If you've got stomach pain and nausea, any number of gastrointestinal problems could be to blame. When these symptoms don't go away, one possibility is that you have a peptic ulcer. Let's talk about peptic ulcers.
A peptic ulcer is a defect in the lining of your stomach or the first part of your small intestine, the duodenum. When the defect is in your stomach, it's called a gastric ulcer. A defect in your duodenum is called a duodenal ulcer.
Your stomach is filled with strong acid, which breaks down and digests the foods you eat. If you've ever seen a strong acid at work, you know that it starts to burn away anything it touches. That's why your stomach and intestines are equipped with a special lining to protect them. But if that lining breaks down for any reason, acids can start eating their way through. When acids burn a hole all the way through the stomach or duodenum, it's called a perforation, and that's a medical emergency.
You may joke that your boss is giving you an ulcer, and it's possible that stress does play some part in ulcers. More likely, your ulcer is caused by a stomach infection with a type of bacteria called H. pylori. Other common ulcer risks include smoking cigarettes, drinking a lot of alcohol, or regularly using NSAID pain relievers like aspirin and ibuprofen.
If the ulcer is small, you may have no idea that you have it because there are no symptoms. Larger ulcers can cause abdominal pain, a feeling of fullness in the stomach, and nausea.
If you have any of these ongoing symptoms, your doctor will look inside your GI tract to see what's going on. One way to do this is with an upper endoscopy, a thin tube with a camera on one end that takes pictures as it moves through your stomach and small intestine. A lower GI is a series of x-rays that are taken after you drink a radioactive substance called barium. Your doctor will also test you for the H. pylori bacteria that may be causing your ulcer.
Treatment for peptic ulcers works in two ways. If you have an H. pylori infection, you'll have a medication regimen to kill the bacteria. You'll also get a medicine called a proton pump inhibitor, such as Prilosec or Prevacid, which reduces the amount of acid in your stomach.
Try to avoid taking NSAID pain relievers for long periods of time, especially if you have a problem with H. pylori. Use Tylenol instead. If you do have to take NSAIDs, also take an acid-blocking drug to protect your sensitive stomach. Also avoid tobacco smile and excess alcohol.
Follow your doctor's instructions carefully for treating a peptic ulcer. If you don't follow your treatment as directed, your ulcer could come back. Call your doctor right away if you have sharp stomach pain, you're sweating a lot or feeling confused, or your stomach feels hard to the touch. These could be signs of a serious ulcer complication that needs immediate medical help.
Review Date: 2/18/2016
Reviewed By: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.