It's not known exactly how common stomach ulcers are. They have become much less common since the 1980s because of much more effective treatments. So people with stomach ulcers now usually get better much more quickly.

The term 'peptic ulcer' is used to describe ulcers that are caused by too much acid in the stomach. This includes stomach ulcers and also ulcers in the first part of the gut (small intestine) known as the duodenum. Stomach ulcers are less common than duodenal ulcers.

The main symptom caused by a stomach ulcer is having a pain in the upper tummy (abdomen). Other symptoms may include:

Symptoms

Bloating: This means your tummy swells because your stomach is full of gas or air.

Retching: Also known as 'heaving'. This means sounding and looking as though you're about to be sick (vomit) but not actually vomiting.

Feeling sick (nausea).

Vomiting.

Feeling very 'full' after a meal.           

Stomach ulcers can cause various complications but these are much less common now because of more effective treatments. However, complications can be very serious and include:

Bleeding from the ulcer

This can range from a 'trickle' to a life-threatening bleed.If there is sudden heavy bleeding then this will cause you to vomit blood (this is called a haematemesis) and make you feel very faint. Less sudden bleeding may cause you to vomit and the vomit looks coffee-coloured because the stomach acid has partly broken down the blood.A more gradual trickle of blood will pass through your gut (bowel) and cause your stools (faeces) to look very dark in colour or even black (this is called melaena).

Perforation

This is the term used to describe the ulcer having gone all the way through (perforated) the wall of the stomach. Food and acid in the stomach then leak out of the stomach. This usually causes severe pain and makes you very unwell. Stomach perforation is a medical emergency and needs hospital treatment as soon as possible.

Stomach blockage

This is now rare. An ulcer at the end of the stomach can cause the outlet of the stomach (the part of the stomach that goes into the duodenum) to narrow and cause an obstruction. This can cause frequent severe vomiting.

Cause

Your stomach normally produces acid to help with the digestion of food and to kill germs (bacteria). This acid is corrosive, so some cells on the inside lining of the stomach and the first part of the gut (small intestine) known as the duodenum produce a natural mucous barrier. This protects the lining of the stomach and duodenum.

There is normally a balance between the amount of acid that you make and the mucous defence barrier. An ulcer may develop if there is an alteration in this balance, allowing the acid to damage the lining of the stomach or duodenum.

Treatment

If your doctor thinks you may have a stomach ulcer, the initial tests will include some blood tests. These tests will help to check whether you have become anaemic because of any bleeding from the ulcer. The blood test will also check to see that your liver and pancreas are working properly.

The main tests that are then used to diagnose a stomach ulcer are as follows:

A test to detect the H. pylori germ (bacterium) is usually done if you have a stomach ulcer. The H. pylori bacterium can be detected in a sample of stool (faeces), or in a 'breath test', or from a blood test, or from a biopsy sample taken during a gastroscopy. See the separate leaflet called Helicobacter Pylori for more details.

Gastroscopy (endoscopy) is the test that can confirm a stomach ulcer. Gastroscopy is usually done as an outpatient 'day case'. You may be given a sedative to help you to relax. In this test, a doctor looks inside your stomach by passing a thin, flexible telescope down your gullet (oesophagus). The doctor will then be able to see any inflammation or ulcers in your stomach.

Small samples (biopsies) are usually taken of the tissue in and around the ulcer during gastroscopy. These are sent to the laboratory to be looked at under the microscope. This is important because some ulcers are caused by stomach cancer. However, most stomach ulcers are not caused by cancer.