Stomach Ulcers: What are the Signs and Symptoms?

What is a stomach ulcer?

When a small area of the surface on the inside of the stomach is damaged in a certain way, this is a stomach ulcer.

Ulcers can happen just past the stomach, too - slightly lower down the gut, in the first few centimeters of the small intestine.

The cause of stomach ulcer is damage from the acid contents of the stomach. The stomach is where food first sits after passing down from the mouth.

Stomach acid and churning help with digesting food. The acid also helps protect against harm from microbes. The stomach protects itself from the acid it secretes. If this surface protection is harmed, the acid can cause damage. This damage is what results in an ulcer.

Mouth ulcers and stomach ulcers are both shallow holes in the surface of the moist tissue in these areas. 

Stomach ulcer symptoms

The classic symptom of a stomach ulcer is indigestion. Doctors also call this symptom dyspepsia. Indigestion causes pain or discomfort in the stomach area. Not all stomach ulcers show this symptom.

This main symptom may feel like it is just below the chest and can be mistaken for another problem in the gut known as heartburn. Heartburn is more of a burning sensation and can occur at the same time as ulcer pain.

Pain is the main symptom of a stomach ulcer, either around the stomach or slightly higher up.

Heartburn can be caused by acid reflux or GERD. It occurs slightly higher up from the stomach and is felt in the lower part of the chest. In some cases, heartburn can be felt even higher.

Stomach ulcer symptoms tend to be more distinct than heartburn, but symptoms can still be vague. An ulcer tends to:

• Produce a burning pain, but often a precise sensation in the stomach area
• This pain is also described as a sort of "biting" or "gnawing" pain
• Many people have symptoms that are not clear or typical like the above two
• Some people describe a hungry sensation

Ulcers in the stomach tend to show slightly different symptoms and signs than those in the small intestine:

• Stomach ulcers tend to show less clear symptoms, with the pain being less consistent. Sometimes the pain is worse after eating food.
• Small intestine ulcers are more likely to produce a consistent pain. The pain can wake many in the middle of the night but is not there first thing in the morning. When the pain appears later in the day, eating food tends to reduce it.

The difference may be of interest to doctors, who may want to ensure nighttime acid is treated for small intestine ulcers.

Some stomach ulcers go unnoticed and show no typical indigestion-type pains. These ulcers are less common and tend to be diagnosed after the ulcer has started bleeding. Some ulcers can develop into the more serious problem of a hole in the stomach wall. This is known as perforation.

Stomach ulcer symptoms can change over time. However, it can be difficult to the spot the signs and symptoms of a stomach ulcer, let alone whether they have progressed.