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Heartburn

Updated 22 August 2018

Symptoms of peptic ulcers

Many people with ulcers suffer from severe burning pain in the upper abdomen, immediately after a meal and often at night.

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Symptoms of peptic ulcers vary widely. Although an estimated 70% of people don’t experience indigestion, discomfort or any of the other symptoms commonly associated with these ulcers, others suffer from a severe dyspepsia – i.e. discomfort and a burning, gnawing pain in the upper abdomen (between the navel and the lower end of the breastbone).

This pain usually occurs during or immediately after eating a meal (this is common in the case of a gastric ulcer), 2-3 hours after enjoying a meal (most often in the case of a duodenal ulcer), and often between 12am and 2am at night.

The pain in the upper abdomen may also occur after drinking fruit juice, coffee, tea or alcohol, or after taking aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs). Eating something or taking an antacid usually relieves the discomfort in benign ulcers.

Any condition that “stiffens” the stomach muscles (such as stomach cancer, stomach-outlet obstruction, large pre-pyloric ulcers and non-ulcer dyspepsia) impairs the ability of the stomach to accommodate the increased volume of a meal and will lead to symptoms during or within 10 minutes after eating. It’s of utmost importance to see a medical practitioner when these latter symptoms are present.

Other symptoms include:

  • A bloated or full feeling during or after meals
  • Belching
  • Loss of appetite
  • Hunger pangs
  • Weight loss
  • Fatigue (a sign of chronic bleeding and anaemia)
  • Back pain (less common)
  • Difficulty breathing
  • Nausea and occasional vomiting (vomiting may relieve pain)
  • Tar-like, black or bloody stools

A peptic ulcer may cause heartburn – a result of increasing acid build-up and reflux into the oesophagus (gullet). And symptoms of peptic ulcers may last anything from a few minutes to a couple of hours.

Other health problems may present with similar symptoms, so it’s important to see your healthcare practitioner to confirm the diagnosis.

Read more: 
How peptic ulcers are diagnosed
What are peptic ulcers?
The causes of peptic ulcers

Reviewed by Dr Estelle Wilken, senior specialist in Internal Medicine and Gastroenterology at Tygerberg Hospital. December 2017.