Gastric Ulcer: Causes, Symptoms, Diagnosis, and Treatment

What is a Gastric Ulcer?

A gastric ulcer, also known as a stomach ulcer, is a type of peptic ulcer that forms an open sore in the lining of the stomach. This condition occurs when there is an imbalance in the stomach's natural defenses, leading to an erosion in the stomach mucosa.

In normal circumstances, the stomach's internal walls are protected by a mucus layer and various defense mechanisms from the corrosive action of gastric juices. However, when these defenses are compromised, the stomach lining becomes susceptible to damage.

Causes of Gastric Ulcers

The primary factor that weakens the stomach's defense and repair capabilities is a bacterium known as Helicobacter pylori. This bacterium settles between the mucus and the stomach wall, where it releases substances that damage the mucosal layer.

There are other contributing factors to the development of gastric ulcers, such as:

  • Poor dietary habits
  • Smoking
  • Chronic stress
  • Excessive alcohol consumption

Additionally, the prolonged use of certain medications, like non-steroidal anti-inflammatories and corticosteroids, can also lead to gastric ulcers. In rare cases, this condition can be a symptom of a more serious disease, such as a tumor.

Symptoms of Gastric Ulcers

The symptoms of a gastric ulcer can vary based on the location of the lesion and the patient's age. Common symptoms include:

  • Dull pain or a burning sensation in the upper and central region of the abdomen, typically appearing shortly after eating.
  • Difficult digestion, nausea, vomiting, belching, and abdominal swelling.
  • Loss of appetite and weight loss.

In some cases, gastric ulcers can be asymptomatic. They tend to be chronic and recurrent, with periods of exacerbation followed by periods of apparent healing.

Complications of Gastric Ulcers

Gastric ulcers can lead to serious complications if left untreated. For instance, a deep ulcer can erode nearby blood vessels, causing a digestive hemorrhage. This can result in dark tarry stools and bloody vomiting, indicative of internal bleeding, which can lead to anemia and weakness.

In extreme cases, the ulcer can perforate the stomach wall, causing intense, persistent pain. This is a medical emergency that requires immediate attention.


The diagnosis of gastric ulcers begins with a thorough medical history and symptom assessment, which helps to differentiate gastric ulcers from other gastrointestinal conditions. Common symptoms include persistent stomach pain, bloating, and indigestion.

A key diagnostic tool is an endoscopic examination (gastroscopy), where a thin, flexible tube with a camera on the end is inserted through the mouth to view the stomach lining. This procedure allows direct visualization of the ulcer and helps assess its size and severity.

Biopsies of the gastric mucosa may be taken during endoscopy to rule out malignancy and to test for the presence of Helicobacter pylori (H. pylori), a bacterium that significantly contributes to ulcer formation. Testing for H. pylori can also be done through breath, blood, or stool tests, which are non-invasive and widely used.


The treatment strategy for gastric ulcers focuses on reducing the production of stomach acid to allow the ulcer to heal and to prevent further damage. This usually involves a combination of medications:

  • Antacids that neutralize stomach acid and provide quick relief from pain.
  • Proton pump inhibitors (PPIs) like omeprazole, which decrease the acid produced by the stomach.
  • H2-receptor antagonists like ranitidine, which also reduce stomach acid production.

If H. pylori infection is confirmed, a course of antibiotic therapy is necessary to eradicate the bacteria. This treatment typically includes a combination of antibiotics along with a proton pump inhibitor, and sometimes bismuth subsalicylate, to enhance antibiotic effectiveness and protect the stomach lining.

In more severe cases, such as those involving digestive hemorrhage or perforated ulcers, urgent medical-surgical intervention is required. This may involve endoscopic techniques to stop bleeding or surgery to repair the perforation.

In conclusion, gastric ulcers are a serious health condition that requires medical attention. If you experience symptoms associated with gastric ulcers, it's crucial to seek medical advice promptly.

Remember, this article is intended to provide a comprehensive understanding of gastric ulcers but should not replace professional medical advice.

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The Wellyme Team

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