing the doctor to see what is happening and take samples if necessary.


Most ulcers respond well to treatment with drugs which heal them. Sometimes these drugs need to be taken for a prolonged time to suppress excess acid production in the stomach.

If Helicobacter pylori is present it should be eradicated with antibiotics. Eradication of H. pylori greatly reduces the likelihood of duodenal ulcers recurring and the need for long-term acid suppression therapy. Very rarely surgery is necessary, either to stop bleeding or to cut the nerves to the stomach, reducing acid secretion.

If you have symptoms suggestive of an ulcer, see the doctor.

This common condition is easily managed and serious complications are usually preventable.

Last Reviewed: 30/09/2009



1. Therapeutic Guidelines (eTG). Helicobacter pylori and peptic ulcer disease.. In: Gastroenterology Guidelines [updated 2006, Sep; accessed 2009, Oct 2]. Available from: http://www.etg.hcn.net.au/
2. Ford A, McNulty C, Delaney B, Moayyedi P. Helicobacter pylori infection. BMJ Clinical Evidence 2007; 06:406

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