A peptic ulcer is a sore in the lining of your stomach (gastric ulcer) or your duodenum, the first part of your small intestine (duodenal ulcer).

Peptic ulcers occur when the acids that help you digest food damage the walls of the stomach or duodenum.

The most common cause is infection with a bacteria called Helicobacter pylori (H. pylori). Other causes may include:

  • Drinking too much alcohol
  • Regular use of aspirin, ibuprofen, naproxen, or other nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Smoking cigarettes or chewing tobacco
  • Being very ill, such as being on a breathing machine
  • Having radiation treatments

Stress and spicy foods do not cause ulcers, but can make them worse.

Small ulcers may not cause any symptoms but burning stomach pain is the most common. The pain:

  • Starts between meals or during the night
  • Briefly stops if you eat or take antacids
  • Lasts for minutes to hours
  • Comes and goes for several days or weeks

Other possible symptoms include:

  • Bloody or dark tarry stools
  • Chest pain
  • Fatigue
  • Vomiting, possibly bloody
  • Weight loss


To diagnose an ulcer, your doctor may order:

  • An upper endoscopy (EGD)
  • An upper GI series of X-ray tests for H. pylori
  • A hemoglobin blood test to check for anemia
  • Stool occult blood test to test for blood in the stool


Peptic ulcers will get worse if not treated. Treatment may include medicines to reduce stomach acids or antibiotics to kill H. pylori. Antacids and milk can't heal peptic ulcers. Not smoking and avoiding alcohol can help.

If a peptic ulcer bleeds a lot and/or does not heal, an Esophagogastroduodenoscopy (EGD) may required. Methods used to stop the bleeding include injecting medicine into and/or applying metal clips to ulcer. If the EGD fails to stop the bleeding and the ulcer has caused a tear, surgery may be required.

There is a good chance that the H. pylori infection will be cured if you take your medicines and follow your doctor’s treatment advice. You will be much less likely to get another ulcer.

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