Symptoms of peptic ulcers vary widely. Though many patients do not have indigestion or discomfort, others suffer from a severe burning or hunger pain in the upper abdomen (between the navel and the lower end of the breastbone), immediately after a meal and often at night.
This pain may also occur after drinking orange juice, coffee or alcohol, or after taking aspirin. Eating something or taking an antacid usually relieves the discomfort.
Other symptoms may include a bloated or full feeling during or after meals; nausea and vomiting; tar-like, black or bloody stools; weight loss and fatigue.
A duodenal ulcer may cause heartburn by increasing acid build up and reflux into the oesophagus.
When to call a doctor
Contact your doctor if:
- You have an ulcer and develop sudden, severe abdominal pain that your usual home treatment does not relieve. You suspect that you may have an ulcer but your symptoms do not improve within two weeks of home treatment
- You have been diagnosed with a stomach ulcer and suddenly get symptoms of anaemia, such as pallor, dizziness, weakness and fatigue – your ulcer may be bleeding and need medical attention.
- You have stomach ulcer symptoms and you have severe back pain – your ulcer may be perforating the wall of the stomach. You may need urgent surgery.
- You have stomach ulcer symptoms and vomit blood, which gastric acid may have changed to look like ground coffee – you may have internal bleeding. It is important to call a health professional urgently.
- You have an ulcer and become cold and clammy, feel faint or actually faint – these are symptoms of shock, usually due to massive blood loss. You’ll require immediate medical attention. You feel the kind of pain associated with a peptic ulcer and shortness of breath or other symptoms that might be related to heart problems. See a doctor urgently.
Note: that two to three percent of stomach ulcers become stomach cancer – report all continuing or recurrent symptoms to your doctor.
How peptic ulcers are diagnosed
What are peptic ulcers?
The causes of peptic ulcers
Revised and reviewed by Dr John P Wright MBChB, MRCP (UK), PhD. Gastroenterologist in private practice, Cape Town. February 2015
Previously reviewed by Prof Jan van Zyl, Department of Gastroenterology, University of the Free State, July 2011