Digestive Health Peptic Ulcer Disease Peptic Ulcer Disease Guide Peptic Ulcer Disease Guide Symptoms Causes Diagnosis Treatment Coping Symptoms of Peptic Ulcer Disease By Sharon Gillson Sharon Gillson is a writer living with and covering GERD and other digestive issues. Learn about our editorial process Sharon Gillson Medically reviewed by Medically reviewed by Akash Goel, MD on March 11, 2020 linkedin Akash Goel, MD, is board-certified in internal medicine and practices gastronomy and internal medicine. He is an assistant professor at Weill Cornell Medical Center in New York City. Learn about our Medical Review Board Akash Goel, MD on March 11, 2020 Print Table of Contents View All Frequent Symptoms Rare Symptoms Complications When to See a Doctor Next in Peptic Ulcer Disease Guide Causes and Risk Factors of Peptic Ulcers 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). Peptic ulcers can cause a variety of symptoms, such as pain, discomfort, or gas, 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 your doctor if you notice any related symptoms. Anna Bizon / Getty Images Frequent Symptoms Pain is the most common symptom of a peptic ulcer. It is typically 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 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 squash appetite or the desire to eat. Some people feel that certain foods (like fatty choices) exacerbate the symptoms, while other foods either alleviate or do not affect them. While pain is the most common symptom, be aware that more than half of the people with peptic ulcers have no symptoms at all. Other common symptoms of peptic ulcers include: Discomfort, bloatingIndigestion, heartburnChronic nausea or a sense of discomfort with eatingFrequent burpingLoss of appetite Signs 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 stoolFatigue or weakness, which can result from malnutrition or anemia due to small amounts of bleeding from the ulcerUnexplained 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 doctor to determine what's at the root of your pain. Complications There are a number of 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 loss of blood, 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. Complications of Peptic Ulcers People are prone to peptic ulcers due to infection by the Helicobacter pylori bacterium, but there are some habits that can contribute to their development, such as taking non-steroidal anti-inflammatory medications (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. Doctors use to attribute ulcers to stress until Helicobacter pylori was discovered. When to See a Doctor/Go to the Hospital 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 doctor. He or she will determine whether you need prescription medications and whether you have complications, such as bleeding or anemia. Make an appointment with your doctor if you have: Pain that radiates to the backPain that doesn't go away when you take medicationUnintended weight lossWeakness, fatigueVomitingDifficulty swallowing Call or see a doctor immediately if you have these serious symptoms:Vomiting bloodBlack or tar-like stoolSudden, severe pain in the abdominal areaFeverChills, shakingDizzinessLoss of consciousness A Word From Verywell Peptic ulcers do not simply go away on their own. Be sure to see your doctor 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. Causes and Risk Factors of Peptic Ulcers Was this page helpful? Thanks for your feedback! Gas pain? Stool issues? Sign up for the best tips to take care of your stomach. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article 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. Lee SP, Sung IK, Kim JH, Lee SY, Park HS, Shim CS. Risk Factors for the Presence of Symptoms in Peptic Ulcer Disease. Clin Endosc. 2017;50(6):578-584. doi:10.5946/ce.2016.129 Malik TF, Singh K. Peptic Ulcer Disease. StatPearls Publishing. Updated December 4, 2018. Budimir I, Stojsavljević S, Baršić N, et al. Scoring systems for peptic ulcer bleeding: Which one to use? World J Gastroenterol. 2017;23(41):7450-7458. doi:10.3748/wjg.v23.i41.7450 Vomero ND, Colpo E. Nutritional care in peptic ulcer. Arq Bras Cir Dig. 2014;27(4):298-302. doi:10.1590/S0102-67202014000400017 Chung KT, Shelat VG. Perforated peptic ulcer - an update. World J Gastrointest Surg. 2017;9(1):1-12. doi:10.4240/wjgs.v9.i1.1 Ramakrishnan K, Salinas RC. Peptic Ulcer Disease. Am Fam Physician. 2007;76(7):1005-1012. Culafić DM, Matejić OD, Dukić VS, Vukcević MD, Kerkez MD. Spontaneous gastrojejunal fistula is a complication of gastric ulcer. World J Gastroenterol. 2007;13(3):483-5. doi:10.3748/wjg.v13.i3.483 Narayanan M, Reddy KM, Marsicano E. Peptic Ulcer Disease and infection. Mo Med. 2018;115(3):219-224. Konturek SJ, Bielański W, Płonka M, et al. Helicobacter pylori, non-steroidal anti-inflammatory drugs and smoking in risk pattern of gastroduodenal ulcers. Scand J Gastroenterol. 2003;38(9):923-30. doi:10.1080/00365520310004696 Additional Reading American College of Gastroenterology. Peptic Ulcer Disease. National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms & Causes of Peptic Ulcers (Stomach Ulcers).