Published by PMR of NY & CT
A burning or gnawing ache in your upper belly, often worse on an empty stomach, is the classic sign of a peptic ulcer. For decades, the standard advice was a strict, bland diet, which did little to help.
Most ulcers are caused by an infection with H. pylori bacteria or by regular use of certain pain relievers. Treating that cause, along with acid-reducing medicine, heals the ulcer. A stomach ulcer diet plays a supporting role: it may ease discomfort and give your body the nutrients it needs to heal.
What causes stomach ulcers
A peptic ulcer is an open sore in the lining of the stomach or the first part of the small intestine, called the duodenum. The two main causes are:
- H. pylori infection. These bacteria can live in the stomach for years and weaken its protective lining. Doctors usually test for them with a breath or stool test, or a biopsy during an endoscopy, and treat them with antibiotics plus acid-reducing medicine.
- NSAIDs. Nonsteroidal anti-inflammatory drugs, such as ibuprofen, naproxen and aspirin, reduce substances that protect the stomach lining. The risk rises with higher doses, daily use, older age and a past ulcer.
Spicy food and everyday stress don't cause ulcers, though they can make symptoms worse for some people. Smoking and heavy drinking raise the risk and slow healing.
Foods to include in a stomach ulcer diet
No single food heals an ulcer, but a balanced, mostly whole-food diet supplies the protein and vitamins your body uses for repair. Many people find these choices comfortable:
- Protein-rich foods, such as salmon, turkey, eggs and Greek yogurt
- Colorful produce you tolerate, such as berries, bell peppers, leafy greens and sweet potatoes, which supply vitamins A and C
- Whole grains and legumes, such as barley, brown rice and lentils, if they agree with you
- Moderate amounts of healthy fats, such as olive oil and avocado
Some research suggests probiotics, from yogurt with live cultures or supplements, may ease side effects such as diarrhea during antibiotic treatment for H. pylori. The evidence is mixed, so ask your doctor before adding a supplement.
Foods and drinks that may make symptoms worse
A stomach ulcer diet doesn't need to be strict or bland. Instead, notice how you feel after:
- Alcohol, which irritates the stomach lining and can slow healing
- Spicy dishes, if they bring on burning
- Large, high-fat meals, which stay in the stomach longer
- Acidic foods, such as citrus juice and tomato sauce, for some people
- Carbonated drinks, which can add to bloating
Milk was once a standard ulcer remedy. It may soothe briefly, but it also prompts the stomach to make more acid, so it's no longer recommended as treatment. If dairy agrees with you, there's no need to avoid it. Cut out only foods that clearly bother you.
Daily habits that help an ulcer heal
How and when you eat matters too:
- Choose moderate portions. A very large meal stretches the stomach and can increase discomfort.
- Leave time before bed. Finishing meals two to three hours before lying down may mean less discomfort at night.
- Quit smoking. Smoking slows healing and makes ulcers more likely to come back.
- Finish your medicines. Take the full course of antibiotics for H. pylori, even after you feel better, and keep any follow-up test to confirm the infection is gone.
Managing pain without irritating your stomach
Many ulcers develop after months of taking NSAIDs for back pain, arthritis or an old injury. If that sounds familiar, ask your doctor about other pain relievers or a medicine to protect your stomach. Don't stop a daily aspirin prescribed for your heart without talking with your doctor first.
Non-drug care can help, too. A physiatry and pain management evaluation looks at what’s driving your pain and builds a plan that may include physical therapy, exercise or acupuncture. These approaches may reduce how often you reach for pain relievers.
When ulcer symptoms are an emergency
Ulcers can bleed or, less often, wear a hole through the stomach wall. Call 911 or go to the emergency room if you have:
- Vomit that contains blood or looks like coffee grounds
- Black, tarry or bloody stools
- Sudden, severe belly pain that doesn't let up
- Dizziness, fainting or a racing heart
See your doctor soon for burning stomach pain that keeps coming back, pain that wakes you at night, trouble swallowing, ongoing vomiting or weight loss you can't explain.
Frequently asked questions
How long does it take a stomach ulcer to heal?
With treatment, many ulcers heal within about four to eight weeks. Your doctor usually prescribes an acid-reducing medicine, plus antibiotics if H. pylori is the cause. Healing can take longer with a large ulcer or if you keep smoking or taking NSAIDs. Your doctor may recheck for H. pylori after treatment or repeat an endoscopy to confirm the ulcer has healed.
Can stress cause a stomach ulcer?
Everyday emotional stress isn't a main cause of ulcers, though it may make symptoms feel worse and make healthy habits harder to keep. Severe physical stress is different. People who are critically ill, such as those in intensive care after major surgery, serious burns or severe injuries, can develop stress ulcers, which hospital teams work to prevent.
Is coffee bad for a stomach ulcer?
Coffee doesn't cause ulcers, but both regular and decaf coffee can increase stomach acid, and some people notice more burning after a cup. If coffee bothers you, cut back while you heal and avoid drinking it on an empty stomach. If it doesn't affect your symptoms, a moderate amount is usually fine. Ask your doctor if you're unsure.
Talk with our team about pain relief
Your primary care doctor or a gastroenterologist treats the ulcer itself. If ongoing back, neck or joint pain has you relying on pain relievers, Physical Medicine & Rehabilitation of NY & CT (PMR) can talk through other ways to manage it. Request an appointment, and a member of our team will be in touch to schedule.
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