What does an ulcer feel like? Experts say symptoms can range from subtle to intense—here’s what to look out for, say two gastroenterologists.
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What is an ulcer?A stomach ulcer is a “crater” on the lining of the stomach that develops when the stomach is inflamed, Dr. Plaut says. “In most cases, stomach acid is a key driver of ulcer formation.” While the term “stomach ulcer” is commonly used, these sores can form in different parts of your digestive tract:
“When discussed together, the term ‘peptic ulcer’ is often used,” he says. Peptic ulcers are pretty common, too, affecting up to 20 million people per year, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). What causes a stomach ulcer?Normally, the stomach has a protective layer that keeps stomach acid from damaging sensitive tissue—but if this barrier weakens, an ulcer can form. Dr. Plaut says that the two most common causes of ulcer formation are:
“The role of stress in ulcer development is often considered, but its actual role in causing an ulcer has never been proven,” he says.
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Signs of an ulcer you shouldn’t ignoreUlcers can be dangerous, says Dr. Plaut. If left untreated, an ulcer may:
“Gastric ulcers sometimes are malignant, while duodenal ulcers are rarely malignant,” he explains. “This is an important difference, and biopsy of ulcers—especially those in the stomach—must be done to be sure they are not cancerous.” Given these risks, knowing what an ulcer feels like is important to ensure you get the right medical treatment before complications occur. You have upper abdominal painSevere upper abdominal pain is one of the most common symptoms of an ulcer, says Neil Sengupta, MD, a gastroenterology specialist at the University of Chicago Medicine. In fact, 2024 research published in a JAMA, a journal of the American Medical Association, found that one in 10 people who see a doctor for this type of pain has an ulcer. According to the NIDDK, ulcer-related abdominal pain usually occurs when your stomach is empty, and it can come and go for months at a time.
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 You feel nauseousOne of the other telltale ulcer symptoms is feeling nauseous, Dr. Sengupta says. Many patients report that having a little food in their stomach can help ulcer symptoms subside.
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You’ve had unexplained vomitingNausea from an ulcer can sometimes be so severe that it leads to vomiting. If that happens, stay away from medications like ibuprofen and aspirin. Dr. Sengupta says these common pain relievers can worsen an existing ulcer and even increase your risk of developing another one.
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 You experience excessive vomitingOccasional vomiting from nausea is one thing, but Dr. Plaut warns that excessive vomiting with fluid loss can mean that an ulcer has perforated, creating a hole in the stomach wall. “This is usually a very painful event requiring immediate medical attention,” he says. A perforated ulcer can cause an urgent, serious infection throughout the abdomen. Fortunately, this is not a common complication, he assures.
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There’s blood in your vomitBlood coming from the gastrointestinal (GI) tract can signal a variety of underlying health issues. Still, Dr. Sengupta says that if it’s combined with upper abdominal pain, he’s “highly suspicious” it may be a sign of an ulcer. If you notice blood in your vomit, seek immediate medical care. According to the Cleveland Clinic, this may appear bright red—like fresh blood—or look darker or tarry, like coffee grounds.  Your poop is blackBlood from a bleeding ulcer can travel further down your digestive tract, too, which can turn your stool black, says Dr. Sengupta. According to NIDDK, blood in your stool can also be due to hemorrhoids, colitis, or even colon cancer, so it’s a good idea to get checked out by your doctor.
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 You have chest painSome patients with ulcers describe chest pain known as “non-cardiac chest pain”—discomfort that’s not caused by a heart attack or heart disease, explains the American College of Gastroenterology. The discomfort is commonly caused by a GI problem, though it can also stem from stress or anxiety.
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 You have no appetiteAn ulcer may kill your appetite due to the stomach inflammation it causes, according to Dr. Plaut. It can also interfere with gastric motility, he says, which refers to the way parts of your digestive system contract and relax to help digest food. “Appetite can be reduced based on the inability of the stomach to freely expand when eating, or the stomach’s inability to pass food along into the small intestines,” he says. In some people, this can result in unexplained weight loss.
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You notice that eating eases painIn some cases, people with an ulcer may find temporary relief after eating. “It is noteworthy that eating food can help reduce the pain of an ulcer because food can briefly—but unreliably—reduce the acid content of the stomach,” Dr. Plaut explains. “But most patients with an ulcer have problems at mealtimes because the stomach can’t work properly to accept the incoming food.”
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You’re bloated or burpingUlcers can trigger indigestion-like symptoms, such as bloating or frequent burping, according to the NIDDK. Because an ulcer is an open sore, it’s easily irritated by stomach acid, leading to this type of discomfort. An H. pylori infection may also play a role by increasing gas production, causing excessive bloating and burping.
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 You have back painWhile stomach pain is more common, some people with an ulcer experience back pain, too. This can happen because your stomach and back share a complex network of nerves, so pain from a stomach ulcer might “radiate” or “refer” to the back. However, back pain may also signal something more serious. According to The Merck Manuals, it may mean the ulcer has penetrated the stomach wall and is now affecting nearby organs.
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When to see a doctor if you think you have an ulcerAny changes to your digestive health should be evaluated by a doctor. But Dr. Plaut says that three ulcer symptoms in particular require immediate medical attention:
Your doctor may first check for an H. pylori infection, which Dr. Plaut notes is “easy to identify by a test of the stool or upper endoscopy, and the infection should be treated if found.” If an infection isn’t to blame, he says that there are many ways to treat a peptic ulcer. “The main idea for treating an ulcer is to heal it, not only reduce the symptoms of pain,” Dr. Plaut says. That’s why it’s important to seek medical care and not try to manage ulcer symptoms on your own. How to prevent an ulcerThe two best ways to prevent ulcer formation are to limit NSAID use, such as ibuprofen, and avoid an H. pylori infection, Dr. Plaut says. H. pylori is a common bacteria that is thought to spread from person to person or through contaminated food and water. To reduce your risk, the experts at Johns Hopkins Medicine recommend these simple rules:
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Sources
- Medscape: "What is the prevalence of peptic ulcer disease in the U.S.?"
- National Institute of Diabetes and Digestive and Kidney Diseases: "Peptic Ulcers (Stomach Ulcers)"
- Neil Sengupta, MD, a gastroenterology specialist at the University of Chicago, Illinois.
- National Institute of Diabetes and Digestive and Kidney Diseases: “Symptoms & Causes of Peptic Ulcers (Stomach Ulcers).”
- National Institute of Diabetes and Digestive and Kidney Diseases: “Symptoms & Causes of GI Bleeding.”
- American College of Gastroenterology: "Non-Cardia Chest Pain"
- Merck Manual: “Peptic Ulcer Disease.”
Medically reviewed by 
