What Is a Stomach Ulcer?H. pylori and Ibuprofen

It’s a gnawing in the upper belly that shows up between meals, or in the middle of the night. A bite of food takes it away, or makes it worse. You’ve been popping ibuprofen for back pain most days for months, and now you’re also getting full after a few bites. You assume it’s reflux, and you’ve started eating less.

Symptoms

The NIDDK¹ lists pain or discomfort in the upper abdomen, feeling full too soon while eating, nausea, vomiting, bloating and belching. Many people have no symptoms at first. See heartburn and GERD and nausea after eating for look-alikes.

What causes it

H. pylori is a bacterial infection. The NIDDK¹ says NSAIDs, such as aspirin, ibuprofen and naproxen, are another common cause because they make the stomach lining more prone to damage and ulcers. It lists corticosteroids, antidepressants and some conditions among less common causes.

If you take ibuprofen or similar medicines most days, mention it to your clinician, who can look at your options. Ask before changing a prescribed medicine.

How it’s found

The NIDDK² lists several tests: a urea breath test, where you swallow a capsule, liquid or pudding that contains specially labeled urea and your breath is checked for the carbon dioxide the bacteria make, a stool test, a blood test, an upper endoscopy with a camera and tissue samples, and an upper GI series with barium X-rays.

Treatment

The NIDDK³ says doctors prescribe acid-reducing medicines, proton pump inhibitors (PPIs) or H2 blockers. For H. pylori, they typically combine two or more antibiotics with a PPI, and the NIDDK says to finish the entire course, because stopping early lets bacteria survive and develop resistance. It says testing at least 4 weeks after you finish the antibiotics confirms the infection is gone.

If NSAIDs caused it, your doctor may recommend changing your medicines, switching, lowering the dose or taking a PPI alongside. The NIDDK³ says quitting smoking helps, since smoking can slow ulcer healing.

Bleeding, the urgent part

The NIDDK¹ says to contact a doctor immediately for black or tarry stool, or red or maroon blood mixed with stool, or sudden, sharp or severe abdominal pain that doesn’t go away. Other warning signs include vomiting blood, dizziness, fainting and a rapid pulse.

The play

Try this: a pain-and-pills note

For two weeks, write down when the pain comes (before, during or after meals, at night), what it feels like, and what eases it.

List every medicine you take, including ibuprofen, naproxen, aspirin, steroids and antidepressants, with how often.

Bring it to your clinician and ask about H. pylori testing.

When to get checked

Don’t wait if

1. Urgent

   Get urgent care for black or tarry stool, vomiting blood, sudden severe belly pain, dizziness or fainting.

Book an appointment if any of these fit:

• Upper belly pain or burning keeps coming back
• You feel full after only a few bites
• You take ibuprofen, naproxen or aspirin regularly and have stomach symptoms
• You’ve been treated for H. pylori and haven’t been retested

Pain that comes and goes isn’t always acid. Test before you guess.