Stomach Ulcers: Causes, Warning Signs and When to Act

Expert reviewed by Qurath Ain, Certified Nutritionist and Clinical Dietitian

You’ve probably heard someone say, “I think I have an ulcer.” Maybe after weeks of stomach pain. Or because spicy food suddenly became difficult to eat. 

Sometimes, people use the word ulcer to describe almost any stomach discomfort. But a stomach ulcer is a specific medical condition — not just another name for indigestion or “gas trouble.”

Having said that, stomach ulcers are treatable. The important part is recognising the symptoms and knowing when it’s time to seek medical care instead of trying to manage the problem on your own.

What is a stomach ulcer?

A stomach ulcer is an open sore that develops in the lining of the stomach. Ulcers can also occur in the first part of the small intestine (called a duodenal ulcer). Together, they’re known as peptic ulcers.

The stomach normally protects itself from its own digestive acids with a layer of mucus. With localised erosion of this protective barrier, acid can irritate the lining, allowing an ulcer to develop.

An ulcer isn’t something that appears overnight. It usually develops over time.

What causes stomach ulcers?

Contrary to popular belief, stress and spicy food alone don’t cause stomach ulcers. Today, doctors know that most peptic ulcers are linked to one of two major causes.

1. Helicobacter pylori (H. pylori) infection

H. pylori is a type of bacteria that can live in the stomach. In some people, it damages the stomach’s protective lining and increases the risk of developing an ulcer. Not everyone with H. pylori develops an ulcer, but it is one of the most common underlying causes.

2. Long-term use of certain pain relievers

Frequent or prolonged use of non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can reduce the stomach’s natural protective mechanisms and increase the risk of ulcers. This is one reason it’s important to use these medicines only as directed and to discuss long-term use with a healthcare professional.

What does a stomach ulcer feel like?

Symptoms can vary from person to person. Common signs include:

• Heartburn, aching, gnawing pain in the upper abdomen/epigastric pain (between ribs and navel)/between the belly button and the breastbone
• Sometimes back pain or radiating pain can last for a few minutes to a few hours and continue or come and go for weeks. The use of antacids or acid reducers may control the pain, flatulence, bloating or distension, etc.
• Feeling unusually full after eating
• Bloating
• Nausea
• Frequent burping
• Reduced appetite
• Loss of appetite and weight loss.

Some people notice that the discomfort changes after eating, while others experience pain between meals or during the night. It’s also possible to have an ulcer without obvious symptoms.

Is every stomach pain an ulcer?

No. Many digestive conditions can cause similar symptoms. For example, acid reflux (heartburn), indigestion, gastritis, functional dyspepsia and gallbladder problems to name a few.

Because these conditions can overlap, it’s difficult to diagnose an ulcer based on symptoms alone. If stomach pain keeps returning, it’s important not to assume the cause.

Can food cause ulcers?

This is one of the biggest myths. Spicy food doesn’t create stomach ulcers. Neither does drinking coffee occasionally.

However, certain foods may make existing symptoms feel worse for some people. If you already have an ulcer or another digestive condition, your healthcare professional may recommend avoiding foods that consistently trigger discomfort while the underlying cause is being treated.

How are stomach ulcers treated?

Treatment depends on the cause. If an H. pylori infection is present, a healthcare professional may prescribe antibiotics along with medicines that reduce stomach acid.

If the ulcer is related to long-term NSAID use, your doctor may recommend changing or stopping those medicines where appropriate and prescribe treatment to allow the stomach lining to heal.

Trying to treat a suspected ulcer with home remedies alone can delay proper diagnosis.

Supporting your digestive health

Although food doesn’t usually cause ulcers, everyday habits still matter for overall digestive health. A balanced eating pattern can help support your digestive system while you follow the treatment plan recommended by your healthcare professional.

That includes eating meals at regular times, staying hydrated, including fruits and vegetables daily, choosing whole grains regularly, avoiding smoking, and taking medicines only as advised by your doctor.

Nutritional tips to manage ulcers

• Try to limit strong flavours, such as sour and spicy foods, that may cause irritation.
• Avoid consuming hot beverages and prefer cold beverages.
• Avoid/limit drinks like alcohol, coffee (or anything with caffeine), which may stimulate acid secretion.
• Consume Vitamin B6, which is found in fish, poultry, beans, lentils, nuts and seeds.
• Rich food sources of Vitamin B12 and B2 include chicken, fish, prawns, crabs, eggs, fortified cereals, mushrooms, beetroot, potato, milk and milk products.
• Include omega-3 fatty acid-rich fish, mainly salmon, mackerel, sardines, and herring; they help produce prostaglandins, which in turn protect the mucosal lining of the stomach and intestines.
• Antioxidant-rich fruits and vegetables help in managing ulcers.
• Keep yourself well hydrated and drink at least 8-10 glasses of water per day.
• Avoid bedtime snacks that stimulate acid production at night.
• Stop eating at least two hours before bedtime.
• Have meals in a relaxed atmosphere.
• Frequent small meals with less spicy food may increase comfort.
• Fish and chicken proteins are preferable to red meat, but ensure you remove the fatty skin.

Whole grains also contribute to daily fibre intake. For example, Aashirvaad Namma Chakki 100% Khapli Atta provides about 11.4g of fibre per 100g, similar to whole wheat atta. Rotis prepared with it, alongside vegetables, dals, seasonal fruits and adequate hydration, can be part of balanced meals that support everyday digestive health.

Warning signs you shouldn’t ignore

Seek medical attention promptly if you experience:

• Severe or worsening abdominal pain
• Vomiting blood or material that looks like coffee grounds
• Black, tarry stools or blood in stools
• Unexplained weight loss
• Persistent vomiting
• Difficulty swallowing
• Ongoing stomach pain that doesn’t improve

These symptoms may indicate a more serious problem and should be assessed without delay.

Ask Happy Tummy GPT

Try this prompt:

“I’ve been experiencing upper stomach pain, along with details about when it happens, my eating pattern, medicines I’m taking and any other symptoms. Can you help me understand what information I should discuss with my doctor? Please don’t diagnose me, but help me organise my symptoms before my appointment.”

The Bottom Line

Stomach ulcers are a specific medical condition, most commonly caused by H. pylori infection or long-term use of certain pain-relieving medicines—not simply by eating spicy food or feeling stressed.

Persistent upper abdominal pain, nausea or discomfort deserves proper medical evaluation rather than self-diagnosis. While balanced meals, hydration and healthy routines support overall digestive health, ulcers require appropriate diagnosis and treatment based on their underlying cause.

Disclaimer

This article is intended for general educational purposes only and should not be considered medical advice. If you have persistent stomach pain, vomiting blood, black stools, unexplained weight loss, severe abdominal pain or other concerning symptoms, seek prompt medical attention.