Stomach (Peptic) Ulcers: Symptoms and Complications

Many people do not experience any symptoms at all

Peptic ulcers are open wounds found either in the stomach (gastric ulcers) or the upper part of the small intestine, otherwise known as the duodenum (duodenal ulcers). Pain is the most common peptic ulcer symptom, though many people do not experience any symptoms at all.

Peptic ulcers can get worse, may bleed, and can cause a perforation (hole) or obstruction (blockage) in the digestive system—all serious emergencies. This is why you should consult a healthcare provider if you notice any related symptoms. 

Woman in bed with severe morning stomach pain
Anna Bizon / Getty Images

Common Symptoms

Pain is the most common symptom of a peptic ulcer. Typically, ulcer pain is located in the upper part of the abdomen, anywhere from your breastbone to your navel, but you may also feel it in your back.

Your pain may be dull, burning, or gnawing. It is less commonly described as intense or stabbing. 

Often, the pain is worse at night or in the morning, but it can vary. The duration of pain can last from a few minutes to a few hours. Many people with peptic ulcers particularly complain of pain on an empty stomach. You may experience relief immediately after eating only to have pain return or worsen within an hour.

This brief reprieve does not cause people with ulcers to overeat, however, as frequent nausea and discomfort can quash appetite or the desire to eat. Some people feel that certain foods (like high-fat choices) make peptic ulcer symptoms worse, while other foods soothe an ulcer.

Risk Factors for Peptic Ulcers

Lifestyle factors, such as smoking, are a risk factor. Acidic foods and alcohol use change the stomach lining and can make it more susceptible to Helicobacter pylori  (H. pylori) infection, a known cause of stomach ulcers. Overuse of  nonsteroidal anti-inflammatory drugs (NSAIDs), medical conditions such as Crohn's disease, and a genetic predisposition also may lead to peptic ulcers.

Other common symptoms of a peptic ulcer include:

  • Discomfort, bloating
  • Indigestion, heartburn
  • Chronic nausea or a sense of discomfort with eating
  • Frequent burping
  • Loss of appetite

The warning signs of an ulcer also can include unexplained anemia or iron deficiency.

Rare Symptoms

These symptoms are rare, but are more severe and could point to a complication:

  • Vomiting (with or without blood)
  • Blood in the stool; black and tarry stool
  • Fatigue or weakness, which can result from malnutrition or anemia due to small amounts of bleeding from the ulcer
  • Unexplained weight loss

Symptoms of peptic ulcers can occur as a result of other conditions, including gastroesophageal reflux disease (GERD), chronic dyspepsia, gallbladder disease, liver disease, or a gastrointestinal infection. It's important to see your healthcare provider to determine what's at the root of your pain.

Peptic Ulcer Complications

There are many complications that can occur if you have a chronic or worsening peptic ulcer. These include:

  • Bleeding: Bleeding is the most common complication of peptic ulcer disease. Slow and subtle bleeding can often go unnoticed and may be detected only once you have developed anemia due to this constant small loss of blood. Black or tarry stools are a sign of this bleeding. But the ulcer can erode a blood vessel and cause a sudden and even massive blood loss, becoming life-threatening.
  • Malnutrition: You can become deficient in vitamins and minerals due to low food intake. Immune deficiencies, bone weakness, and skin fragility can all result from malnutrition, but may not be noticeable at first. However, malnutrition is not common in today's world as a complication of peptic ulcers.
  • Perforation: An ulcer can eventually wear away at the lining of the stomach or small intestine, causing a perforation (hole), which can leak gastrointestinal fluid into the body. This can cause severe abdominal pain and shock. This is an emergency that requires urgent medical treatment, which is often surgery.
  • Obstruction: An ulcer can become inflamed, blocking the passageway of digested food and causing severe dysfunction of the small intestine. Like perforation, this is a medical emergency.
  • Fistula: A perforated ulcer can establish a connection (fistula) with an adjacent abdominal organ or structure, including the colon, biliary tree, pancreas, or a major blood vessel. This results in exchanges of material and fluids, which can result in vomiting these materials or hemorrhages. This is a medical emergency that requires surgical correction.

Peptic ulcer symptoms may be due to H. pylori infection, but there are some habits that can contribute to their development, such as taking NSAIDs or smoking.

These habits interfere with your natural production of the mucus that coats your digestive system to protect it from acidity, abrasion, and bleeding.

Despite common misconceptions, one lifestyle factor that does not cause ulcers is stress. Healthcare providers used to attribute ulcers to stress until the link to H. pylori was discovered.

When to See a Healthcare Provider

You may feel relief with an antacid, but you should not ignore symptoms of a peptic ulcer. If you have persistent symptoms for longer than a week, it is best to see your healthcare provider. They will determine whether you need prescription medications and whether you have complications, such as bleeding or anemia. 

Make an appointment with your healthcare provider if you have:

  • Pain that radiates to the back
  • Pain that doesn't go away when you take medication
  • Unintended weight loss
  • Weakness, fatigue
  • Vomiting
  • Difficulty swallowing

Call or see a healthcare provider immediately if you have these serious symptoms:

  • Vomiting blood
  • Black or tar-like stool
  • Sudden, severe pain in the abdominal area
  • Fever
  • Chills, shaking
  • Dizziness
  • Loss of consciousness

A Word From Verywell

Peptic ulcers do not simply go away on their own. Be sure to see your healthcare provider when you notice the symptoms. While such an ulcer can take time to heal, the discovery of H. pylori as a cause makes it curable rather than something you must simply learn to live with.

Frequently Asked Questions

  • What are the symptoms of a bleeding ulcer?

    Symptoms may include vomiting blood that looks like coffee grounds and bowel movements that look black and tarry. You may also have anemia from bleeding, which can cause you to feel weak or faint. Seek emergency care for symptoms of a bleeding ulcer.

  • How long do ulcer symptoms last?

    Pain may last for minutes or hours at a time. Symptoms will keep coming back until you get treatment for the ulcer. With treatment, the ulcer may take about eight weeks to heal, but the pain usually goes away after several days.

  • How are peptic ulcers treated?

    Many cases of peptic ulcer are due to H. pylori infection, which is treated with an antibiotic. Drugs known as H2 blockers and proton pump inhibitors limit stomach acids. In some cases, surgery may be needed.

11 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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Additional Reading

By Sharon Gillson
 Sharon Gillson is a writer living with and covering GERD and other digestive issues.