Symptoms of an ulcer in a man

Signs and symptoms

The most common symptom of a stomach ulcer is a burning or gnawing pain in the centre of the tummy (abdomen).

But stomach ulcers aren't always painful and some people may experience other symptoms, such as indigestion, heartburn and acid reflux and feeling sick.

When to seek medical advice

You should visit your GP if you think you may have a stomach ulcer.

Contact your GP or NHS 111 immediately if:

• you are passing dark, sticky, tar-like stools
• you have a sudden, sharp pain in your tummy that gets steadily worse

Go to your nearest accident and emergency (A&E) department or call 999 if:

• you are vomiting blood – the blood can appear bright red or have a dark brown, grainy appearance, similar to coffee grounds

These could be a sign of a serious complication, such as internal bleeding.

Causes of stomach ulcers

Stomach ulcers happen when there’s damage to the layer that protects the stomach lining from the acids in your stomach.

This is usually a result of:

• an infection with Helicobacter pylori (H. pylori) bacteria
• taking anti-inflammatory medicines (NSAIDs), such as ibuprofen or aspirin – particularly if they're taken for a long time or at high doses

It used to be thought that stress or certain foods might cause stomach ulcers, but there's little evidence to suggest this is the case.

Stomach ulcers can affect anyone but are more common in people aged 60 or over. Men are more affected than women.

How stomach ulcers are treated

Treatment will depend on what caused the ulcer.

Most people will be prescribed a medication called a proton pump inhibitor (PPI) to reduce the amount of acid in their stomach.

You’ll also need antibiotics if your ulcers were caused by a H. pylori infection.

Stomach ulcers can come back after treatment, although this is less likely to happen if the underlying cause is addressed.

Possible complications

Complications of stomach ulcers are relatively uncommon, but they can be very serious and potentially life threatening.

Abdominal pain is the most common symptom of a peptic ulcer.

Abdominal pain is the most common symptom of a peptic ulcer. The pain may be dull or burning and may come and go over time. For some people, the pain may occur when the stomach is empty or at night, and it may go away for a short time after they eat. For other people, eating may make the pain worse.

Many people who have peptic ulcers don’t have any symptoms. They may not develop symptoms until an ulcer leads to complications.

You should call or see your doctor right away if you have symptoms that could be caused by a complication. These symptoms include

• black or tarry stool, or red or maroon blood mixed with your stool
• red blood in your vomit or vomit that looks like coffee grounds
• sudden, sharp, or severe abdominal pain that doesn’t go away
• feeling dizzy or fainting
• a rapid pulse or other symptoms of shock
• a change in or worsening of your peptic ulcer symptoms

What causes peptic ulcers?

The most common causes of peptic ulcers are Helicobacter pylori (H. pylori) infection and nonsteroidal anti-inflammatory drugs (NSAIDs). Other causes of peptic ulcers are uncommon or rare.

People with certain risk factors are more likely to develop ulcers.

H. pylori

H. pylori infection is a common cause of peptic ulcers. Researchers are still studying how people become infected with H. pylori bacteria. The bacteria may spread from person to person through contact with an infected person’s vomit, stool, or saliva. Food or water contaminated with an infected person’s vomit, stool, or saliva may also spread the bacteria from person to person.

NSAIDs

Taking NSAIDs—such as aspirin, ibuprofen, and naproxen—is another common cause of peptic ulcers. NSAIDs relieve pain, but they also make the stomach lining more prone to damage and ulcers. Some types of NSAIDs are more likely to cause ulcers than others.

You have a higher chance of developing a peptic ulcer due to NSAIDs if you take

• NSAIDs for a long time
• a type of NSAID that is more likely to cause an ulcer
• high doses of an NSAID or more than one NSAID
• NSAIDs along with other medicines that increase the risk for ulcers
• NSAIDs and you are also infected with H. pylori

Other causes

Less common causes of peptic ulcers include

• infections caused by certain viruses, fungi, or bacteria other than H. pylori
• medicines that increase the risk of developing ulcers, including corticosteroids, medicines used to treat low bone mass, and some antidepressants, especially when you take these medicines with NSAIDs
• surgery or medical procedures that affect the stomach or duodenum

Less common causes of peptic ulcers also include certain diseases and health conditions, such as

• diseases that can affect the stomach, such as cancer or Crohn’s disease
• injury, blockage, or lack of blood flow that affects the stomach or duodenum
• life-threatening health conditions that require critical care
• severe chronic diseases, such as cirrhosis or chronic obstructive pulmonary disease
• Zollinger-Ellison syndrome, a condition that occurs when one or more tumors—called gastrinomas—cause your stomach to make too much acid

In rare cases, doctors can’t find the cause of peptic ulcers. Doctors may call ulcers with unknown causes idiopathic peptic ulcers.

How would I know if I have an ulcer?

What does the beginning of an ulcer feel like?

What causes male ulcers?

Can stomach ulcers go away on their own?