Stomach Ulcers and H. pylori: Understanding the Pain

A burning or gnawing pain in the upper belly that comes and goes can be more than just “bad gas.” Stomach ulcers are a common and very treatable condition, but they are often misunderstood. Knowing what causes them and what symptoms to watch for can help you find relief and avoid complications.

What Is a Stomach Ulcer?

A stomach ulcer, also called a peptic ulcer, is an open sore that forms in the lining of the stomach or the first part of the small intestine. Normally a protective layer of mucus shields this lining from powerful stomach acid. When that protection breaks down, acid can damage the tissue and create a painful sore.

For many years people blamed ulcers on stress and spicy food. We now know the real culprits are usually a bacterial infection and certain medications.

What Causes Ulcers?

H. pylori Infection

The most common cause worldwide is a bacterium called Helicobacter pylori (H. pylori). This germ can live in the stomach lining for years, weakening its protective barrier and triggering inflammation. Many people carry H. pylori without symptoms, but in some it leads to ulcers. It is usually picked up in childhood through contaminated food or water.

The good news is that H. pylori is easily detected and can be cleared with a course of antibiotics combined with acid-reducing medicine.

Pain Relievers (NSAIDs)

The second major cause is the regular use of non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, diclofenac, and aspirin. These are often taken for joint pain, headaches, or arthritis. Used frequently or in high doses, they can irritate and erode the stomach lining.

Other contributors include smoking, heavy alcohol use, and, less commonly, other medical conditions.

Recognising the Symptoms

Ulcer symptoms can vary, but the most common include:

• A burning or gnawing pain in the upper abdomen, often between meals or at night
• Pain that eases temporarily after eating or taking antacids
• Bloating or a feeling of fullness
• Nausea or loss of appetite
• Belching or indigestion

Some people, especially older adults or those taking NSAIDs, may have an ulcer with few or no symptoms.

Warning Signs You Should Not Ignore

Occasionally ulcers cause bleeding or other complications. Seek medical care urgently if you experience:

• Vomiting blood or material that looks like coffee grounds
• Black, tarry, or bloody stools
• Sudden, severe, or sharp abdominal pain
• Unexplained weight loss
• Difficulty swallowing or feeling that food gets stuck
• Dizziness, weakness, or fainting

These can signal a bleeding or perforated ulcer, which needs prompt attention.

How Ulcers Are Treated

Most ulcers heal well with the right treatment:

• Acid-reducing medicines such as proton pump inhibitors lower stomach acid so the sore can heal
• Antibiotics clear H. pylori when it is present
• Stopping or adjusting NSAIDs, with your doctor’s guidance, removes a key cause
• Lifestyle changes like quitting smoking and reducing alcohol support healing

With treatment, symptoms often improve within days, though the full course is important to prevent the ulcer from returning.

When Is Endoscopy Needed?

An upper endoscopy is a quick procedure in which a thin, flexible camera is gently passed into the stomach while you are comfortably sedated. It lets the doctor see the ulcer directly, take a small sample to test for H. pylori, and rule out other causes. Endoscopy is usually recommended when:

• You are over 45 with new or persistent symptoms
• You have any of the warning signs above
• Symptoms do not improve with treatment
• The doctor needs to confirm the diagnosis or check that an ulcer has healed

It is a safe, routine test that provides clear answers.

When to See Phoenix Gastroenterology

Please book a visit if you have ongoing upper abdominal pain, frequent indigestion, or symptoms that keep returning despite over-the-counter remedies. You should also see us if you regularly take pain relievers and worry about your stomach, or if you would like to be tested for H. pylori.

Our specialists offer accurate testing, effective treatment, and on-site endoscopy when needed, helping you get to the root of the problem and find lasting relief.

This article is for educational purposes only and is not a substitute for personalised medical advice from a qualified healthcare provider.