Symptoms of peptic ulcer include:

• Burning or gnawing pain between the bottom of the breastbone and the navel. In patients with duodenal ulcers, the pain improves after eating, but returns a few hours later or in the middle of the night. In patients with gastric ulcers, the pain usually worsens when food is eaten.
• A change in appetite with weight gain or weight loss.
• Nausea or vomiting.
• Frequent burping or bloating.

About 20 percent of peptic ulcers are "silent," without associated symptoms.

If you develop any of these symptoms, seek emergency care:

• Sudden or persistent sharp abdominal pain
• Bloody vomit or vomit that contains coffee-ground-like material
• Bloody or black stools
• Dizziness or feeling faint, especially upon standing or exertion

Treatment plan

Once the ulcer is diagnosed, your doctor will treat you to achieve these goals:

• Eliminate the H. pylori bacteria with antibiotics
• Relieve pain and promote healing by using medications that will reduce digestive acid secretions

You can take measures to promote healing as well as reduce the pain of peptic ulcers:

Diet modifications. Stress and spicy foods do not cause peptic ulcers. However, they can make the pain worse and interfere with healing. Do your best to take it easy while on medications for peptic ulcers and avoid spicy foods.

Smoking. Smoking cigarettes or other tobacco products increases acid production and interferes with the stomach's protective lining. Quit smoking to promote healing and help to prevent further ulcer formation.

Alcohol. Alcoholic beverages irritate the stomach lining, leading to gastritis and peptic ulcers. In addition, some medications for ulcers can increase your blood alcohol concentration. Avoid or limit alcoholic beverages while being treated for peptic ulcers.

Avoid nonsteroidal anti-inflammatory drugs (NSAIDs): These medications make the stomach more susceptible to recurrence of ulcers.

Be aware that herbs and supplements are not strictly regulated by the Food and Drug Administration. Do not assume if a product is considered "natural" that it is harmless. Many substances do not have sound science behind them to prove their safety or how well they work. Manufacturers may not be giving you what you think you are getting, or the way the substance is processed may be unhealthy or unsafe.

With many of these products, doctors do not know enough about them. Herbs and supplements may interact with prescription and over-the-counter medications or can worsen your health conditions. Consider that some supplements, such as vitamin A, may be unsafe when taken in mega doses.

It is strongly advised that you talk to your doctor before taking any supplement or herb. If you are taking an herb or supplement and notice any unusual symptoms, stop taking the substance immediately and talk to your doctor.

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This article was reviewed and updated June 2007.