Stomach ulcers: what they are and what to do

Stomach ulcers, or peptic ulcers, are open sores on the stomach lining or the first part of the small intestine. They hurt, mess with your appetite, and can bleed if left untreated. Most ulcers come from one of two things: an H. pylori infection or long-term use of NSAIDs like ibuprofen. Smoking, heavy drinking, and stress can make symptoms worse.

How do you know it’s an ulcer? Common signs are a burning or gnawing pain in the upper belly, feeling full quickly, bloating, belching, heartburn, nausea, or losing weight without trying. If you see dark or bloody stools, vomit blood, faint, or have very severe pain, get urgent care. Those are signs of bleeding or a perforated ulcer.

Simple, practical tests and diagnosis

Your doctor will ask about meds and do a physical check. To find H. pylori, they usually use a breath test or a stool antigen test. Blood tests can show past exposure but aren’t great for current infection. If symptoms are severe or come back, an upper endoscopy (EGD) lets a doctor look directly, take biopsies, and treat bleeding if needed. Endoscopy is the most reliable test when the problem is complicated.

Treatment that gets results

Treatment depends on the cause. If H. pylori is found, doctors give a course of antibiotics plus a proton pump inhibitor (PPI) to lower stomach acid. Typical antibiotics include amoxicillin, clarithromycin or metronidazole, but your doctor will pick the best combo for you. If NSAIDs caused the ulcer, stopping them and starting a PPI usually heals the tissue.

PPIs such as omeprazole or pantoprazole reduce acid and help ulcers close. If you ever need to switch between PPIs, pharmacist guides can help match doses so you don’t under- or over-treat. Antacids and H2 blockers can relieve pain but aren’t a cure for infected or NSAID-caused ulcers.

Small daily habits make a big difference. Stop NSAIDs when possible and use acetaminophen for pain. Quit smoking and cut back on alcohol. Eat smaller meals, avoid foods that trigger you (spicy, fried, very acidic), and don’t lie down right after eating. Probiotics, or eating yogurt, may reduce antibiotic side effects. Some people find coriander or other gentle herbs help digestion, but herbs don’t replace medical therapy.

After treatment for H. pylori, your doctor may repeat a breath or stool test about 4–12 weeks later to confirm the infection is gone. Expect pain to ease in days but full healing takes weeks. If symptoms return, contact your provider—ongoing infection, continued NSAID use, or resistant bacteria are common causes of relapse.

If you’re unsure what step to take first, talk to your pharmacist or primary care doctor. They can explain tests, safe medicines, and follow-up. Quick, clear action prevents complications and gets you back to feeling normal faster.