These are all potential signs of a peptic ulcer

Your gut's burning, you've been throwing up, and you've lost weight. These are all potential signs of a peptic ulcer.

Don’t presume that the burning feeling between your breastbone and belly button is heartburn. It could be a peptic ulcer. While you can crunch a few antacids to ease the pain, it’s also a good idea to see your doctor if you have ulcer symptoms. Untreated ulcers can lead to serious health problems.

An ulcer is basically just a small, eroded sore. You can get ulcers almost anywhere on your body and for a variety of reasons. In addition to frequently seen stomach ulcers and duodenal (first part of the small intestine) ulcers, there are a number of different types of ulcers including:

• Leg ulcer. Sores or wounds that will not heal on the leg are a complication of arterial diseases and diabetes. About 0.7 percent of adults will develop leg ulcers.
• Foot ulcer. Sores that will not heal on the foot are a complication of diabetes for out 15 percent of adults with diabetes.
• Mouth ulcer. These ulcers occur because of irritation or even an allergic reaction to certain ingredients. Some are due to viral infections, like Herpes. Others can be caused by inflammatory diseases like ulcerative colitis.
• Colon ulcer. This is a sore in the lining of the colon and can be caused by a number of factors and conditions, such as ulcerative colitis.

Digestive ulcers rank as the most commonly known variety, so when someone complains casually about their ulcer, they probably are complaining about ulcer pain caused by peptic ulcer disease or a bleeding stomach ulcer. Talking to a gastroenterologist is the first step in teasing out your ulcer causes and symptoms as well as treatment options.

Symptoms of Ulcers

As with many health concerns, the symptoms of ulcers overlap with other types of conditions that cause abdominal pain and, sometimes, just feeling generally unwell. Symptoms to watch out for include:

Epigastric pain. A peptic ulcer affects the lining of either your stomach or the duodenum, causing a duodenal ulcer. The most common symptom of these ulcers is a type of stomach pain referred to as epigastric pain, in which ulcer pain or discomfort typically appears at the midline of your abdomen. Touch your belly button and move up about four inches — that’s where you’ll feel the pain, says James McGuigan, MD, professor of medicine in the division of gastroenterology, hepatology, and nutrition at the University of Florida College of Medicine in Gainesville.

Loss of well-being. You may also simply start to notice that you don’t have the same feeling of well-being after eating that you once had. You may not feel out-and-out pain — you might just not feel right or have a feeling of poor digestion, explains Patrick I. Okolo, III, MD, MPH, chief of endoscopy at Johns Hopkins Hospital and assistant professor of gastroenterology and hepatology at Johns Hopkins University School of Medicine in Baltimore.

The early symptoms of peptic ulcers are much like the symptoms of other types of stomach ailments, which can make it difficult for you to know whether to wait or schedule an appointment with your doctor. Many people confuse their ulcer with acid reflux or the more serious gastroesophageal reflux disease (GERD). Besides a burning pain in your midsection, other early symptoms of peptic ulcers include:

• Pain that comes and goes
• Pain that starts up to three hours after you eat
• Pain that wakes you up at night
• Stomach pain eased by eating
• Stomach pain eased by taking antacids
• Unintended weight loss
• Loss of appetite
• Feeling bloated
• Belching or feeling burpy
• Nausea
• Vomiting

It is a good idea to get started early with diagnosis and treatment, to make sure you rule out serious health problems and avoid severe complications.

When Ulcer Symptoms Worsen

Without treatment, ulcers can get worse. They can get bigger or cause a tear in your stomach or intestine; this is called a perforated ulcer. If you notice any of these symptoms, get immediate medical help:

• Sharp or increasing pain
• Pain when you press on your belly
• Blood in stool or in vomit (blood can appear as black or red)
• Feeling tired and weak
• Confusion

Bleeding and perforation are the biggest concerns, says Dr. Okolo, who adds that ulcer emergencies can happen even when you have been diagnosed with an ulcer and are being treated, so it helps to know what ulcer-emergency symptoms look like.

Even without an emergency, an untreated ulcer can cause narrowing and obstruction because of the swelling and scarring that occur as your body tries to heal itself.

Causes of Ulcers

The many seemingly unrelated top ulcer causes are:

• Helicobacter pylori. H. pylori is a common bacteria that is the most common cause of peptic ulcers.
• Non-steroidal anti-inflammatory drugs (NSAIDs). The second most common cause of peptic ulcers is the use of these over-the-counter pain medications.
• Hydrochloric acid and pepsin. Some data suggests that people whose body is sensitive to these naturally produced stomach acids are more likely to develop ulcers.
• Alcohol. While drinking alcohol doesn’t cause ulcers, people with diseases that occur because of excessive alcohol consumption, like cirrhosis, also tend to have ulcers.
• Smoking. People who smoke may find that they are more likely to get an ulcer and that they have a harder time healing.

Many people think diet (especially spicy foods), stress, and caffeine cause peptic ulcers. They are not typically causes, but they can make ulcer symptoms worse and generally cause you to feel less comfortable if you have an ulcer.

Conditions Related to Ulcers

Occasionally people with ulcers have something more complicated than peptic ulcer disease. There are several conditions that are related to peptic ulcer disease, often because they have a similar cause (such as H. pylori infection) or similar symptoms (such as stomach discomfort). They include:

• Gastritis. Gastritis is an inflammation of the stomach lining — mild by comparison with some of the other conditions associated with ulcers. However, it results in discomfort, nausea, and loss of appetite and can lead to ulcers in some people.
• Gastroesophageal Reflux Disease (GERD). The classic symptom of this extreme acid reflux is a burning sensation behind the breast bone, but you may also experience a persistent cough or difficulty swallowing. These symptoms can be confused with ulcers.
• Stomach lymphoma. More technically known as gastric mucosa-associated lymphoid tissue (MALT) lymphoma, this rare type of stomach cancer is, like peptic ulcer disease, associated with H. pylori.
• Gastric cancer. Also known as stomach cancer, this type of cancer kills about 730,000 people annually. It is also related to the presence of H. pylori.
• Gallbladder disease. People who have an inflamed gallbladder or gallstones may have similar symptoms to peptic ulcer disease. The most common overlapping symptoms are feeling bloated, full, gassy, or generally uncomfortable.

If you don’t already have an ulcer diagnosis, but suspect an ulcer is causing your discomfort, read about ulcer risk factors to find out whether ulcers could be a concern for you. Be sure to respond promptly to any ulcer symptoms you may have. Recent advances in ulcer treatment mean you can be on your way to relief in no time.