Stomach Ulcer

Stomach ulcers develop when the lining of the stomach becomes damaged, which causes the creation of sores. They usually occur due to an imbalance of acidity levels in the stomach.

  1. Cause burning in the abdomen, indigestion and nausea
  2. Several possible causes
  3. Sometimes treated with antibiotics or antacids

If you have a severe stomach ache or a diagnosed peptic ulcer in your stomach, you may want to speak to a healthcare professional about how to manage symptoms. Our private online video consultation service enables you to speak to one of our UK doctors, who can provide the guidance you need.

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What is a stomach ulcer?

A stomach ulcer is an open sore that develops when the stomach lining becomes damaged from an imbalance in acid levels. It is usually caused by either the presence of the bacteria, Helicobacter pylori, or the use of non-steroidal anti-inflammatory drugs (NSAIDs). A stomach ulcer can be categorised as being at least 5 mm in diameter; any smaller break is called an ‘erosion’.

What causes a stomach ulcer?

The stomach normally produces acid to aid food digestion and kill unwanted bacteria. It is a corrosive acid, but does not usually affect the wall of the stomach, as it is protected by a natural mucus barrier. However, too much acid in the stomach can damage this lining, as the bacteria on the wall are not able to stop the acid. Common NSAIDs that can cause this include aspirin, corticosteroids and potassium supplements, as well as some recreational drugs.

How common are stomach ulcers?

According to BMJ, stomach ulcers have a lifetime prevalence in the region of 10%, and occur annually in around 0.3% of the US population. The incidence rate for stomach ulcers increases with age, with a peak between the ages of 50 and 70. The prevalence of the bacteria responsible for many stomach ulcers has decreased rapidly in the last 50 years, as treatments have become increasingly effective.

The risk of a stomach ulcer recurring is around 60% if the H. pylori bacteria is not eradicated, and only 5% if it is. If an ulcer has formed following the use of a NSAID, stopping the drug or using an acid suppression drug will largely reduce the risk of the ulcer ever recurring.

What symptoms does a stomach ulcer cause?

It's possible for a stomach ulcer to be asymptomatic, but the most clear and obvious symptom is quite severe pain in the abdomen. Aside from the pain, stomach ulcers can also cause bloating, retching, nausea, vomiting and generally feelings of unwellness. However, these symptoms are much less common.

There are a number of complications that can develop from a stomach ulcer, though they are rare now thanks to the availability of effective treatment. It is possible for the stomach to bleed, which can cause someone to vomit blood (haematemesis) or for stools to appear darker in colour due to a more gradual leaking.

Perforation is a more severe complication, where the ulcer completely breaks through the stomach wall, which leads to the contents of the stomach leaking out. This requires urgent medical attention. An ulcer may also cause an outlet of the stomach to narrow, which leads to frequent and severe vomiting.

If you're experiencing stomach pain that you are concerned about, or you have been diagnosed with a stomach ulcer and would like further advice, our doctors may be able to help. Our private online video consultation service enables you to speak to a UK doctor about your condition. Choose an appointment slot at a time convenient for you. If you require treatment, our doctor can also prescribe this for you. The medication can either be dispensed at our pharmacy and shipped to you, or you can opt to have an e-prescription sent to your local pharmacy if you prefer. 

Page last reviewed:  15/06/2020
Diagnosis and treatment

How is a stomach ulcer diagnosed?

A stomach ulcer can usually be diagnosed by a combination of assessing the symptoms present, and also by testing for the presence of helicobacter pylori bacteria. If someone has recently taken a non-steroidal anti-inflammatory drug (NSAID), then this too may lead to the suspicion of a stomach ulcer.

Will I need tests?

In order to confirm a doctor’s suspicion of a stomach ulcer, tests are required. The test for helicobacter pylori bacteria can be done by examining a stool sample, performing a breath test, or sometimes through a blood test. 

These are the most common tests, however there are also more invasive tests that can be conducted, such as a gastroscopy and a biopsy. A gastroscopy involves passing a thin tube with a light and a small camera on the end down the oesophagus to get an image of the ulcer. A biopsy takes some tissue sample from the ulcer, usually during a gastroscopy, to be examined under a microscope in a laboratory.

What will a doctor normally advise?

The advice a doctor will provide depends on the cause of the stomach ulcer. If it has not been caused by bacteria, a doctor will likely review any medication you may be on, assess any indications of stress, and suggest lifestyle changes. Common advice for stomach ulcers includes losing weight, avoiding trigger foods, eating smaller meals, reducing alcohol consumption and stopping smoking.

If the ulcer was caused by an anti-inflammatory medicine, the treatment course should, if possible, be stopped, to allow the ulcer time to heal. You may also be given some acid-suppressing tablets.

What treatments are there for stomach ulcers?

If the ulcer was caused by bacteria, a course of antibiotics will be necessary. This can be prescribed in several ways, but the most common regimen includes amoxicillin 1g twice each day and clarithromycin 500mg twice each day, taken in addition to a proton pump inhibitor (a group of drugs used to reduce the production of acid).

Page last reviewed:  15/06/2020
Questions and Answers

How are stomach ulcers treated?

Stomach ulcers are either treated by making lifestyle changes to allow the ulcer to heal, or taking a course of antibiotics if the ulcer has been caused by H. pylori bacteria. It can also help to take acid-suppressing medication for 4-8 weeks after the ulcer has healed.

What treatments are there?

There are a number of combinations of antibiotics that can be prescribed for a stomach ulcer caused by H. pylori bacteria. However, NICE guidelines recommend a proton pump inhibitor, such as lansoprazole or omeprazole, combined with amoxicillin and clarithromycin. 

For ulcers not caused by H. pylori bacteria, the focus of recovery will be on making lifestyle changes to allow the ulcer to heal, as well as using acid-suppressing medication for up to two months after the ulcer has healed.

Can I consult a doctor about stomach ulcers online?

Yes, you can consult our UK doctors through our online video consultation service at a suitable time for you. They can provide advice on how to manage your ulcer and prescribe antibiotics should you need them.

Page last reviewed:  15/06/2020

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