The Top 6 Signs You May Have an Ulcer

Know the Signs and Symptoms of Ulcers

Do These 6 Things to Avoid Getting an Ulcer
Do These 6 Things to Avoid Getting an Ulcer.

“Doc, my ulcer is acting up again,” is one of the more common opening lines my patients tell me. The reality is that it usually isn’t an ulcer but something else. Any pain in the abdomen might get you thinking you have an ulcer, so I thought I would clarify the symptoms a little more.

Peptic ulcer disease (PUD), commonly called ulcers, is the formation of painful, open sores, which develop in the lining of the stomach or at the duodenum, the first section of the small intestine. If an ulcer is located in the stomach, it is described as a gastric ulcer. If it is found in the small intestine, it is referred to as a duodenal ulcer. PUD can affect children, adults and elderly, but is more prevalent among men and individuals who are 60 years old or older.

In the United States, more than six million Americans are diagnosed with ulcers each year and the count excludes the population of recurrent cases or those left untreated. Often times, ulcers are left untreated or misdiagnosed because the symptoms can be very similar to other digestive issues. Left untreated, ulcers can be very painful and damaging to the digestive tract. Knowing the signs and symptoms can ensure a correct diagnosis and treatment. [1]

Belly Pain in the Middle of Your Abdomen

Belly Pain in the Middle of Your Abdomen
Belly Pain in the Middle of Your Abdomen.

Many times people may actually have an ulcer and not have significant pain until it is too late. The most common symptom for symptomatic ulcers is pain located between your rib cage and the umbilicus. The pain is often described as dull or burning and may come and go. Untreated ulcers may cause pain for a short period of time, and either progress or come and go over a period of time. When the pain is relieved by using an over the counter antacid, it is possible you may have an ulcer.

Stomach (or peptic) ulcers may produce few or no symptoms, or they may cause burning, gnawing pain in the upper middle part of the abdomen that is relieved by eating or taking an antacid. Stomach ulcers often are not consistent. For example, eating sometimes will make the pain worse rather than better with certain types of ulcers, such as pyloric channel ulcers, which are often associated with bloating, nausea and vomiting, symptoms of a blockage caused by swelling (edema) and scarring.

Duodenal ulcers tend to cause consistent pain. A patient may feel no pain when he or she awakens, but by midmorning it is present. The pain can be relieved by eating, but it usually returns two to three hours later. Pain that wakes a patient at night is common for duodenal ulcers.

Pain Associated with Eating

Pain Associated With Eating
Pain Associated With Eating.

Eating can cause inconsistent belly pain depending on where the ulcer is located. Belly pain that increases shortly after you eat may signal a gastric ulcer, while belly pain that increases 2-3 hours after a meal may signal a duodenal ulcer. Either way, eating can trigger pain caused by an ulcer and may result in poor appetite or weight loss. Many people also notice increased pain at times when the stomach may be empty – either late at night or early in the morning

Pain That Improves After Eating

Pain That Improves After Eating
Pain That Improves After Eating.

Ironically, belly pain that improves immediately after you eat, can also be a sign of an ulcer. The presence of food acts as a buffer to the irritated lining. Unfortunately, the pain relief is usually temporary until the food passes through the upper digestive system and the stomach or small intestine is empty again. This explains why ulcer pain that is relieved by eating may cause frequent spells of hunger.   

Bloating or Burping

Bloating or Burping
Bloating or Burping.

Any condition that affects the normal passage of gastric contents through the digestive system can cause bloating, that uncomfortable sensation of pressure in the abdomen. Ulcers can also cause you to feel full early after eating and can lead to increased burping or the release of air found in the upper digestive tract.  

Nausea With or Without Vomiting

Nausea With or Without Vomiting
Nausea With or Without Vomiting.

Ulcers can cause nausea, or that queasy feeling that comes before vomiting. An ulcer that is bleeding can also result in vomiting blood. The blood can either be bright red or described as the same color and consistency as coffee grounds. Vomiting blood is considered a danger sign that would warrant seeking immediate emergency care.  

Blood Found in Your Stool

Blood Found in Your Stool
Blood Found in Your Stool.

Occasionally, an ulcer can cause blood to be seen in the stool. Upper digestive tract bleeding found in the stool is commonly described as jet black and sticky, similar to how tar might look. This sign would also warrant an urgent evaluation with your doctor or in the ER.  [2, 3, 4]

Ulcers have a variety of symptoms or can even be asymptomatic, but when you suspect that you could have one it is not something to ignore. Most people with ulcers get better when treated appropriately. However, when left untreated, an ulcer can lead to serious complications such as bleeding/hemorrhaging, perforation, obstruction, and even death. If you or someone you know has the above symptoms, it is advisable to see your health care professional as soon as possible in order to get it checked out.


  1. Gastrointestinal ulcers, role of aspirin, and clinical outcomes: pathobiology, diagnosis, and treatment., Cryer BMahaffey KW.;  J Multidiscip Healthc. 2014 Mar 3;7:137-46. doi: 10.2147/JMDH.S54324. eCollection 2014
  2. Ulcers; Kenneth Brown MD;
  3. Peptic Ulcer Disease, American College of Gastroenterology;
  4. Peptic Ulcer Disease, WebMD,

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