In short
Peptic ulcers form when the protective lining of the stomach or upper small intestine breaks down, most often from an H. pylori infection or long-term NSAID use — and both are treatable once identified.
On your report
Hemoglobin
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01
What Causes an Ulcer
A peptic ulcer is an open sore in the lining of the stomach (a gastric ulcer) or the first part of the small intestine (a duodenal ulcer), where stomach acid has worn through the protective mucus layer. The two dominant causes are infection with Helicobacter pylori, a common stomach bacterium, and regular use of NSAID pain relievers like ibuprofen or naproxen, which weaken that protective lining.
Contrary to older assumptions, stress and spicy food don't cause ulcers on their own, though they can make existing symptoms feel worse. Smoking and heavy alcohol use also raise the risk and can slow healing.
02
Symptoms to Watch For
A burning or gnawing pain in the upper abdomen is the most common symptom. Duodenal ulcers classically hurt more on an empty stomach and ease temporarily with food or antacids, while gastric ulcers can do the opposite and worsen soon after eating — but the overlap between the two is large enough that the pattern alone can't reliably tell them apart. Bloating, nausea, and feeling full quickly can also occur.
Vomiting blood or material that looks like coffee grounds, black or tarry stools, or sudden, severe abdominal pain that spreads can mean the ulcer is bleeding or has perforated the stomach or intestinal wall — these need emergency care immediately, not a scheduled appointment.
03
Getting Tested
H. pylori infection is checked with a breath test, stool test, or biopsy taken during an upper endoscopy — a thin camera passed through the mouth to directly view the stomach lining, which can also confirm and locate the ulcer itself. Blood antibody tests for H. pylori are less reliable and less commonly used now.
A complete blood count checking hemoglobin is often included when an ulcer is suspected, since a slow ulcer bleed can lower blood counts gradually before causing obvious symptoms.
04
Treatment
H. pylori-related ulcers are treated with a short course combining antibiotics and an acid-reducing medication, which clears the infection in most people and allows the ulcer to heal. NSAID-related ulcers are managed by stopping or reducing the NSAID where possible and taking acid-reducing medication to let the lining heal.
Most ulcers heal within a few weeks to a couple of months of appropriate treatment. A repeat test to confirm H. pylori has actually cleared is standard practice, since treatment occasionally fails on the first attempt and needs a different antibiotic combination.
05
Preventing Recurrence
Avoiding unnecessary NSAID use, not smoking, and moderating alcohol are the main modifiable factors. Anyone who needs NSAIDs regularly for another condition can discuss adding a protective, acid-reducing medication with their doctor rather than stopping a needed treatment outright.
A gastroenterologist is the right specialist for ulcers that don't heal as expected, recur, or need a closer look with endoscopy. A gastric ulcer that hasn't healed on a follow-up endoscopy is usually biopsied if it wasn't already, since a small share of gastric ulcers turn out to be a cancer rather than a benign ulcer — persistent symptoms after a full course of treatment are worth reporting rather than repeating over-the-counter remedies indefinitely.
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Sources
- Peptic Ulcermedlineplus.gov
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