What is an Ulcer?

An ulcer is an open sore that develops on an internal or external surface of the body. When people talk about ulcers, they most commonly refer to peptic ulcers, which are sores that form in the lining of the digestive tract.

This includes the lining of the stomach (gastric ulcers) and the upper part of the small intestine (duodenal ulcers). They occur when the protective layer of mucus in these areas is eroded, allowing corrosive stomach acid and digestive juices to damage the underlying tissue.

The two primary causes of peptic ulcers are infection with the bacterium Helicobacter pylori (H. pylori) and the long-term, regular use of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), such as ibuprofen and aspirin. While stress and spicy foods don’t cause ulcers, they can certainly make the symptoms worse.

What are the Warning Signs of an Ulcer?

Recognizing the warning signs of an ulcer is crucial for timely diagnosis and treatment, which helps prevent serious complications. The symptoms can vary in severity, and some people may not experience any noticeable symptoms at all (“silent ulcers”).

Common Symptoms

The most common and characteristic symptom of a peptic ulcer is abdominal pain:

• Burning or Gnawing Pain: This discomfort is typically felt in the upper abdomen (epigastric region), between the breastbone and the navel. It’s often described as a burning or gnawing sensation.
• Pain Timing: The pain frequently occurs when the stomach is empty, such as between meals or at night, and may wake you from sleep. Eating or taking antacids often provides temporary relief, especially with duodenal ulcers. Conversely, the pain from a gastric ulcer may be worsened by eating.
• Indigestion and Heartburn: Symptoms of general indigestion, like a feeling of bloating, fullness, and belching, are common. Heartburn, a burning sensation in the chest, can also be a sign.
• Nausea or Vomiting: Feeling sick to your stomach or vomiting may occur, particularly if the ulcer causes inflammation that obstructs the passage of food.

Severe and Emergency Warning Signs

If an ulcer erodes deeply, it can lead to complications such as bleeding or perforation (a hole in the digestive wall). These are medical emergencies and require immediate attention:

• Blood in Stool: Black, sticky, or tarry-looking stools (melena) indicate the presence of digested blood.
• Vomiting Blood: Vomit that contains bright red blood or looks like coffee grounds (partially digested blood).
• Sudden, Severe Abdominal Pain: Sharp, persistent, and intense pain that does not go away may indicate a perforation of the stomach or intestinal wall, a life-threatening condition.
• Unexplained Weight Loss or Loss of Appetite: This can be a sign of a severe ulcer or a rarer, more serious underlying condition.
• Signs of Severe Blood Loss: Feeling dizzy, faint, or experiencing paleness (pallor) or a rapid pulse.

Conclusion

While the occasional bout of indigestion is normal, persistent or worsening upper abdominal pain—especially when accompanied by any of the severe warning signs should not be ignored. Peptic ulcers are highly treatable, typically with antibiotics to eradicate H. pylori and medications to reduce stomach acid.

Early medical consultation for recurring or severe symptoms is vital to prevent complications and ensure a swift recovery. If you experience any symptoms of a bleeding ulcer or perforation, seek emergency medical care immediately.

Dr. Kailash Mishra
Director & Gastroenterologist Consultant
Prime Gastro Liver Clinic