Bleeding Ulcers: Everything You Need to Know

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Peptic ulcer disease is a condition in which there are one or more sores (ulcers) in the stomach lining or in the lining of the first part of the small intestine (the duodenum). In some cases, an ulcer can bleed. The bleeding can be minimal or severe. Treatment can help with symptoms and eventually cause the ulcer to go away.

This article looks at the symptoms, causes, treatment, and complications of bleeding ulcers.

Man with stomach pain, possibly from ulcer

Moyo Studio / Getty Images

Symptoms

Minor ulcers may not cause any symptoms. But some potential symptoms of ulcers may include:

  • Pain in the upper abdomen
  • Pain on an empty stomach
  • Difficulty staying hydrated 
  • Feeling of fullness
  • Vomiting
  • Nausea
  • Fatigue
  • Weight loss
  • Heartburn
  • Bloating
  • Lack of appetite
  • Burping

If an ulcer is bleeding, you may also experience:

Often, people don’t know they have a bleeding ulcer. They might have extreme fatigue or other symptoms of anemia (a low number of healthy red blood cells). The anemia may be diagnosed before the ulcer.

The pain from an ulcer tends to be dull and achy instead of sharp. It can last for hours or come and go.

When to Seek Medical Help

It’s important to see a healthcare provider if you’re experiencing several of the above-listed symptoms. An ulcer can lead to complications if left untreated. 

Get emergency treatment if you:

  • Experience sudden sharp pain in your abdomen
  • Develop a hard abdomen that hurts when you touch it
  • Are throwing up blood (this can look like coffee grounds)
  • Have blood in your stool 
  • Experience symptoms of shock like sweating profusely or confusion


Causes

Ulcers can happen for several reasons. Some of the most common causes are:

Helicobacter Pylori Bacteria

Most people with stomach ulcers have a Helicobacter pylori (H. pylori) infection present in their gut. However, not everyone with this type of bacteria will develop stomach ulcers.

This bacterium can damage the special mucous coating that protects the small intestine and stomach lining, allowing stomach acid to reach the lining and eat away at the tissue.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Frequently taking nonsteroidal anti-inflammatory drugs such as aspirin, Advil (ibuprofen), or Aleve (naproxen) can also elevate your risk of developing an ulcer.

While NSAIDs can help with pain, fever, and inflammation, they also reduce the natural mucous layer that protects the stomach from its own acid. This can lead to ulcers, especially if you take NSAIDs regularly.

Rare Tumors

A rare condition (Zollinger-Ellison syndrome) results in tumors that produce the hormone gastrin. This stimulates the release of large amounts of stomach acid and leads to ulcers.

Risk Factors

You’re at higher risk for developing ulcers if you:

  • Drink excessively
  • Smoke regularly
  • Use chewing tobacco
  • Are experiencing high amounts of stress
  • Have recently undergone radiation therapy
  • Are very ill
  • Use NSAIDs regularly

Treatment

The first-line treatment for ulcers caused by NSAIDs involves medication such as:

  • H2 blockers such as Pepcid (famotidine) that inhibit the production of stomach acid
  • Proton pump inhibitors (PPI) such as Prilosec (omeprazole) that reduce stomach acid production and protect the lining of the stomach
  • Medications like Carafate (sucralfate) that protect the lining of the stomach and small intestine
  • Antacids

If an H. pylori infection is causing your ulcer, a doctor will also prescribe antibiotics to kill any H. pylori bacteria in your digestive tract.

In some cases, doctors may also need to treat excessive bleeding. They can address this complication by:

  • Injecting medication directly into the ulcer
  • Using heat therapy on the ulcer
  • Clipping the ulcer with metal clips
  • Performing surgery

In cases where the bleeding is severe, a person may need a blood transfusion as part of treatment.

Typically, healthcare providers perform surgery when an ulcer is bleeding profusely, and the bleeding doesn’t stop. You may also need surgery if the stomach or small intestine lining tears because the ulcer has eaten away at the tissue.

Complications

Left untreated, an ulcer can eventually lead to a tear in the stomach or small intestine lining and cause severe internal bleeding. The bacterium Helicobacter pylori (often associated with ulcers) is in itself a significant risk factor for stomach cancer.

Outlook

Proper treatment can get rid of an ulcer and prevent serious complications. However, ulcers often come back. If you continue to take NSAIDs frequently, for example, you may develop another ulcer. 

Summary 

A bleeding ulcer isn’t a symptom to ignore. Untreated ulcers can lead to complications like severe blood loss or perforation of the tissue lining your stomach. Thankfully, there are ways to treat ulcers and stop bleeding.

If severe bleeding or treatment doesn’t stop or slow the bleeding, a healthcare provider may recommend surgery. 

A Word From Verywell

If you have any symptoms of an ulcer, make an appointment with a healthcare provider to get a diagnosis and start treatment. Blood in your stool or vomit, along with severe abdominal pain, is a sign that you have internal bleeding that needs immediate attention.

Ideally, you should receive treatment before an ulcer gets to this point. With treatment, most ulcers will heal and won’t lead to complications like severe blood loss.

Frequently Asked Questions

  • What does a bleeding ulcer feel like?

    Because an ulcer is a wound inside your body, it won’t feel the same as a cut or scrape on the surface of your skin. You may not even have symptoms. If an ulcer starts to bleed heavily, though, you may feel light-headed or faint because of blood loss. 

  • Will a bleeding ulcer heal on its own?

    Sometimes. However, ulcers tend to return on their own, too. Getting treatment increases the chances that ulcers won’t come back. 

  • How long does it take for a bleeding ulcer to heal?

    This depends on the type and size of the ulcer. A large stomach ulcer, for instance, may take several months to heal.

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6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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