Peptic (Stomach) Ulcers: Causes, Symptoms, and Relief

A burning stomach pain that comes and goes could be a peptic ulcer — an open sore in the stomach or upper gut. A clear guide to what causes ulcers (it's often not stress or spicy food), symptoms, and treatment.

A gnawing or burning pain in the upper stomach that comes and goes — often between meals or at night — could be a peptic ulcer: an open sore in the lining of the stomach or the first part of the small intestine. Ulcers are common and very treatable, but they're also widely misunderstood — most people blame stress and spicy food, when the real causes are usually different. This is a clear, plain-language guide to peptic ulcers: what actually causes them, the symptoms, and how they're treated.

What Is a Peptic Ulcer?

A peptic ulcer is a sore that forms where stomach acid has damaged the protective lining of the stomach (gastric ulcer) or the duodenum (the first part of the small intestine). Normally the lining protects against acid; when that protection breaks down, an ulcer can form. This causes the characteristic pain and, if untreated, can lead to complications.

The Real Causes (It's Usually Not Spicy Food)

Busting the ulcer myths Contrary to popular belief, ulcers are not usually caused by stress or spicy food — those can aggravate symptoms, but they're rarely the cause. The two main causes are actually a bacterium called H. pylori (a common stomach infection) and regular use of certain painkillers (NSAIDs like some anti-inflammatory tablets). Knowing this matters, because it points to the real treatment.
  • H. pylori infection — a very common cause, treatable with specific medicines
  • Regular NSAID painkillers (like ibuprofen-type drugs), especially long-term
  • Smoking and heavy alcohol can contribute
  • Spicy food and stress may worsen symptoms but usually aren't the root cause

Symptoms

  • A burning or gnawing pain in the upper abdomen — often between meals or at night
  • Pain that may ease or worsen with eating (varies by ulcer type)
  • Bloating, feeling full quickly, nausea, or indigestion
  • Sometimes no symptoms until a complication occurs
Warning signs — seek urgent care
  • Vomiting blood, or vomit that looks like coffee grounds
  • Black, tarry stools or blood in stool (signs of bleeding)
  • Sudden, severe, or worsening stomach pain
  • Feeling faint, or a rigid, very tender abdomen — seek emergency care

These can signal a bleeding or perforated ulcer — a medical emergency needing immediate attention.

How It's Treated

The good news: peptic ulcers usually heal well with the right treatment. This typically means medicines to reduce stomach acid (allowing the ulcer to heal), and — crucially — treating the cause: antibiotics to clear H. pylori if present, and stopping or changing the painkillers responsible. A doctor may arrange tests (for H. pylori, and sometimes an endoscopy). Because the cause matters, self-treating with antacids alone often isn't enough — see a doctor to sort out the underlying reason.

When to See a Doctor

See a doctor for persistent or recurring upper-stomach pain, indigestion that doesn't settle, or if you regularly take painkillers and get stomach pain — proper diagnosis and treating the cause (H. pylori, painkillers) is what actually heals an ulcer. Treat vomiting blood, black stools, or severe pain as an emergency. An online consultation is a good first step to describe symptoms, arrange testing (like for H. pylori), and get the right treatment. Ulcers are very treatable once the real cause is addressed. (See our guides on acidity/heartburn, chronic acid reflux/GERD, and using antibiotics wisely.)

A note on sources General education based on trusted public health and gastroenterology sources (NHS, NIH). It does not replace an assessment by a doctor, who diagnoses the cause and treats peptic ulcers.

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