Diagnosis of a stomach ulcer typically involves either an upper gastrointestinal (GI) series or an endoscopy.

If you’re experiencing a stomachache or what could be stomach ulcer symptoms, you should know that there are many types of ulcers and many places within the digestive system in which they can occur.

For instance, peptic ulcer symptoms start with a sore that forms in the lining of the stomach (gastric ulcer) or the first section of the small intestine (duodenal ulcer). Gastric ulcers can occur anywhere in the stomach; however, they are most common in the lower part of the stomach (called the antrum). Duodenal ulcers occur in the first few inches of the small intestine (the duodenum).

In the past, it was thought that ulcers were caused by stress, spicy foods, or an overabundance of stomach acid. It’s now known that amongst the main causes of ulcers is an infection with the bacterium H. pylori. Long-term use of NSAIDs also can cause ulcers. Older adults are more likely to have ulcers, which may be because they have a higher infection rate with H. pylori or because they use more NSAIDs.

Stomach Ulcer Symptoms: What You’ll Feel

The first stomach ulcer symptom is usually a burning sensation in the upper to middle abdomen within one to two hours after a meal. Other symptoms of an ulcer may include:

• Pain that feels like a dull, gnawing ache.
• Pain that is intermittent or constant, lasting for days to weeks at a time before subsiding.
• Pain that strikes in the middle of the night, or any other time the stomach is empty.
• Pain that decreases after meals.

Some stomach ulcer symptoms warrant emergency medical attention because they indicate that the ulcer has caused a perforation in the stomach or duodenal wall, broken a blood vessel, or blocked the path of food leaving the stomach and entering the intestine.

If you experience bleeding ulcer, characterized by any of the following symptoms, seek medical help right away:

• Sharp, sudden, persistent stomach pain.
• Bloody or black stools.
• Bloody vomit or vomit that looks like coffee grounds.

Stomach Ulcer Diagnosis

To diagnose an ulcer, the first test performed will probably be either an upper gastrointestinal (GI) series or an endoscopy. An upper GI series is an X-ray of the esophagus, stomach, and duodenum. If there is an ulcer, testing for H. pylori bacteria follows.

Treatments for ulcers are highly effective. The three goals to treat ulcers caused by bacteria are to reduce stomach acid, protect the stomach lining, and kill the bacteria. This triple therapy allows the ulcer to heal and lowers the chance that it will come back. Antibiotics are used to destroy the bacteria. Reducing stomach acid is generally accomplished with a proton pump inhibitor (PPI), and sucralfate and bismuth are typical medications to protect the stomach lining.

Originally published in May 2016 and updated.