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Treatment for a bleeding ulcer can depend on its location, cause, and severity. It may involve medical procedures or medications. Peptic ulcers are open sores in your digestive tract. When

they’re located inside your stomach, they’re also called gastric ulcers. When they are found in the upper part of your small intestine, they are called duodenal ulcers. Some people aren’t

even aware they have an ulcer. Others have symptoms like heartburn and abdominal pain. Ulcers can become very dangerous if they perforate the gut or bleed heavily (also known as a

hemorrhage). Keep reading to learn more about symptoms and treatment for ulcers, as well as to uncover a few ulcer myths. What are the symptoms of an ulcer? Ulcers don’t always cause

symptoms. In fact, only about one quarter of people with ulcers experience symptoms. Some of these symptoms include: * abdominal pain * bloating or a feeling of fullness * belching *

heartburn * nausea * vomiting Symptoms may be a little different for each person. In some cases, eating a meal can ease the pain. In others, eating only makes things worse. An ulcer can

bleed so slowly that you don’t notice it. The first signs of a slow-bleeding ulcer are symptoms of anemia, which include: * pale skin color * shortness of breath with physical activity *

lack of energy * fatigue * lightheadedness An ulcer that is bleeding heavily may cause: * stool that is black and sticky * dark red or maroon colored blood in your stool * bloody vomit with

the consistency of coffee grounds Rapid bleeding from an ulcer is a life-threatening event. If you have these symptoms, seek immediate medical attention. What causes ulcers? There’s a layer

of mucus in your digestive tract that helps protect the gut lining. When there’s too much acid or not enough mucus, the acid erodes the surface of your stomach or small intestine. The result

is an open sore that can bleed. Why this happens can’t always be determined. The two most common causes are _Helicobacter pylori _and nonsteroidal anti-inflammatory drugs. _HELICOBACTER

PYLORI_ (_H. PYLORI_) _H. pylori_ is a bacterium that lives within the mucus in the digestive tract. It can sometimes cause inflammation in the stomach lining, which leads to an ulcer. The

risk may be greater if you are infected with _H. pylori_ and you also smoke. NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS) These medications make it hard for your stomach and small intestine

to protect themselves from stomach acids. NSAIDs also reduce the ability of your blood to clot, which can make a bleeding ulcer much more dangerous. Drugs in this group include: * aspirin

(Bayer Aspirin, Bufferin) * ibuprofen (Advil, Motrin) * ketorolac (Acular, Acuvail) * naproxen (Aleve) * oxaprozin (Daypro) Acetaminophen (Tylenol) is not an NSAID. NSAIDS are also included

in some combination medications used to treat stomach upset or colds. If you’re using multiple medications, there’s a good chance you’re taking more NSAIDs than you realize. The risk of

developing an ulcer caused by NSAIDs is greater if you: * take a higher than normal dose * take them too frequently * drink alcohol * are elderly * use corticosteroids * have had ulcers in

the past ADDITIONAL RISK FACTORS Zollinger-Ellison syndrome is another condition that can lead to ulcers. It causes gastrinomas, or tumors of the acid-producing cells in your stomach, which

causes more acid. Another rare type of ulcer is called Cameron’s ulcer. These ulcers occur when a person has a large hiatal hernia and often cause GI bleeding. What is the treatment for

ulcers? If you have ulcer symptoms, see your doctor. Prompt treatment can prevent excessive bleeding and other complications. Ulcers are usually diagnosed after an upper GI endoscopy (EGD or

esophagogastroduodenoscopy). An endoscope is a long flexible tube with a light and camera on the end. The tube is inserted into your throat, then to the esophagus, stomach, and upper part

of the small intestine. Learn how to prepare for an endoscopy here. Generally performed as an outpatient procedure, it allows the doctor to locate and identify problems in the stomach and

upper intestine. Bleeding ulcers must be addressed quickly, and treatment can start during the initial endoscopy. If bleeding from ulcers is found during the endoscopy, the doctor can: *

inject medication directly * cauterize the ulcer to stop the bleeding * clamp off the bleeding vessel If you have an ulcer, you’ll be tested for _H. pylori._ This can be done using a tissue

sample taken during the endoscopy. It can also be accomplished with noninvasive tests such as a stool sample or breath test. If you have the infection, antibiotics and other drugs can help

fight the bacteria and ease symptoms. To be certain you get rid of it, you must finish taking the medication as directed, even if your symptoms stop. Ulcers are treated with acid-blocking

drugs called proton pump inhibitors (PPIs) or H2 blockers. They can be taken orally, but if you have a bleeding ulcer, they can also be taken intravenously. Cameron ulcers are usually

treated with PPIs, but sometimes surgery is needed to repair the hiatal hernia. If your ulcers are the result of taking too many NSAIDs, work with your doctor to find another medication to

treat pain. Over-the-counter antacids sometimes relieve symptoms. Ask your doctor if it’s okay to take antacids. Recovering from an ulcer You’ll have to take medication for at least a few

weeks. You should also avoid taking NSAIDs going forward. If you have severely bleeding ulcers, your doctor may want to perform another endoscopy at a later date to be certain that you’re

fully healed and that you don’t have more ulcers. What are the possible complications? An untreated ulcer that swells or scars can block your digestive tract. It can also perforate your

stomach or small intestine, infecting your abdominal cavity. That causes a condition known as peritonitis. A bleeding ulcer can lead to anemia, bloody vomit, or bloody stools. A bleeding

ulcer usually results in a hospital stay. Severe internal bleeding is life-threatening. Perforation or serious bleeding may require surgical intervention. Outlook Ulcers can be successfully

treated, and most people heal well. When treated with antibiotics and other medications, the success rate is 80 to 90 percent. Treatment will only be effective if you take all your

medication as prescribed. Smoking and continued use of NSAIDs will impede healing. Also, some strains of _H. pylori_ are antibiotic resistant, complicating your long-term outlook. If you’re

hospitalized due to a bleeding ulcer, the 30-day mortality rate is about 11 percent. Age, recurrent bleeding, and comorbidity are factors in this outcome. The main predictors for long-term

mortality include: * old age * comorbidity * severe anemia * tobacco use * being male Busting ulcer myths There’s a lot of misinformation about ulcers, including what causes them. For a long

time, it was thought that ulcers were due to: * stress * worry * anxiety * a rich diet * spicy or acidic foods People with ulcers were advised to make lifestyle changes such as reducing

stress and adopting a bland diet. That changed when _H. Pylori_ was discovered in 1982. Doctors now understand that while diet and lifestyle can irritate existing ulcers in some people,

generally they do not cause ulcers. While stress can increase stomach acid that in turn irritates the gastric mucosa, stress is rarely the main cause of an ulcer. An exception is in

individuals who are very ill, such as those in a critical care hospital unit. Another longstanding myth is that drinking milk is good for ulcers. That may be because milk coats your stomach

lining and relieves ulcer pain, at least for a short time. Unfortunately, milk encourages production of acid and digestive juices, which actually makes ulcers worse.