Peptic Ulcers

What I need to know about

Peptic Ulcers

NATIONAL INSTITUTES OF HEALTH

National Digestive Diseases Information Clearinghouse

U.S. Department

of Health and

Human Services
What I need to know

about Peptic Ulcers

NATIONAL INSTITUTES OF HEALTH

National Digestive Diseases Information Clearinghouse
Contents

What is a peptic ulcer? ........................................... 1

What are the symptoms of peptic ulcers? ............. 2

What causes peptic ulcers? .................................... 4

Do stress or spicy foods cause peptic ulcers? ....... 5

What increases my risk of getting peptic 

ulcers? ...................................................................... 6

Can peptic ulcers get worse? ................................. 7

How can I find out whether I have peptic 

ulcers? ...................................................................... 8

How are peptic ulcers treated? ............................. 9

Can I use antacids? ............................................... 10

Can peptic ulcers come back? ............................. 11

What happens if peptic ulcers don’t heal? 

Will I need surgery? .............................................. 11

What can I do to prevent peptic ulcers? ............. 12

What can I do to lower my risk of getting 

peptic ulcers? ......................................................... 12

Glossary ................................................................. 13

For More Information .......................................... 13

Acknowledgments ................................................ 14
What is a peptic ulcer?

A peptic ulcer is a sore in the lining of your

stomach or duodenum.* The duodenum is the

first part of your small intestine. If peptic ulcers

are found in the stomach, they’re called gastric

ulcers. If they’re found in the duodenum, they’re

called duodenal ulcers. You can have more than

one ulcer.

Many people have peptic ulcers. Peptic ulcers can

be treated successfully. Seeing your doctor is the

first step.

Peptic ulcers occur in the wall of the stomach and

duodenum.

Ulcer

1

*Words in bold type are defined in the glossary on

page 13.
What are the symptoms of peptic

ulcers?

A burning pain in the gut is the most common

symptom. The pain 

● feels like a dull ache

● comes and goes for a few days or weeks

● starts 2 to 3 hours after a meal

● comes in the middle of the night when your

stomach is empty

● usually goes away after you eat

2

A burning pain in the gut is a common

symptom of peptic ulcers.
Other symptoms are

● losing weight

● not feeling like eating

● having pain while eating

● feeling sick to your stomach

● vomiting

Some people with peptic ulcers have mild 

symptoms. If you have any of these symptoms,

you may have a peptic ulcer and should see your

doctor.

3
What causes peptic ulcers?

Peptic ulcers are caused by

● bacteria called Helicobacter pylori, or H. pylori

for short

● nonsteroidal anti-inflammatory drugs (NSAIDs)

such as aspirin and ibuprofen

● other diseases

Your body makes strong acids that digest food.

A lining protects the inside of your stomach and

duodenum from these acids. If the lining breaks

down, the acids can damage the walls. Both

H. pylori and NSAIDs weaken the lining so acid

can reach the stomach or duodenal wall.

4

Nonsteroidal anti-inflammatory

drugs can cause peptic ulcers.
H. pylori causes almost two-thirds of all ulcers.

Many people have H. pylori infections. But not

everyone who has an infection will develop a peptic

ulcer.

Most other ulcers are caused by NSAIDs. Only

rarely do other diseases cause ulcers.

Do stress or spicy foods cause

peptic ulcers?

No, neither stress nor spicy foods cause ulcers. But

they can make ulcers worse. Drinking alcohol or

smoking can make ulcers worse, too.

5
What increases my risk of getting

peptic ulcers?

You’re more likely to develop a peptic ulcer if you 

● have an H. pylori infection

● use NSAIDs often

● smoke cigarettes

● drink alcohol

● have relatives who have peptic ulcers

● are 50 years old or older

6

Having relatives with peptic ulcers puts you at risk of

having them too.
Can peptic ulcers get worse?

Peptic ulcers will get worse if they aren’t treated.

Call your doctor right away if you have any of these

symptoms:

● sudden sharp pain that doesn’t go away

● black or bloody stools

● bloody vomit or vomit that looks like coffee

grounds

These could be signs that

● the ulcer has gone through, or perforated, the

stomach or duodenal wall 

● the ulcer has broken

a blood vessel 

● the ulcer has stopped

food from moving

from the stomach

into the duodenum 

These symptoms must

be treated quickly.

You may need surgery.

7

Call your doctor if the pain

gets worse.
How can I find out whether I have

peptic ulcers?

If you have symptoms, see your doctor. Your 

doctor may

● take x rays of your stomach and duodenum,

called an upper GI series. You’ll drink a liquid

called barium to make your stomach and

duodenum show up clearly on the x rays.

● use a thin lighted tube with a tiny camera on

the end to look at the inside of your stomach

and duodenum. This procedure is called an

endoscopy. You’ll take some medicine to relax

you so your doctor can pass the thin tube

through your mouth to your stomach and

duodenum. Your doctor may also remove a

tiny piece of your stomach to view under a

microscope. This procedure is called a biopsy.

If you do have

a peptic ulcer,

your doctor may

test your breath,

blood, or tissue

to see whether

bacteria caused

the ulcer.

8

Peptic ulcers can show up on x rays.
How are peptic ulcers treated?

Peptic ulcers can be cured. Medicines for peptic

ulcers are 

● proton pump inhibitors or histamine receptor

blockers to stop your stomach from making acids

● antibiotics to kill the bacteria 

Depending on your symptoms, you may take one

or more of these medicines for a few weeks.

They’ll stop the pain and help heal your stomach

or duodenum.

Ulcers take time to heal. Take your medicines

even if the pain goes away. If these medicines

make you feel sick or dizzy, or cause diarrhea

or headaches, your doctor can change your

medicines.

If NSAIDs caused your peptic ulcer, you’ll need to

stop taking them. If you smoke, quit. Smoking

slows healing of ulcers.

9
Can I use antacids?

Yes. If you have a peptic ulcer, taking antacids will

● stop the acids from working and reduce the pain

● help ulcers heal

You can buy antacids at any grocery store or drugstore. But you must take them several times a day.

Also, antacids don’t kill the bacteria, so your ulcer

could come back even if the pain goes away.

10

Antacids can reduce pain and help ulcers heal.
Can peptic ulcers come back?

Yes. If you stop taking your antibiotic too soon,

not all the bacteria will be gone and not all the

sores will be healed. If you still smoke or take

NSAIDs, your ulcers may come back.

What happens if peptic ulcers don’t

heal? Will I need surgery?

In many cases, medicine heals ulcers. You may

need surgery if your ulcers

● don’t heal

● keep coming back

● perforate, bleed, or obstruct the stomach or 

duodenum (see page 7)

Surgery can

● remove the ulcers

● reduce the amount of acid your stomach makes

11
What can I do to prevent peptic

ulcers?

● Stop using NSAIDs. Talk with your doctor about

other pain relievers.

12

What can I do to lower my risk of

getting peptic ulcers?

● Don’t smoke.

● Don’t drink alcohol.
Glossary

Barium (BAIR-ee-um): A chalky liquid used to

coat the inside of organs so that they will show

up on an x ray.

Biopsy (BYE-op-see): Removing a small piece of

tissue to view under a microscope.

Duodenum (doo-AW-deh-num): The first part of

your small intestine, right after your stomach.

Endoscopy (en-DAH-skoh-pee): A test to look

inside the stomach and small intestine. The

doctor uses a thin, flexible tube that contains a

light and a tiny video camera. This device is

called an endoscope.

Helicobacter pylori (HELL-ih-koh-BAK-tur 

py-LOH-ree): A bacterium that can damage

stomach and duodenal tissue, causing ulcers.

It is known as H. pylori for short.

For More Information

You can get information about peptic ulcers from

the

Centers for Disease Control and Prevention

1600 Clifton Road

Atlanta, GA 30333

Phone: 1–888–MY–ULCER or (404) 639–3534

Internet: www.cdc.gov

13
Acknowledgments

The National Digestive Diseases Information

Clearinghouse (NDDIC) would like to thank the

following individuals for assisting with scientific

and editorial review of this publication.

David A. Peura, M.D.

University of Virginia

Steven J. Czinn, M.D. 

Case Western University

Thanks also to Anne Barker, R.N., B.S.N., at the

Health Alliance, Columbia, MD, for facilitating

field-testing of this publication.

14
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Email: nddic@info.niddk.nih.gov

Internet: www.digestive.niddk.nih.gov

The National Digestive Diseases Information

Clearinghouse (NDDIC) is a service of the National

Institute of Diabetes and Digestive and Kidney Diseases

(NIDDK). The NIDDK is part of the National Institutes

of Health under the U.S. Department of Health and

Human Services. Established in 1980, the clearinghouse

provides information about digestive diseases to people

with digestive disorders and to their families, health care

professionals, and the public. NDDIC answers inquiries,

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Publications produced by the clearinghouse are carefully

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This publication is not copyrighted. The clearinghouse

encourages users of this booklet to duplicate and

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This booklet is also available at

www.digestive.niddk.nih.gov.
U.S. DEPARTMENT OF HEALTH 

AND HUMAN SERVICES

National Institutes of Health

National Institute of Diabetes and 

Digestive and Kidney Diseases

NIH Publication No. 05–5042

November 2004