On this page
Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Yes, usually. A likely stomach ulcer is assessed by video, an H. pylori test arranged, and an acid-suppressing course plus eradication treatment prescribed where the test is positive; vomiting blood, black stools, sudden severe pain, swallowing difficulty or weight loss go to urgent in-person care.
- What it is: a break in the lining of the stomach or duodenum, usually 0.5 to 2 cm across, where acid reaches the tissue beneath; about 1 in 10 people have a peptic ulcer at some time, duodenal ulcers in younger adults and stomach ulcers after 50.
- Two causes: H. pylori infection is behind most duodenal and many stomach ulcers, and anti-inflammatory painkillers (ibuprofen, naproxen, aspirin) behind most of the rest; smoking slows healing, and spicy food and everyday stress do not cause ulcers, though they can make one feel worse.
- How long: with the cause treated, most ulcers heal over 4 to 8 weeks of acid suppression, larger or painkiller-related ulcers taking up to 12; H. pylori eradication is a 1 to 2 week course, re-tested 4 weeks later, and a stomach ulcer is re-scoped.
- Test prep: before an H. pylori breath or stool test, acid-suppressing tablets are stopped for 2 weeks and antibiotics for 4, or the result can be falsely negative; the test and the prescription are both arranged in the consultation.
- Emergency: call 112 or go to emergency care for vomiting blood or coffee-ground material, black tar-like stools, feeling faint or sweaty, or sudden severe abdominal pain with a hard rigid belly, which can mean a bleeding or perforated ulcer.
Vomiting blood or material that looks like coffee grounds, or passing black tar-like stools, means an ulcer may be bleeding: call 112 or go to emergency care now. Sudden, severe abdominal pain with a hard, rigid belly can mean a perforated ulcer and is also an emergency. Difficulty swallowing, food sticking, or unexplained weight loss need urgent in-person investigation, not an online prescription.
Can an online doctor treat a stomach ulcer?
Often, yes, when there are no emergency signs. A stomach ulcer is usually caused by H. pylori infection or anti-inflammatory painkillers, and the core treatment (stopping the trigger, testing for H. pylori, and a defined course of acid-suppressing medication) can be organised by video.[1] Bleeding signs, severe pain or alarm features need emergency or in-person care instead.
The consultation is built to separate the two situations quickly: the common, treatable ulcer that responds to test-and-treat and acid suppression, and the small number of presentations that must be seen in person the same day.
Listen: Stomach Ulcers Treatment Online
The audio version of this topic from the Mobi Doctor podcast. Open the episode.
How an online consultation helps with a stomach ulcer
- Finding the actual cause: the doctor works through your painkiller use, alcohol and smoking, and your symptom pattern, because ulcer treatment that ignores the cause simply lets it come back.[1]
- The H. pylori test-and-treat pathway, organised: if testing is appropriate, the doctor directs you to the right test locally, explains how to prepare so the result is valid, and prescribes eradication treatment if it is positive.[2]
- An honest healing plan: a proton pump inhibitor is used at the right dose for a defined course to let the ulcer heal, with a clear plan rather than an open-ended repeat prescription.
- A clear line to endoscopy and emergency care: if your symptoms, age or alarm features mean the guideline answer is a camera test, or if there is any sign of bleeding, the doctor says so plainly and directs you, instead of treating blind.[3]
What the doctor checks in an online stomach ulcer consultation
Peptic ulcer assessment is history-driven, which is why it suits a video consultation, provided there are no emergency features. The doctor will typically establish:
- The pain pattern: where it sits, whether it burns or gnaws, its relationship to meals (duodenal ulcers often ease with food and wake you at night; gastric ulcers can worsen with eating), and how long it has been going on.[2]
- Painkillers that cause ulcers: ibuprofen, naproxen, diclofenac and aspirin, including the doses hidden in cold and flu remedies, and whether you take them regularly or must continue them.
- Alcohol and smoking: both delay healing and raise the risk, and both are part of the plan.
- Bleeding signs, asked directly: black tarry stools, vomiting blood or coffee-ground material, and symptoms of anaemia such as unusual tiredness and breathlessness. Any of these moves you from online treatment to urgent in-person care.[3]
- Alarm features: difficulty swallowing, food sticking, persistent vomiting and unintended weight loss, which point to an endoscopy pathway rather than a prescription.
- Whether H. pylori testing is due: based on your symptoms, history and any testing you have already had.
- What you have already tried: antacids, previous acid-suppressing courses, and any prior ulcer or eradication treatment.
What causes stomach ulcers?
A peptic ulcer is a break in the protective lining of the stomach (a gastric ulcer) or the first part of the small intestine (a duodenal ulcer), where stomach acid has reached and damaged the tissue underneath. Two causes account for the great majority.[1][4]
H. pylori infection
Helicobacter pylori is a bacterium that colonises the stomach lining, usually from childhood, and is one of the most common chronic infections in the world. Most carriers never notice it, but in some people it weakens the lining's defences and drives ulcers, which is why guidelines recommend testing for it and eradicating it when an ulcer or persistent symptoms are present.[1][2][5]
Anti-inflammatory painkillers (NSAIDs)
Non-steroidal anti-inflammatory drugs such as ibuprofen, naproxen, diclofenac and aspirin reduce the stomach's protective mucus, leaving the lining exposed to acid. Taken regularly, at higher doses, or by older people, they are a leading cause of ulcers and of ulcer bleeding.[1] If you take one of these for a genuine reason, do not simply stop it without advice: tell the doctor, who weighs the reason against the risk and can arrange stomach protection where the drug must continue.
What does not cause ulcers
Spicy food and everyday stress do not cause ulcers, despite the folklore, though they can make an existing ulcer feel worse. Pinning symptoms on a stressful month is a common way people delay finding the real, treatable cause.
How does H. pylori test-and-treat work?
Test-and-treat means confirming the infection with a reliable test, treating it with a short combination course, and then confirming it has gone rather than assuming.[2] The usual tests are a stool antigen test or a urea breath test; blood antibody tests are less useful because they stay positive long after the infection clears. Acid-suppressing tablets must be stopped for about two weeks before testing, and antibiotics for four, or the test can read falsely negative.[2] Eradication is roughly a one-week course combining two antibiotics with an acid-suppressing tablet.[5] This is one of the situations where antibiotics are genuinely indicated: they are prescribed against a confirmed bacterial target, not on suspicion, and finishing the full course exactly as prescribed matters, because half-finished courses breed resistance and failed eradication. A retest confirms success, and for a gastric (stomach) ulcer a follow-up endoscopy is usually recommended to confirm healing and rule out anything more serious.[3] An online doctor can direct the whole sequence, including where you collect the test.
Is my stomach ulcer suitable for online care?
Uncomplicated ulcers usually are; bleeding or alarm features are not. This is the decision framework the doctors use, aligned with the cited guidance.
Swipe sideways to compare →
| Presentation | Likely first step | Suitable for online care? | When referral or in-person care is needed |
|---|---|---|---|
| Burning or gnawing upper-stomach pain, no alarm features | H. pylori test-and-treat and/or a defined PPI healing course[1] | Usually yes | No improvement after a proper course, or diagnosis unclear |
| Ulcer linked to regular NSAID or aspirin use | Stop or review the NSAID; PPI course; stomach-protection plan | Often yes | The drug cannot be stopped safely, or complex medication decisions |
| Confirmed gastric (stomach) ulcer | PPI course, eradication if H. pylori positive, planned follow-up[3] | Assessment and management with referral for endoscopy | Follow-up endoscopy to confirm healing is usually recommended |
| Alarm features: swallowing difficulty, weight loss, persistent vomiting, anaemia | Urgent endoscopy referral[3] | Assessment and referral only | Always: these need investigation, not blind treatment |
| Vomiting blood or coffee-ground material, black tarry stools, or severe rigid-belly pain | Emergency care | No | Call 112 or go to emergency care immediately |
Not sure which row is you? A doctor can tell you in one consultation.
See available times →Treatment options for stomach ulcers
What you can do yourself
Remove what you can control. Pause NSAID painkillers where possible (paracetamol is the safer stand-in for most people), and if an anti-inflammatory was prescribed to you, ask the doctor before stopping rather than deciding alone. Cut alcohol right down while the ulcer heals, and take seriously the fact that smoking both raises ulcer risk and slows healing. Smaller, earlier evening meals sit more comfortably, and pharmacy antacids give short-term relief while the underlying plan works. None of this replaces treating the cause: an ulcer left with H. pylori on board, or with the painkiller still going in, tends to return.
Prescription treatment, with honest limits
A prescription is never issued without a consultation. The healing workhorse is a proton pump inhibitor (PPI) such as omeprazole, taken as a defined course (commonly four to eight weeks, longer for larger or NSAID-related ulcers) to let the ulcer close.[1][4] Where H. pylori is confirmed, eradication treatment (two antibiotics plus a PPI for about a week) deals with the cause, and a retest confirms it worked. Two honest notes belong here. First, a PPI heals but is not a permanent answer to an unexamined symptom: persistent need for acid suppression should prompt H. pylori testing and a look at the trigger, not an automatic repeat. Second, if you must stay on an anti-inflammatory or aspirin, the plan is co-prescribed stomach protection and review, not a hope that it will be fine.[1]
When it might be something else
Upper-abdominal pain has several causes, and part of the consultation is telling them apart. Inflammation of the stomach lining without a true ulcer is gastritis, which overlaps closely and shares the same triggers. Burning that rises behind the breastbone with an acid taste is reflux, covered on the GORD page. General meal-related discomfort without an ulcer may be functional indigestion. Pain boring through to the back with vomiting raises the pancreas; right-sided pain after fatty food raises gallstones; and any abdominal pain that is crushing, central and comes with sweating or breathlessness is treated as a possible heart problem, which is why the doctor asks about it directly.
When stomach ulcers are treated online, and when you need in-person care
Treated online: uncomplicated ulcers without alarm features; H. pylori testing, eradication treatment and retesting; defined PPI healing courses; stomach-protection reviews for people who must stay on anti-inflammatories or aspirin; and follow-up after a previous course. A stomach ulcer sits within the wider group of stomach and digestive problems the doctors assess online.
In-person care: anyone with alarm features (difficulty swallowing, food sticking, unintended weight loss, persistent vomiting, signs of anaemia) goes on an urgent endoscopy pathway;[3] a confirmed gastric ulcer is usually followed up with endoscopy to confirm healing; symptoms that persist despite eradication and an adequate PPI course need gastroenterology assessment; and any sign of bleeding or a perforation is an emergency, not a consultation. In those cases the video appointment buys you the right referral at the first step, with a full refund if your doctor decides you need to be seen in person.
When to get in-person care
Call 112 or go to emergency care immediately if you vomit blood or material like coffee grounds, pass black tar-like stools, have sudden severe abdominal pain with a hard, rigid belly, or feel faint and sweaty with stomach pain. These can mean a bleeding or perforated ulcer and are unmissable emergencies. Arrange urgent in-person investigation, within days not weeks, for difficulty swallowing, food sticking, unintended weight loss or persistent vomiting.
How Mobi Doctor works
- Book a time that suits you: open daily 7am–11pm CET. You can see a doctor over video, usually within 15 minutes. No subscription, exact price up front.
- Speak to a licensed doctor about stomach ulcers: a private video call: you describe what you feel, the doctor asks what matters, and you agree the right plan together.
- Leave with your plan: everything agreed before you hang up: your plan, and a prescription to use at a pharmacy near you where medication is clinically right for you. If your doctor decides you need to be seen in person, you get a full refund.
No sign-up needed
Not sure it’s a stomach ulcer? Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Gastritis can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about stomach ulcers
What is a stomach ulcer, and what causes it?
A stomach ulcer is an open sore in the lining of the stomach, or in the duodenum just beyond it, where stomach acid has eaten through the protective mucus layer into the tissue beneath. Almost all are caused by Helicobacter pylori infection, which weakens the lining, or by regular anti-inflammatory painkillers and aspirin, which reduce its protection; smoking, alcohol, steroids and age add to the risk, and stress and spicy food do not cause ulcers.
What are the symptoms of a stomach ulcer?
A stomach ulcer causes a gnawing, burning or aching pain in the upper middle abdomen, often worse soon after meals, while a duodenal ulcer typically hurts two to three hours after eating and at night and eases with food or antacids. Indigestion, bloating, nausea, belching, loss of appetite and weight loss come with it, and some ulcers cause no pain at all until they bleed, showing as black stools or vomited blood.
Can an online doctor prescribe stomach ulcer treatment in Europe?
Yes, after a video consultation, when there are no emergency signs. The doctor can prescribe a defined acid-suppressing course for a stomach ulcer and, where a test confirms H. pylori, eradication treatment, with the prescription sent to a pharmacy near you and an endoscopy referral where it is needed. A prescription is never issued without a consultation, and alarm features are investigated before treatment.
Which H. pylori test do I need for a stomach ulcer, and where do I get it?
For a suspected stomach ulcer the doctor usually directs a urea breath test, done at a laboratory or some pharmacies, or a stool antigen kit you collect at home and drop off; blood antibody tests are avoided because they stay positive after cure. Both read falsely negative after acid-suppressing tablets in the previous fortnight or antibiotics in the previous month, and a breath test a month after eradication proves the cause is gone.
What are the warning signs of a bleeding ulcer?
Vomiting blood or material like coffee grounds, passing black tar-like stools, and feeling faint, sweaty, breathless or light-headed are signs a stomach ulcer may be bleeding, and sudden severe pain with a rigid belly means it may have perforated. These are emergencies: call 112 or go to emergency care immediately rather than booking an online appointment, because bleeding ulcers are treated by endoscopy in hospital.
How long does a stomach ulcer take to heal?
With the cause treated and an acid-suppressing course, most ulcers heal over four to eight weeks, and larger or painkiller-related stomach ulcers can take up to twelve. Pain usually eases within days, which is not the same as healing, so stopping treatment early is the classic way to relapse. A gastric ulcer is usually followed up with endoscopy to confirm healing and rule out anything else.
Can I keep taking ibuprofen if I have an ulcer?
Usually not while a stomach ulcer heals, because anti-inflammatory painkillers such as ibuprofen are a leading cause of ulcers and bleeding. Use paracetamol for pain instead, and if you take an anti-inflammatory or aspirin for a genuine reason such as heart protection, tell the doctor rather than stopping alone: they weigh the need against the risk and may continue it with stomach protection.
What is the difference between a stomach ulcer and a duodenal ulcer?
Both are peptic ulcers caused by acid on a weakened lining. A stomach (gastric) ulcer sits in the stomach itself, is commoner after 50, often hurts soon after eating and is checked by endoscopy because a small number turn out to be cancers. A duodenal ulcer sits just beyond the stomach, is commoner in younger adults and with H. pylori, hurts when the stomach is empty and at night, and is almost never malignant.
What should I eat with a stomach ulcer?
No diet heals a stomach ulcer, but eating helps comfort: small regular meals, plain food such as oats, rice, bananas, cooked vegetables, lean protein and yoghurt, and avoiding alcohol, coffee, fizzy drinks, very spicy or fatty food and late large meals while the ulcer heals. Milk soothes briefly but stimulates acid afterwards, and there is no need for a bland diet once the ulcer has healed.
What can I do at home for a stomach ulcer?
At home, with a stomach ulcer, take the acid-suppressing course for the full length even once pain has gone, stop anti-inflammatory painkillers and aspirin unless prescribed, use paracetamol instead, stop smoking, cut alcohol, eat small regular meals, avoid lying down within three hours of eating, complete the H. pylori treatment and re-test, and watch for black stools or vomited blood, which mean emergency care.
How can I prevent stomach ulcers coming back?
Prevent a stomach ulcer returning by confirming H. pylori has been eradicated with a re-test, avoiding anti-inflammatory painkillers or pairing an essential one with stomach protection, not smoking, limiting alcohol, taking steroid or blood-thinning tablets only with the doctor's plan, and reporting any return of ulcer-type pain early rather than treating it with antacids for months.
What complications can a stomach ulcer cause?
An untreated stomach ulcer can bleed, slowly causing anaemia or suddenly causing vomited blood and black stools; perforate, spilling stomach contents into the abdomen; or scar and narrow the stomach outlet so food cannot pass, causing vomiting and weight loss. Long-standing H. pylori infection also slightly raises stomach cancer risk. Treating the cause and completing the course prevents nearly all of these.
Is a stomach ulcer different in pregnancy or in older people?
In pregnancy, stomach ulcers are uncommon and ulcer-type pain is more often reflux; antacids and some acid-suppressing tablets are considered suitable after a consultation, and H. pylori eradication usually waits until after the birth. In older people, ulcers are more often caused by aspirin and anti-inflammatory painkillers, bleed more easily and more silently, and new upper abdominal pain after 55 is investigated by endoscopy rather than treated blind.
- Gastro-oesophageal reflux disease and dyspepsia in adults: investigation and management (CG184), NICE, National Institute for Health and Care Excellence, 2014 (updated 2019).
- Dyspepsia, proven peptic ulcer: Clinical Knowledge Summary, NICE, National Institute for Health and Care Excellence, 2023.
- Suspected cancer: recognition and referral (NG12), NICE, National Institute for Health and Care Excellence, 2015 (updated 2023).
- Stomach ulcer, HSE, Health Service Executive Ireland, 2025.
- Eradication therapy for peptic ulcer disease in Helicobacter pylori-positive people (systematic review), Cochrane, Cochrane Collaboration, 2016.
- Stomach ulcer, NHS, National Health Service (UK), reviewed August 2025.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
Related conditions
Related reading from the Mobi Doctor blog
Eight Symptoms Of Gastritis
What Are the Main Symptoms of Gastritis? Gastritis often causes discomfort in the upper stomach along with digestive s...
Read article → Health and WellbeingPoop Looks Like Coffee Grounds
What does it mean if your poop looks like coffee grounds? Poop that looks like coffee grounds usually means digested bl...
Read article →Speak to a doctor about stomach ulcers over video, usually within 15 minutes
Licensed doctors · open daily 7am–11pm CET · exact price before payment
See available times →