Gastric Pain and Stomach Ulcer

Many patients sought our advice for the problem of gastric pain. Such patients often say they have “gastric”. It usually points to a discomfort over the gastric area, which is the area in the centre, just below the breastbone. If the pain is intense, the patient may have a stomach ulcer (medically called a peptic ulcer). Any painful sores that affect the stomach lining or small intestine are considered as peptic ulcer.

Understand your problem

Under normal circumstances, acid is produced in the stomach to aid digestion of food. The stomach also has several mechanisms to protect its lining against the highly corrosive acid. When there is an imbalance between acid production and the protective mechanisms, ulcers can form.


The following are most commonly identified as contributors to the imbalance:


  • Helicobacter pylori infection – this is a kind of bacteria
  • Drugs like aspirin and certain pain medication like Ponstan, Synflex, Indocid, etc
  • Severe physiologic stress
  • Chronic smoking
  • Alcohol, especially binge drinking


Peptic ulcer can present with upper abdominal pain or indigestion. It can also give rise to complications such as bleeding, perforation or obstruction.


When the ulcer erodes through a blood vessel, bleeding will occur. You may complain of vomiting of either fresh blood or black material (partially digested blood), or the passing of black, sticky stools. This blood loss can also lead to anemia.



If the ulcer erodes through the wall and into the abdominal cavity, a perforation occurs. The patient will complain of sudden, severe diffuse abdominal pain when this happens. This is a serious complication, and if left untreated, can be quickly fatal.

Seek for Treatment

Assessment for peptic ulcer disease may include performing a gastroscopy to visualise the lining of the stomach and duodenum. If an ulcer is present, a biopsy of the ulcer can be taken to check for the presence of cancer cells. A special test can also be performed on a small biopsy of the stomach lining to check for presence of Helicobacter pylori infection. A urea breath test can also be done to rule out Helicobacter pylori infection.


The doctor will prescribe medications either to reduce acid secretion or to eradicate the Helicobacter pylori infection.


Consult your doctor if you experience any of following symptoms:

  • black, tarry stools
  • recent unexplained weight loss
  • symptoms of anaemia: lethargy, shortness of breath, palpitations, chest pain, or dizziness
  • recurrent burning pain in your upper abdomen

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