A peptic ulcer is an open sore in the lining of the stomach (gastric ulcer) or the first part of the small bowel (duodenal ulcer). Most ulcers heal well with treatment, and treating the cause helps stop them coming back.
Common causes
- H. pylori, a stomach infection that is common in Singapore
- Painkillers such as anti-inflammatory medicines (NSAIDs) and aspirin, including those bought over the counter or in traditional remedies
- Smoking and heavy drinking, which slow healing
- Rarely, a stomach ulcer is caused by cancer. This is why stomach ulcers are biopsied, and checked again after treatment.
Symptoms
- A burning or gnawing pain in the upper abdomen, which may be better or worse with food
- Bloating, fullness, nausea or poor appetite
- Some people, especially those on painkillers, have no pain until the ulcer bleeds
Complications
An ulcer can bleed, causing black, tarry stools or vomiting of blood. Less often, it can cause a tear in the stomach wall (perforation), with sudden severe pain, or narrowing that causes repeated vomiting.
Tests
- A gastroscopy, which shows the ulcer directly and allows biopsies, including a test for H. pylori
- Blood tests, for example to check for anaemia
Treatment
- Acid-reducing medicine, usually for several weeks, to let the ulcer heal
- Treating H. pylori if it is present, and then confirming that it has cleared
- Stopping or changing painkillers that may have caused the ulcer. Do not stop aspirin or a blood thinner on your own; discuss it with your doctor first.
- Stopping smoking and cutting down alcohol
- For a stomach ulcer, a repeat gastroscopy is often advised to check that it has healed
A bleeding ulcer can often be treated during an emergency gastroscopy, by injecting it or applying clips.
Seek urgent care at an emergency department for vomiting blood, black or bloody stools with dizziness or fainting, or sudden severe abdominal pain.
General information only. Reviewed by Dr Chia Chung King, 2026-11-07. Book a consultation.