Stomach (Peptic) Ulcers: Symptoms and Complications

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. 

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.

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.

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

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.