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Although many stomach ulcers can be treated effectively, if left untreated, they can lead to serious complications. The most common complication of a stomach ulcer is bleeding, which can occur when the ulcer erodes a blood vessel in the stomach lining. Symptoms of bleeding include vomiting blood or having black, tarry stools. Severe bleeding may require emergency medical treatment, including blood transfusions. A perforated ulcer occurs when the ulcer creates a hole in the stomach wall, allowing stomach acid and digestive enzymes to leak into the abdominal cavity. This condition is lifethreatening and requires immediate surgical intervention. A stomach ulcer can cause swelling and scarring, leading to a blockage in the digestive tract. This obstruction can prevent food from passing through the stomach into the small intestine, resulting in vomiting, weight loss, and malnutrition. Chronic infection with H. pylori is associated with an increased risk of gastric cancer, particularly in individuals with long-standing ulcers. However, the majority of people with ulcers do not develop cancer. If a stomach ulcer is suspected, a healthcare provider will typically perform a physical examination and inquire about the patient’s medical history and symptoms. To confirm the diagnosis, the following tests may be used. An endoscopy involves inserting a flexible tube with a camera into the stomach to directly visualize the ulcer. This test is particularly useful for diagnosing complications such as bleeding or perforation. If an H. pylori infection is suspected, a doctor may order tests such as a blood test, stool test, or breath test to detect the presence of the bacteria. In some cases, a barium X-ray may be used to visualize the stomach lining. The patient swallows a barium solution, which helps highlight any ulcers or abnormalities on the X-ray. The treatment of stomach ulcers depends on the underlying cause, the severity of the ulcer, and the presence of complications. The main goals of treatment are to alleviate symptoms, promote healing, and prevent complications. If the ulcer is caused by an H. pylori infection, antibiotics are prescribed to eradicate the bacteria. A combination of antibiotics, usually clarithromycin and amoxicillin or metronidazole, is often used for this purpose. PPIs, such as omeprazole or lansoprazole, reduce the production of stomach acid and promote healing of the ulcer. These medications are often prescribed for a few weeks to help heal the ulcer and relieve symptoms. Drugs like ranitidine or famotidine reduce stomach acid production and may be used in conjunction with PPIs to treat ulcers. Antacids, such as calcium carbonate or magnesium hydroxide, can help neutralize stomach acid and relieve discomfort. Additionally, medications that protect the stomach lining, such as sucralfate, may be prescribed. Lifestyle changes are essential for managing and preventing ulcers. These include avoiding NSAIDs, reducing alcohol consumption, quitting smoking, and managing stress. A diet rich in fiber and low in spicy or acidic foods may also help alleviate symptoms. In rare cases, when an ulcer is large, bleeding, or causing perforation, surgery may be required. This may involve removing the ulcer or part of the stomach, or repairing a perforation. Preventing stomach ulcers involves addressing the underlying causes and making lifestyle changes.

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The authors declare that they have no competing interests.