Stomach Ulcers

Everyone has occasional heartburn. But if you’re feeling a burning, stinging pain in your stomach all the time, you might have an ulcer. Our gastroenterologists, dietitians and specially-trained nurses are all experts in digestive health. They’re here to help you figure out what’s causing your symptoms.

Types of stomach ulcers

The medical term for an ulcer is a peptic ulcer (it’s named after pepsin, one of the digestive juices in your stomach). There are two types of ulcers:

• Stomach ulcers (gastric ulcers): These are open sores in your stomach that happen when acid wears through your stomach lining.
• Small intestine ulcers (duodenal ulcers): Some ulcers aren’t in your stomach, and instead develop in the first section of your small intestine (your duodenum).

What to expect at your first visit

Trust your body and don’t downplay your symptoms. Our specialists are here to help you get to the bottom of what’s happening. Your provider will start by asking you a few questions. This will help them understand how you’re feeling and know which tests you’ll need. They’ll ask you:

• Which symptoms you’re experiencing.
• When your symptoms started, and if you notice when they get better or worse.
• Which medications or supplements you’re taking.
• How much your symptoms affect your life or your everyday routine.

We’ll also go over your medical history and give you a physical exam so we can check your overall health.

If your provider suspects that you have a stomach ulcer, you’ll need an upper endoscopy.

You might need some other tests, too, including:

• Blood tests.
• A breath test that checks for the bacterial infection that causes some ulcers (H. pylori).
• Stool tests to look for signs of H. pylori in your poop.
• X-rays.
• CT scan (computed tomography scan).

We’ll recommend treatments that can help relieve your pain and protect your stomach while it heals. Then, we’ll customize your treatment plan based on which type of ulcer you have and any complications it’s causing.

Over-the-counter medicine

Over-the-counter (OTC) medicine, like bismuth subsalicylate or other antacids, can relieve your symptoms. Other treatments will help heal your stomach lining.

Prescriptions

You might need prescription medications, including:

• Antibiotics: If a bacterial infection caused the ulcer, you’ll need antibiotics to kill it.
• Histamine receptor antagonists (H2 blockers): H2 blockers stop the chemical signals (histamines) that tell your body to produce more stomach acid.
• Proton pump inhibitors (PPIs): PPIs are strong acid blockers that help your tissue heal, too.
• Cytoprotective agents: These are medications that coat and protect your stomach lining.

Diet and lifestyle changes

Your provider might suggest making some changes in your daily routine to help your stomach heal and prevent ulcers from coming back. You might have to:

• Take NSAIDs less often.
• Eat fewer rich, high-fat or acidic foods.
• Quit smoking.
• Reduce how much alcohol you drink.
• Manage stress. Your mental health can affect your digestive health through the gut-brain connection.

Stomach ulcer surgery

Most people don’t need surgery to treat an ulcer. You might need an ulcer surgically repaired if it’s causing internal bleeding or has torn (perforated) your stomach or intestine. Your provider will walk you through each step of the process if you need surgery.

Follow-Up Care

Care doesn’t stop with your last treatment. We’ll check in with you after a few weeks of treatment to make sure your symptoms are getting better. You might need a follow-up visit with your specialists. Talk to your provider if your symptoms come back or get worse.

Taking the Next Step

It can be stressful when your stomach is on the attack — against itself. But know that stomach ulcers are very treatable with the right care. Cleveland Clinic’s digestive disease experts are here for you. We’ll find the best treatments for your symptoms now and while your stomach lining heals. And we’ll be there over the long run to help keep the pain at bay.