What Are the Symptoms of a Stomach Ulcer? Which Foods Trigger It?

A stomach ulcer is an open sore that develops when the protective mucosal lining of the stomach is eroded. The most common symptoms of a stomach ulcer include a gnawing, burning pain in the upper abdomen, especially between meals or severe enough to wake you from sleep at night. During seasonal transitions, particularly in the spring and autumn months, these complaints may increase.

• The most fundamental symptom of a stomach ulcer is a gnawing pain felt in the upper middle part of the abdomen.
• The pain usually subsides when you eat or when stomach acid decreases.
• The most common causes are the Helicobacter pylori bacteria and the unprescribed, excessive use of painkillers.
• Spicy foods, acidic beverages, and coffee can trigger ulcer complaints.
• Vomiting that looks like coffee grounds or black, tarry stools are signs of stomach bleeding requiring emergency intervention.

What is a Stomach Ulcer?

Stomach ulcers are painful sores that occur when digestive acids damage the inner lining of the stomach or the duodenum (the first part of the small intestine). Medically, they are also known as peptic ulcers. Under normal conditions, the inner lining of the stomach is coated with a thick layer of mucus to protect it from the corrosive effects of acid. However, when this protective layer thins out or when stomach acid increases abnormally, the acid comes into direct contact with the tissues, paving the way for sore formation.

While it can be seen in all age groups, it is generally more common in middle-aged and older adults. In Türkiye, it is a fairly widespread health issue due to certain dietary habits and fast-paced, stressful living conditions. Especially during seasonal transitions, as the weather gets colder or warmer, fluctuations in stomach acid secretion can occur during the body's adaptation process. A noticeable increase in stomach ailments is observed during these periods. Rather than a superficial irritation, this condition is a deep sore that, if left untreated, seriously diminishes your quality of life.

Causes and Risk Factors

Rather than a single factor, a combination of various elements that disrupt the stomach's protective mechanism plays a role in the development of a stomach ulcer. Contrary to popular belief, stress or spicy foods are not the direct cause of this sore; however, they do worsen an existing sensitivity. The most fundamental cause is a bacterium called Helicobacter pylori (H. pylori). This bacterium settles in the stomach mucosa, leading to inflammation and, over time, tissue damage. In our country, this bacterial infection is quite common.

The second most common cause is the unprescribed and long-term use of non-steroidal anti-inflammatory drugs (NSAIDs), frequently taken for complaints like rheumatism, joint pain, or headaches. These medications suppress the enzymes that allow the stomach to produce protective mucus, leaving the stomach vulnerable to acid attacks. Furthermore, smoking increases stomach acid and delays healing, while excessive alcohol consumption directly irritates the stomach lining, accelerating sore formation. A family history of similar digestive system diseases is also a significant risk factor in terms of genetic predisposition.

What Are the Symptoms of a Stomach Ulcer?

Complaints can vary from person to person and may change depending on the size and location of the sore. The answer to the question "what does ulcer pain feel like?"—which patients wonder about the most—is generally a gnawing, burning, or scraping pain felt between the breastbone and the belly button. This pain can occur when the stomach is empty, especially between meals, or it can be severe enough to wake you up in the middle of the night. Eating food or taking medication that balances stomach acid can temporarily relieve the pain.

Other common symptoms besides pain include a feeling of quick fullness, bloating, burping, nausea, and loss of appetite. In some cases, a burning sensation in the chest may also be felt as stomach acid escapes into the esophagus. At this point, the complaints can be confused with acid reflux; you can examine the differences between these two conditions in detail in our article titled What is Stomach Reflux? Symptoms, Causes, and Reflux Diet. As the condition progresses, more prominent symptoms such as unexplained weight loss and persistent vomiting may also be added to the picture.

Which Foods Irritate It? (The Ulcer Diet)

If you have a sore in your stomach, the foods you consume directly affect your healing process. Following a special ulcer diet both alleviates your pain and gives the stomach mucosa a chance to repair itself. So, which foods irritate the stomach? First and foremost, you should stay away from foods that increase stomach acid and irritate the sore. Citrus fruits like oranges, tangerines, lemons, and grapefruits, as well as tomatoes, increase complaints due to their high acid content.

Spicy foods like hot peppers, black pepper, red pepper flakes, and hot sauces cause a burning sensation over the sore. Fried foods, excessively fatty meats, and processed foods stay in the stomach for a long time, triggering acid secretion. You must also be careful with beverages; even if decaffeinated, coffee, dark tea, carbonated drinks, and alcohol irritate the stomach lining. Instead of these, you should opt for foods that are easy to digest and do not tire the stomach, such as boiled vegetables, lean protein sources, yogurt, bananas, peeled apples, and oatmeal. Eating small, frequent meals, and chewing your food slowly and thoroughly will also lighten the load on your stomach.

How is it Diagnosed at the Hospital?

A definitive diagnosis is made through clinical tests performed after listening to your complaints and conducting a physical examination. The most reliable and gold-standard method applied in the hospital is an endoscopy. A flexible tube with a small, lighted camera at the tip is inserted through the mouth to directly examine the esophagus, stomach, and duodenum on a screen. Since sedation is administered to give the patient a mild sleepy state during the procedure, no pain or discomfort is felt.

During the endoscopy, if a sore is spotted, a small tissue sample (biopsy) may be taken to check for the presence of bacteria or to rule out a malignant formation. In cases where cancer is suspected, advanced imaging techniques are life-saving; you can get detailed information on this topic from our article Early Diagnosis in Stomach and Bowel Cancer with the Staining Method. Aside from endoscopy, methods like a stool antigen test or a urea breath test are also frequently used to diagnose the infection.

Stomach Ulcer Treatment and the Healing Process

Treatment is planned according to the underlying cause and generally includes medication therapy along with lifestyle changes. The primary goal of the treatment is to reduce stomach acid, relieve pain, ensure the healing of the sore, and prevent complications. If bacteria are detected in the tests, a combination therapy consisting of two different antibiotics and acid-suppressing medications is usually prescribed to eradicate it.

In cases not caused by bacteria but linked to painkiller use, the use of these medications is first stopped or changed under a physician's supervision, followed by the initiation of acid-suppressing drugs. The healing process typically takes between 4 to 8 weeks. During this period, strictly following the dietary rules recommended by your doctor and staying away from smoking and alcohol are of critical importance for the success of the treatment. Resting at home, trying to avoid stress, and eating meals at regular hours also help the stomach mucosa recover more quickly.

Complications and Risk Groups

In cases where it is left untreated or doctor recommendations are not followed, this condition can lead to serious, life-threatening complications. Chief among these is stomach bleeding. When the sore erodes the blood vessels in the stomach wall, internal bleeding begins; this situation can lead to anemia slowly and insidiously, or it can occur suddenly and severely.

Another dangerous complication is perforation. As a result of the sore completely piercing the stomach or bowel wall, digestive fluids and food leak into the abdominal cavity, causing a severe infection. Additionally, the scar tissue formed as the sore heals can narrow the stomach's outlet, preventing the passage of food into the intestines. Patients over the age of 60, those who have been using high-dose painkillers for a long time, heavy smokers, and individuals who have not received bacterial treatment are in the high-risk group for these complications.

When to See a Doctor?

Although stomach complaints are often perceived as simple indigestion and ignored, certain symptoms require emergency medical intervention. If your stomach pain lasts longer than a few days, does not go away despite medication, or is progressively worsening, you must absolutely consult a specialist physician. Conditions such as unexplained weight loss, a constant feeling of fullness, or difficulty swallowing should not be neglected either. However, if you experience any of the following symptoms, you should call the 112 Emergency Call Center without delay or go to the nearest hospital's emergency room:

• Vomiting blood that looks like coffee grounds or is a fresh red color.
• Stools that are pitch black like tar, sticky, and very foul-smelling.
• Sudden, stabbing, unbearably severe pain starting in the abdominal region.
• Difficulty breathing, excessive sweating, dizziness, or a feeling of faintness.
• The abdomen becoming board-hard and extremely sensitive to touch.

Diagnosis and Treatment Process at BHT CLINIC

For an accurate diagnosis and effective treatment of your stomach and digestive system disorders, our BHT CLINIC İstanbul Tema Hastanesi Gastroenterology department is by your side with its expert staff. When you apply to our hospital, your complaints are listened to in detail, and your physical examination is performed. In our endoscopy unit, equipped with advanced technology, your procedures are carried out while you are asleep, completely pain-free, and comfortably.

In the event of possible bleeding or severe pain, our 24/7 emergency service and on-duty specialists provide uninterrupted healthcare. When coming to your appointment, having a list of your previous blood tests, endoscopy reports, and the medications you use regularly (especially painkillers and blood thinners) with you will speed up the diagnostic process. Do not postpone your digestive system health; you can book an appointment right away for a detailed evaluation.

Frequently Asked Questions

Will a stomach ulcer heal on its own?

No, a stomach ulcer is a structural sore that requires medical treatment. It is not expected to heal on its own without medication therapy and dietary changes; on the contrary, if left untreated, it can grow and lead to serious problems like bleeding.

Is drinking milk good for an ulcer?

Although drinking milk may momentarily coat the stomach lining and make it feel like the pain is relieved, the calcium and proteins it contains will increase stomach acid secretion shortly after. Therefore, it can worsen complaints in the long run.

Can ulcer pain radiate to the back?

Yes, especially with sores located on the back wall of the stomach, the pain may not stay confined to the abdominal region but can radiate toward the back. Persistent pain radiating to the back should be taken seriously as it could be a sign that the sore is deepening.

Does stress cause stomach ulcers?

Stress alone does not cause a stomach ulcer. However, intense stress exacerbates the complaints of an existing sore and delays the healing process by increasing stomach acid production and weakening the immune system.

How can you tell if there is stomach bleeding?

The most prominent signs of stomach bleeding are vomiting that looks like coffee grounds and stools that are pitch black like tar. If this is accompanied by extreme fatigue, dizziness, and blacking out, emergency medical help must be sought immediately.

This article is for informational purposes only; please consult your physician for diagnosis and treatment.