Peptic Ulcers: Symptoms, Causes, Diagnosis, Treatment, and Prevention
Health ConditionsDigestive Health

What Are Peptic Ulcers?

What Are Peptic Ulcers?
Everyday Health
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Updated on March 23, 2026
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A peptic ulcer is a type of sore that develops on the inner lining of your stomach or duodenum, the upper part of your small intestine just beyond your stomach. In some cases, a peptic ulcer may develop just above your stomach, in your esophagus.

Anyone can develop a peptic ulcer. They’re often caused by a bacterial infection or certain medications. In rare cases, tumors cause them. Contrary to popular belief, they don't happen due to having stress or eating spicy foods. The most common symptom is simply abdominal pain. And the good news is that peptic ulcers are very treatable.

Types of Peptic Ulcers

Peptic ulcers are quite common, affecting about 4 million people each year in the United States. It’s estimated that 1 in 10 people will develop a peptic ulcer at some point.

 The most common kinds are named based on the location where they occur. These include:

  • Gastric Ulcers A common type of ulcer, these occur on the inside of your stomach.
  • Duodenal Ulcers These are located in the upper part of your small intestine, called the duodenum.
  • Esophageal Ulcers These occur less commonly inside your esophagus, the tube that carries food from your throat to your stomach.

You can have more than one type of peptic ulcer at the same time.

Signs and Symptoms of Peptic Ulcers

Many people with peptic ulcers don’t have any signs or symptoms. If they do, upper abdominal pain is often the most common one. But abdominal pain can occur anywhere from your navel up to your breastbone, and it may follow any of these patterns:

  • Feels worse when your stomach is empty
  • Feels better temporarily when you eat or take an antacid
  • Gets worse at night
  • Comes and goes for days or weeks
Less commonly, a severe or complicated peptic ulcer may cause the following symptoms:

  • Nausea or vomiting
  • Vomiting red or dark blood
  • Bloody, black, or tar-like stools
  • Changes in your appetite
  • Feeling dizzy or fainting

Causes and Risk Factors of Peptic Ulcers

For a long time, it was thought that spicy foods or stress caused peptic ulcers — but doctors now know that isn’t the case. Those two factors can, however, make peptic ulcer symptoms worse.

In fact, the most common causes of ulcers are:

  • Use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, Advil or Motrin (ibuprofen), and Aleve (naproxen), can damage the inner lining of your digestive tract
  • Helicobacter pylori (H. pylori) is a type of bacteria that can infect your stomach
Certain factors may put you at greater risk of developing a peptic ulcer, including:

  • Taking high doses of NSAIDs
  • Taking NSAIDs regularly over a long period of time
  • Taking both NSAIDs and corticosteroids, medications that may be prescribed to treat asthma, arthritis, or lupus
  • Being 60 or older with other risk factors
  • Smoking
  • Drinking alcohol
  • Having a history of peptic ulcers
In very rare cases, peptic ulcers may be caused by a condition called Zollinger-Ellison syndrome (also known as gastrinoma). It occurs when a tumor of acid-producing cells forms in the digestive tract, producing an excessive amount of acid that damages nearby tissue.

 Other rare causes of peptic ulcers may include serious illness, surgery, or medications other than NSAIDs.

How Are Peptic Ulcers Diagnosed?

If your doctor suspects that you may have a peptic ulcer, the next steps include taking a full medical history and performing a physical exam. Your doctor may also order the following diagnostic tests:

  • Lab Test A stool test or a breath test may be used to determine whether H. pylori bacteria are present in your body.
  • Endoscopy During this procedure, a flexible tube with a camera will be passed down your throat to your esophagus, stomach, and small intestine. It allows your doctor to look for a peptic ulcer and take a biopsy (tissue sample) if one is present.
  • Barium Swallow For this test, you’ll swallow a white liquid containing barium, which coats your digestive tract to make ulcers more visible in a series of X-rays of your upper digestive tract.

Treatment and Medication Options for Peptic Ulcers

Your course of treatment will be based on the cause of your peptic ulcer. Treatment typically involves taking acid-suppressing medications to kill H. pylori bacteria, if present, and to promote healing, as well as stopping any medications that are causing your peptic ulcer. You may also experience symptom relief from certain lifestyle measures.

Medication Options

If your peptic ulcer is found to be caused by an H. pylori infection, your doctor will prescribe antibiotics to kill the bacteria in your digestive tract.

Over-the-counter antacids like Mylanta, Rolaids, or Tums can help you feel better, but they will not heal ulcers. If left untreated, complications from ulcers can occur.

Proton pump inhibitors (PPIs) are drugs that block acid production and promote healing of peptic ulcers. PPI drugs include:

  • Lansoprazole (Prevacid)
  • Omeprazole (Prilosec)
  • Pantoprazole (Protonix)
  • Rabeprazole (Aciphex)
Acid blockers, also called H2 blockers, reduce acid production and heal ulcers. These include:

  • Cimetidine (Tagamet HB)
  • Famotidine (Pepcid)
  • Nizatidine (Axid AR)

Lifestyle Changes and Prevention of Peptic Ulcers

Certain lifestyle changes may help you recover from a peptic ulcer:

  • Watch your diet. If you know that specific foods or drinks make your ulcer feel worse, avoid them until your treatment is over. For many people, these include alcohol, caffeine, fatty foods, or spicy foods.
  • Stop smoking. Ulcers take longer to heal, and medications for ulcer treatment may be less effective if you are a smoker. Scientists don’t know exactly why smoking has those effects.
  • Use pain medications with caution. Pain relievers known as NSAIDs, which include aspirin, ibuprofen, and naproxen, can slow ulcer healing even if they didn’t cause your peptic ulcer. Acetaminophen (Tylenol) does not cause ulcers, so it may be a good substitute. Be sure to talk to your doctor before taking any of these medications; they may continue putting you on a PPI drug to prevent ulcer recurrences. Taking medication with food may also help.

As far as prevention, peptic ulcers caused by H. pylori are not usually preventable. That said, you may be able to prevent other types of peptic ulcers by avoiding overuse of NSAIDs, limiting alcohol, or avoiding smoking.

How Long Do Peptic Ulcers Last?

Peptic ulcers caused by medication usually begin to heal shortly after you stop taking the medication. Doctors often recommend taking antacids for two to six weeks to assist with healing and relieve pain.

Ulcers caused by H. pylori will heal when the bacteria are killed. The typical course of treatment includes two weeks of antibiotics, along with acid-suppressing medicine. This is usually followed by an additional eight weeks of acid-suppressing medicine alone.

An ulcer can heal temporarily without antibiotics, but it will likely recur — or another one will form nearby — if the bacteria are not killed.

In general, stomach ulcers can take roughly four to eight weeks to heal with appropriate medical treatment. But healing time will vary among individuals.

Complications of Peptic Ulcers

Without treatment, peptic ulcers can result in severe complications and potential health emergencies, including:

  • Internal Bleeding Ulcers can cause bleeding that occurs quickly or slowly over time. Gradual bleeding can lead to anemia (inadequate red blood cells), while sudden bleeding often requires immediate hospitalization, potentially including a blood transfusion.
  • Perforation (Hole) in the Stomach Wall If an ulcer eats through your stomach wall completely, you’ll be at risk of an infection in your abdominal cavity (peritonitis), which may be life-threatening.
  • Obstruction Swelling or scarring related to your ulcer can block the passage of food through your digestive tract. If that happens, you may feel full quickly or vomit when you eat, and you may lose weight.

If you think you or someone you know is having an ulcer emergency, seek immediate medical attention.

The Takeaway

  • Peptic ulcers are sores that can develop on the inner lining of your stomach, upper intestines, and occasionally your esophagus.
  • Although peptic ulcers were once thought to be caused by stress, they’re actually often caused by H. pylori bacterial infections or the chronic use of certain medications, like NSAIDs.
  • Peptic ulcers are marked by abdominal pain that may feel worse when your stomach is empty and feel better temporarily when you eat or take an antacid. In severe cases, peptic ulcers can lead to dangerous symptoms like vomiting blood, blood in the stool, and unexplained weight loss.
  • If you think you have an ulcer, avoid self-medicating and see a doctor for proper diagnosis and treatment.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
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  3. Stomach Ulcer. Cleveland Clinic. March 18, 2024.
  4. Stomach and Duodenal Ulcers (Peptic Ulcers). Johns Hopkins Medicine.
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Yuying Luo, MD

Medical Reviewer

Yuying Luo, MD, is an assistant professor of medicine at Mount Sinai West and Morningside in New York City. She aims to deliver evidence-based, patient-centered, and holistic care for her patients.

Her clinical and research focus includes patients with disorders of gut-brain interaction such as irritable bowel syndrome and functional dyspepsia; patients with lower gastrointestinal motility (constipation) disorders and defecatory and anorectal disorders (such as dyssynergic defecation); and women’s gastrointestinal health.

She graduated from Harvard with a bachelor's degree in molecular and cellular biology and received her MD from the NYU Grossman School of Medicine. She completed her residency in internal medicine at the Icahn School of Medicine at Mount Sinai, where she was also chief resident. She completed her gastroenterology fellowship at Mount Sinai Hospital and was also chief fellow.

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Ashley Welch has more than a decade of experience in both breaking news and long-form storytelling. She is passionate about getting to the crux of the latest scientific studies and sharing important information in an easy-to-digest way to better inform decision-making. She has written about health, science, and wellness for a variety of outlets, including Scientific American Mind, Healthline, New York Family, Oprah.com, and WebMD.

She served as the health editor for CBSNews.com for several years as a reporter, writer, and editor of daily health news articles and features. As a former staff member at Everyday Health, she covered a wide range of chronic conditions and diseases.

Welch holds a bachelor's degree from Fordham University and a master's degree from the Craig Newmark Graduate School of Journalism at the City University of New York, where she studied health and science reporting. She enjoys yoga and is an aspiring runner.

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