Stomach ulcer treatment

A stomach ulcer (gastric ulcer) is a break in the lining of the stomach caused by damage from stomach acid. Common causes include Helicobacter pylori (H. pylori) infection, prolonged use of anti-inflammatory medication (NSAIDs), smoking, alcohol use, and severe illness or stress.

Symptoms may include upper abdominal pain, nausea, bloating, indigestion, vomiting, or bleeding, although some ulcers cause few symptoms and are discovered during investigation.

Diagnosis and assessment usually include:

Gastroscopy (upper endoscopy) to directly visualise the ulcer
Biopsies to exclude malignancy and test for H. pylori
Blood tests if bleeding or anaemia is suspected
Stool or breath tests for H. pylori where appropriate

Urgent assessment is required if there is vomiting blood, black stools, or severe pain.

What to expect

Before Your Surgery

If gastroscopy is planned:
Authorization will be arranged by the rooms or hospital staff if required.
Fasting:
No solid food for 6 hours before the procedure
No clear liquids for 2 hours before the procedure
Most chronic medications may be taken with a sip of water.
Inform your doctor if you are taking blood-thinning medication.
Diabetic medication instructions will be discussed in advance.

Day of Surgery

Gastroscopy is usually performed under sedation. You will be monitored throughout and observed afterwards until fully awake. If bleeding is found, treatment may be performed during the same procedure.

Procedure

Treatment depends on the cause, size, and severity of the ulcer.

Medication treatment is the mainstay:
- Acid-suppressing medication (proton pump inhibitors)
- Antibiotics if H. pylori infection is present
- Stopping or modifying NSAIDs where possible
Endoscopic treatment may be required if there is active bleeding:
- Injection therapy
- Thermal coagulation
- Endoscopic clips
Surgery is rarely required but may be necessary for complications such as perforation or uncontrolled bleeding.

Procedure Length

Gastroscopy: 10–20 minutes
Therapeutic endoscopy (if bleeding): 20–45 minutes, depending on complexity

Possible Complications

Ongoing or recurrent bleeding
Infection
Delayed healing
Ulcer recurrence
Perforation of the stomach (rare but serious)
Reaction to sedation (if endoscopy is performed)
Unintended damage to surrounding structures
Seek urgent medical attention if you develop severe abdominal pain, vomiting blood, black stools, dizziness, or collapse.

Duration of Hospital Stay

Uncomplicated ulcers: often managed as day procedures or outpatient treatment
Bleeding ulcers: hospital admission may be required for monitoring and treatment

Discharge Instructions

Take prescribed medication exactly as directed.
Avoid NSAIDs unless specifically advised otherwise.
Avoid smoking and alcohol.
Follow dietary advice provided.
Monitor for pain, bleeding, or worsening symptoms.

Return to Activities

Normal activities may usually resume the following day if no complications occurred.
Avoid strenuous activity if you were admitted for bleeding until cleared by your doctor.

Stomach ulcer treatment

What to expect

Before Your Surgery

Day of Surgery

Procedure

Procedure Length

Possible Complications

Duration of Hospital Stay

Discharge Instructions

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