Ulcer symptoms, causes and treatment: what to know about peptic ulcers
Last updated November 4, 2026
Based on PhilHealth, MedlinePlus, NHS and other trusted sources listed below. Not yet reviewed by a clinician. See the sources
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In short
A peptic ulcer is a sore in the lining of the stomach or the first part of the small intestine. Common ulcer symptoms are burning pain in the upper belly, often when the stomach is empty or at night. Most ulcers come from H. pylori germs or regular use of painkillers such as ibuprofen and mefenamic acid, not from spicy food or stress. A doctor can test for the cause, and treatment usually heals the ulcer. Vomiting blood or black stools need emergency care.
When to get help now
Call 911 or go to the nearest emergency room straight away if:
- Vomiting blood, or vomit that looks like coffee grounds
- Black, sticky, tar-like and very smelly stools, or blood in your stools
- Severe belly pain, especially if it starts suddenly, or a belly that is hard and hurts to touch
- Fainting, feeling very dizzy or weak, heavy sweating, or confusion
- Chest pain that started suddenly, or chest pain with shortness of breath or sweating
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On this page
What a peptic ulcer is
A peptic ulcer is an open sore in the lining of the stomach (a gastric ulcer) or of the duodenum, the first part of the small intestine (a duodenal ulcer). Both are often called a "stomach ulcer".
Many Filipinos say "may ulcer ako" for any burning pain in the sikmura (upper belly). But the same pain can come from acid reflux, gastritis (a swollen, irritated stomach lining) or indigestion. Only a doctor's tests can show a real ulcer.
A peptic ulcer is also different from singaw, the small sores inside the mouth. See our guide to mouth ulcers (singaw).
Ulcer symptoms: what stomach ulcer pain feels like
The main symptom is pain in the upper middle of the belly, between the breastbone and the belly button. The pain:
- often feels like burning or a dull ache
- often starts when the stomach is empty, about 1 to 3 hours after a meal
- is often worse at night and can wake you up
- may ease for a while after eating or taking an antacid
- comes and goes for days or weeks
Other ulcer symptoms are heartburn, bloating, nausea or vomiting, feeling full quickly, tiredness and weight loss.
Some people feel no pain at all until an ulcer bleeds: learn the signs in Is an ulcer dangerous? For pain in other places, see our stomach pain guide.
What causes ulcers
The two main causes are:
- H. pylori infection. Helicobacter pylori is a germ (bacteria) that can live in the stomach for years. It is the most common cause of ulcers. It probably spreads through unclean food or water, or an infected person's saliva, vomit or stool, and many people who have it never get an ulcer. In a small 2004 study of 52 adults with indigestion at the Philippine General Hospital, about 6 in 10 had H. pylori. There is no recent national figure.
- Regular use of anti-inflammatory painkillers (NSAIDs), such as ibuprofen, aspirin, naproxen and mefenamic acid, often taken for headache, toothache, period pain, rayuma or gout.
The risk from NSAIDs is higher if you take them for a long time or above the label amount, are older, smoke, drink a lot of alcohol, or also take blood thinners, steroid tablets such as prednisone, or some medicines for depression.
Spicy food and everyday stress do not cause ulcers, but they can make the symptoms worse.
Common beliefs about ulcers
"Nalipasan ng gutom kaya nagka-ulcer." Skipping meals is not among the causes medical sources list. Regular, smaller meals may still ease the pain.
"Uminom ka ng gatas para ma-coat ang sikmura." Milk and antacids cannot heal an ulcer. They may ease the pain briefly, but the sore stays until the cause is treated.
"Ulcer lang 'yan, mawawala rin." Ulcers tend to come back or get worse if the cause is not treated, and they can bleed.
"May herbal na gamot sa ulcer online." No tea or product sold online replaces testing and a doctor's treatment.
How doctors check for an ulcer and H. pylori
Tell the doctor every medicine you take, including painkillers from the botika. Tests may include:
- a breath test or stool test for H. pylori
- a blood test to check for anemia (low blood) from slow bleeding
- an upper endoscopy: a thin, flexible tube with a camera is passed through the mouth into the stomach. It shows the ulcer, and small tissue samples can be taken.
Endoscopy is usually done if there is anemia, trouble swallowing, bleeding or unexplained weight loss, or to rule out stomach cancer.
Before a breath or stool test, you may need to stop stomach medicines such as omeprazole for 2 weeks or more, because they can hide the germ. Ask your doctor which ones; do not stop a medicine on your own.
Gamot sa ulcer: how ulcers are treated
Treatment depends on the cause, so a doctor's check comes first. It usually lasts from 1 week to 2 months.
H. pylori ulcers are treated with two antibiotics plus a medicine that lowers stomach acid, taken together for 7 to 14 days. Antibiotics used include amoxicillin, clarithromycin and metronidazole. The acid-lowering medicine is usually a proton pump inhibitor (PPI) such as omeprazole.
Painkiller ulcers are treated by stopping the NSAID if possible and taking a PPI or similar medicine, often for about 8 weeks. If you must keep taking painkillers, ask about safer choices and stomach protection. Do not stop a daily aspirin prescribed for your heart without asking your doctor.
Finish the whole course even when the pain is gone, never share antibiotics, get retested if your doctor asks, and go back if symptoms return.
Pharmacy medicines. Antacids, such as aluminum hydroxide with magnesium hydroxide, ease burning for a short time but do not heal an ulcer. Ask the pharmacist and follow the label. Do not keep buying acid-lowering medicines such as omeprazole on your own: they can hide an ulcer that needs testing, so use them as your doctor advises. For pain, paracetamol is usually gentler on the stomach than NSAIDs: ask the pharmacist which is safe for you.
A bleeding ulcer is treated in hospital, often with an endoscopy. Unsure if your medicines mix safely? Ask our medicines assistant.
Is an ulcer dangerous?
An untreated ulcer can cause serious problems:
- Bleeding: vomiting blood or vomit like coffee grounds, or black, sticky, smelly stools. Slow bleeding causes anemia, with tiredness, weakness and pale skin.
- A hole (perforation) in the stomach wall: sudden severe pain and a hard belly, with a dangerous infection inside the belly. It is an emergency and often needs surgery.
- Blockage: scarring can stop food leaving the stomach, causing repeated vomiting.
- Stomach cancer: H. pylori left untreated for years raises the risk. The World Health Organization lists it among infections that cause cancer.
Vomiting blood, black stools or sudden severe belly pain: call 911 or go to the nearest emergency room now. Do not drive yourself, and bring your medicines.
Preventing ulcers and keeping them away
- Use painkillers wisely. Take NSAIDs only when needed, for the shortest time, as the label says. If you need them long term, for example for arthritis or gout, ask your doctor, who may test for H. pylori and add a stomach-protecting medicine. Check cold, flu and "all-in-one" pain medicines, since some contain them.
- Protect yourself from H. pylori. There is no vaccine. Wash your hands with soap after the toilet and before eating, eat well-cooked food, and drink clean, safe water.
- Do not smoke, and limit alcohol.
- Eat smaller meals, have dinner 3 to 4 hours before bed, and skip foods that trigger your symptoms, such as fatty or spicy food, coffee or chocolate. These steps ease symptoms; treating the cause is what heals the ulcer.
- Finish H. pylori treatment. Once the germ is gone, a new ulcer is much less likely.
Children, pregnancy and older adults
Children. Stomach ache in children is common and an ulcer is only one possible cause. See a doctor if the pain is not better within 24 hours, gets worse or keeps coming back. Never give a child ulcer medicines, antibiotics or painkillers without a doctor's advice. A child with any of the danger signs on this page needs the emergency room, like an adult.
Pregnancy and breastfeeding. Ask a doctor before taking any medicine, including antacids and painkillers.
Older adults. Ulcers and painkiller bleeding are more common with age, and bleeding can start without warning pain. If you are 75 or older, ask your doctor before using ibuprofen. Watch for black stools, dizziness or new tiredness.
Where to get checked and what it costs
Start at your barangay health station, rural health unit (RHU) or city health center: find one near you. If you need more tests, the doctor may send you to a gastroenterologist, a specialist in stomach and gut problems.
PhilHealth YAKAP. Every Filipino can register with one YAKAP clinic. PhilHealth's July 2025 FAQ says check-ups and the listed lab tests are free there; a private YAKAP clinic may charge up to ₱900 a year. Ask whether an H. pylori test is included, or where to get one.
Free medicines (PhilHealth GAMOT). As of mid-2026, the GAMOT list includes omeprazole for ulcers and H. pylori, the antibiotics amoxicillin, clarithromycin and metronidazole for H. pylori, and an antacid. Your YAKAP doctor prescribes them, and you claim them at an accredited GAMOT pharmacy, up to ₱20,000 a year per person. Each omeprazole supply covers up to 14 days, and antibiotics are given as a full course. See our PhilHealth YAKAP guide.
Endoscopy and hospital care. In the PhilHealth case rate lists we checked in November 2026, PhilHealth pays a fixed amount (case rate) of ₱20,553 for an upper endoscopy, ₱24,960 for a hospital stay for a bleeding or perforated ulcer, and ₱11,895 for an ulcer without bleeding or perforation. The hospital deducts this from your bill. Ask the hospital's PhilHealth desk what is left to pay; in a government hospital a Malasakit Center can help. See what PhilHealth covers.
Emergency room. Under its 2025 rules, PhilHealth's Outpatient Emergency Care Benefit covers bleeding, belly pain and persistent vomiting when an accredited ER sends you home within 24 hours.
Not sure what your pain means? Ask our symptoms assistant, book a call with a nurse, or see more stomach and digestion guides.
When to see a doctor
Within 24 hours
See a doctor or go to a health centre today if:
- Your belly pain is getting worse or does not go away
- You keep vomiting, or it hurts or is hard to swallow
- You feel very tired, weak or breathless, or look pale
- You have ulcer symptoms while taking painkillers, blood thinners or steroid tablets
- You feel a lump in your belly
- You have lost your appetite, feel full after a little food, or are losing weight without trying
- A child's belly pain is not better after 24 hours, is getting worse or keeps coming back
Book a visit
Make an appointment at your health centre or YAKAP clinic if:
- Burning pain in your upper belly keeps coming back
- You need antacids on most days, or indigestion does not go away with treatment
- Your symptoms return after ulcer or H. pylori treatment
- You need painkillers often, for example for arthritis or gout, and have had an ulcer before
- Your doctor asked you to come back for a test after finishing H. pylori treatment
- You are pregnant or breastfeeding and have ulcer symptoms or need medicine for them
Questions about your own situation?
Joy, our Symptom guide, answers in your language, free, any time. Joy is an AI agent, not a person: in an emergency, call 911.
Common questions
What are the symptoms of an ulcer?
Burning pain in the upper belly, often between meals or at night, with bloating, heartburn or nausea. Some ulcers cause no pain until they bleed.
Where is ulcer pain located?
Usually in the upper middle of the belly (the sikmura), between the breastbone and the belly button. Pain in the lower right belly has other causes and should be checked by a doctor.
How do I know if I have an ulcer?
Symptoms alone cannot tell, because reflux and gastritis can feel very similar. A doctor can check with a breath or stool test for H. pylori, blood tests, and sometimes an endoscopy.
What causes ulcers?
Mostly H. pylori germs or regular use of NSAID painkillers such as ibuprofen and mefenamic acid. Stress and spicy food do not cause ulcers.
What is the best gamot sa ulcer?
It depends on the cause, which a doctor checks. Treatment is usually an acid-lowering medicine such as omeprazole, plus antibiotics for H. pylori. A doctor prescribes them, and they may be free through PhilHealth YAKAP.
Can an antacid cure an ulcer?
No. Antacids from the botika ease burning for a short time but do not heal an ulcer or kill H. pylori. Follow the label. If you need them often, see a doctor.
What is the difference between an ulcer and hyperacidity?
Hyperacidity is a common word for stomach or chest burning, often acid reflux or indigestion. An ulcer is an actual sore in the lining. They feel alike, so get checked if symptoms keep coming back.
Can an ulcer heal on its own?
Small ulcers sometimes do, but ulcers tend to come back or worsen unless the cause is treated.
Is an ulcer deadly?
Most ulcers heal with treatment, but an untreated ulcer can bleed heavily or make a hole in the stomach. Call 911 or go to the nearest emergency room if you vomit blood, pass black stools or have sudden severe belly pain.
Are there home remedies for ulcers?
Doctors heal ulcers with medicines that kill H. pylori or lower stomach acid; milk and antacids do not heal the sore. Smaller meals, not smoking and less alcohol can ease symptoms, but they do not replace treatment.
Sources
- NHS (UK) Stomach ulcer (opens in a new tab) (checked November 4, 2026)
- MedlinePlus, US National Library of Medicine Peptic ulcer (medical encyclopedia) (opens in a new tab) (checked November 4, 2026)
- MedlinePlus, US National Library of Medicine Peptic ulcer (health topic) (opens in a new tab) (checked November 4, 2026)
- MedlinePlus, US National Library of Medicine Helicobacter pylori infections (opens in a new tab) (checked November 4, 2026)
- MedlinePlus, US National Library of Medicine Helicobacter pylori (H. pylori) tests (opens in a new tab) (checked November 4, 2026)
- MedlinePlus, US National Library of Medicine Ibuprofen (drug information) (opens in a new tab) (checked November 4, 2026)
- MedlinePlus, US National Library of Medicine Omeprazole (drug information) (opens in a new tab) (checked November 4, 2026)
- MedlinePlus, US National Library of Medicine Abdominal pain: children under age 12 (opens in a new tab) (checked November 4, 2026)
- National Institute for Health and Care Excellence (NICE) Gastro-oesophageal reflux disease and dyspepsia in adults: investigation and management (CG184), recommendations (opens in a new tab) (checked November 4, 2026)
- World Health Organization Cancer: fact sheet (opens in a new tab) (checked November 4, 2026)
- Philippine General Hospital researchers, via PubMed Central Laboratory diagnosis and susceptibility profile of Helicobacter pylori infection in the Philippines (Annals of Clinical Microbiology and Antimicrobials, 2004) (opens in a new tab) (checked November 4, 2026)
- PhilHealth Frequently asked questions on PhilHealth YAKAP (as of July 31, 2025) (opens in a new tab) (checked November 4, 2026)
- PhilHealth PhilHealth Circular 2026-0007: Clinical and pharmaceutical standards for PhilHealth YAKAP (Annex A: GAMOT drugs and indications; Annex B: dispensing limits) (opens in a new tab) (checked November 4, 2026)
- PhilHealth PhilHealth Circular 2025-0020: Implementing guidelines for the Outpatient Emergency Care Benefit (OECB), facility-based emergency (Revision 1), with the list of core presentations (opens in a new tab) (checked November 4, 2026)
- PhilHealth PhilHealth Circular 2024-0037, Annex A: list of medical case rates (peptic, gastric and duodenal ulcers) (opens in a new tab) (checked November 4, 2026)
- PhilHealth PhilHealth Circular 2024-0037, Annex B: list of procedure case rates (upper gastrointestinal endoscopy) (opens in a new tab) (checked November 4, 2026)
Related guides
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Almost everyone gets stomach pain at some point. Most of the time it comes from gas (kabag), indigestion, constipation or a stomach bug, and it gets better in a day or two. But some stomach pain needs a doctor fast, such as appendicitis, a bleeding ulcer or a pregnancy outside the womb. Where it hurts, how it feels and the symptoms that come with it give clues about how urgent it is, but only a health worker who examines you can find the cause.
Acid reflux and GERD: symptoms, medicines and warning signs
Acid reflux is stomach acid flowing back up into the food pipe, causing heartburn and a sour taste. Many Filipinos call it hyperacidity. When it keeps coming back, it is called GERD. Smaller meals, an early dinner, losing weight and avoiding triggers often help; pharmacy antacids ease mild symptoms. Chest pain that feels tight or spreads to the arm or jaw may be the heart: call 911. Vomiting blood or black stools need the emergency room. Trouble swallowing or weight loss need a doctor soon.
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Mouth ulcer (singaw): causes, home remedies and when to worry
Singaw is the Filipino word for a mouth ulcer: a small, shallow, painful sore inside the lips, cheeks, tongue or gums. Most singaw heal on their own in 1 to 2 weeks and are not contagious. Salt-water rinses, soft cool food and pharmacy gels or mouthwashes ease the pain. See a doctor or dentist if a sore lasts more than 3 weeks, keeps coming back, or comes with fever, a rash or trouble drinking.
Headache: common types, remedies and when it is dangerous
Most headaches are tension headaches or migraine. They can hurt a lot but are usually not a sign of something serious, and often ease with rest, water, food and a simple painkiller. Taking painkillers too often can itself cause a headache every day. A headache cannot tell you your blood pressure: measure it. Get help straight away for a sudden, extremely painful headache, or a headache with weakness, confusion, a seizure, fever with a stiff neck, or after a head injury.
PhilHealth YAKAP (formerly Konsulta): how to register and what is free
PhilHealth YAKAP is the free primary care benefit that replaced Konsulta in 2025. Every Filipino can register with one YAKAP clinic for free consultations, a yearly health check, lab tests, cancer screening and up to ₱20,000 a year in medicines. You choose a clinic through the eGovPH app, the PhilHealth Member Portal, a PhilHealth office or the clinic itself, then complete your first visit there. Public YAKAP clinics charge nothing for covered services.
What does PhilHealth cover? PhilHealth benefits explained
PhilHealth is the Philippines' national health insurance, and every Filipino is covered under the Universal Health Care law. It pays for hospital stays, emergency room care, pregnancy and childbirth, dialysis, some outpatient treatments, primary care through YAKAP, and costly illnesses under Z Benefits. Under PhilHealth's rules, covered care in a ward bed at an accredited hospital should cost you nothing extra. Here is what PhilHealth covers as of October 2026 and how to use it.
Malasakit Center: how to get help with your hospital bill
A Malasakit Center is a one-stop help desk inside many government hospitals. Staff from PhilHealth, DSWD, PCSO and DOH programmes sit side by side there. They help patients who are poor, or who simply cannot pay a big bill right now, with the cost of hospital care, medicines, tests and some non-medical needs. Bring a valid ID, a clinical abstract and your bill, and see the social worker early in the hospital stay. Asking for help is free.
More on Stomach and digestion
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