‘Stomach ulcers,’ for real, or could it be something else?

General Healthcare

  6 Minutes

‘Stomach ulcers’ is such common South African problem and a term we often hear about on our help line and various social media platforms. Although some patients are formally diagnosed as such, many use the term ‘stomach ulcers’ or simply ‘ulcers’ to describe any condition which causes abdominal pain. In this article we unpack this phenomenon and hopefully provide readers with more context and insight.

A ’real’ stomach ulcer?

The formal medical term for a stomach ulcer is a ‘gastric ulcer’, ‘gastric’ being the medical word for stomach. This where we start to go wrong because many of us use the word ‘stomach’ to describe the whole tummy or abdomen when the stomach is a specific organ within the gastrointestinal tract. Food enters the stomach via the oesophagus above (food pipe) and exits the stomach into the duodenum below which is the first part of the seven-meter-long small intestine. In the stomach, food is chemically broken down and digested by stomach juices including hydrochloric acid.

Human Gastrointestinal Tract

The stomach has a protective layer of mucous which protects the wall of the stomach from the stomach acid it contains, and when this protective layer is weakened or reduced, the stomach acid starts to erode the stomach wall.

Initially, this causes a milder, surface inflammation known as gastritis (gastric inflammation) and if this is not properly treated and it worsens, a deeper eroded area can occur and form an actual gastric ulcer.

Peptic Ulcer

Interestingly, this can also happen just outside the stomach below in the duodenum. When the ulcer appears in this region it’s known as a ‘duodenal ulcer.’ The medical term peptic ulcer disease (PUD) is used to describe ulcers which can be in the stomach itself and/or in the duodenum.

Peptic Ulcer in Stomach

Causes of peptic ulcer disease

Peptic ulcers occur more commonly in men than in women and usually around age 30-50 years. You have an increased risk of developing gastric or duodenal ulcers (peptic ulcer disease) under the following situations:

  • Over consumption of alcohol
  • Smoking
  • High stress levels
  • Long term use of pain medicines such as aspirin, ibuprofen, and naproxen (known as non-steroidal anti-inflammatories)
  • Family history of peptic ulcer disease
  • Presence of a harmful bacteria called helicobacter pylori.

What are the warning signs?

If you have a combination of the following symptoms, you could have a peptic ulcer or the start thereof known as gastritis:

  • Bloating, burping, excessive feeling of fullness.
  • Ongoing indigestion (although this can occur without peptic ulcer or gastritis).
  • Burning or gnawing-like pain in the stomach area (epigastrium) – worse after eating (gastric ulcer) or temporarily improved by eating (duodenal ulcer).
  • Moderate to severe pain in the upper abdomen which can wake you up at night.
  • Ongoing nausea and vomiting.
  • Unexplained dark coloured stool.
  • Weight gain or weight loss (depending on the type of ulcer).

Duodenal ulcers are typically more common than gastric ulcers. With a duodenal ulcer the ‘stomach’ pain temporarily improves from eating and then returns 2-3 hours later, whereas in gastric ulcers pain is worsened by eating, often causing the person to avoid eating. The two forms of ulcers can therefore also result in weight gain or weight loss respectively. In terms of their causes, gastric ulcers are more associated with NSAID medicines and duodenal ulcers more linked with H pylori infections.

Other common conditions often mis-labelled as ‘stomach ulcers’ include:

  • Simple indigestion or ‘heartburn’. This is a sensation of fullness, heaviness, and discomfort felt in the upper abdomen and behind the breastbone and may be experienced as a burning sensation. This is a temporary condition and often related to heavy meals, eating foods we are intolerant of such as gluten, spicy, oily foods, or simply eating too quickly.
  • Gastro oesophageal reflux (GORD), also known as ‘reflux’ or heartburn. This is when the stomach contents and acid move in the wrong direction and up into the food pipe or even into the mouth at times, causing a burning acid taste. This can occur together with a peptic ulcer or can occur on its own.
  • Irritable bowel syndrome. This is a common long-term condition affecting how the intestines contract and function, and can be associated with tummy pain, spasms and cramps known as ‘spastic colon’ or irregular bowel habits i.e., constipation and/or diarrhoea.

What to do if you think you may have a peptic ulcer?

Peptic ulcers are a serious condition which should be assessed and managed by a doctor, however there are important things you can do to prevent and assist with the treatment of this condition, which include:

  • Stop smoking.
  • Reduce or exclude alcohol.
  • If you take NDSAIDS on a regular basis for pain and inflammation, find an alternative way of managing your pain.
  • Try to address high stress levels by exercising, taking walks, meditation etc.
  • Make long terms dietary changes such as reducing intake of red meat, fatty foods, processed foods and fizzy drinks.
  • While ill, consider the ‘root vegetable and pumpkin diet’ below:

Diet Table

Supportive remedies you can consider for a healthy digestive system

A.Vogel Multiforce Alkaline Powder is a multi-mineral combination product, containing health supplements (minerals) and a homeopathic complex that supports the body’s acid buffering mechanism by providing essential alkaline minerals required to combat a typical acidogenic diet (high in animal protein and low/deficient in fruit, vegetables and minerals) and lifestyle, thereby assisting in addressing the negative consequences thereof.

Used daily, A.Vogel Multiforce Alkaline Powder may help to alleviate heartburn and digestive tract discomfort due to excess acid.

Adults: 1 Sachet or one teaspoon (approx. 7,5 g) daily.

A.Vogel Indigestion Formula is a supportive treatment for heartburn, indigestion and associated symptoms. The ingredients balance excessive stomach acid, promote healthy secretion of digestive fluids to improve digestion, reduce discomfort, and combat the effects of overindulgence.

For adults and children over 12: 10 Drops 4 times daily. For children 6 – 12: 5 Drops 4 times daily. For Children 2 – 6: 2 Drops 4 times daily. In acute/severe cases: Take the relevant number of drops, as specified above hourly, gradually reducing frequency as improvement occurs, or as directed by a doctor, pharmacist or other healthcare provider. Discontinue once improvement occurs.

A.Vogel Molkosan is made from lactofermented whey, and is a prebiotic food supplement. It assists in promoting better digestive health. It can be taken either alone, before or alongside a probiotic supplement.

General digestive health maintenance: Adults and children over 12: 10 ml once daily. Children 6 – 12: 5 ml once daily. Additional support: Adults and children over 12: 20 ml once – twice daily. Children 6 – 12: 5 ml twice daily. Children under 6: Consult a healthcare professional.

Taking too many NSAIDS for pain? The following remedies may be of assistance.

  • ThreshHold RealMSM is used as an anti-inflammatory and assists in the temporary relief of pain, swelling, redness, inflammation, and difficult mobility of the joints in patients with arthritis. It improves range of motion and physical function in arthritis patients as well as supports recovery for exercise and reduces post-exercise muscle soreness and joint pain.
  • A.Vogel Multiforce Alkaline Powder, used daily, may help to assist in the relief of joint pain, lower back pain and reduced mobility/flexibility, which are common consequences of an acidogenic diet. It also improves symptoms of osteoarthritis and age-related joint discomfort and degeneration, such as pain and stiffness, support healthy uric acid levels through regulating acid/alkaline balance and, when used in conjunction with conventional therapy, may help relieve the symptoms associated with gout.
  • A.Vogel Petadolor Analgesic Formula is a homeopathic medicine for the supportive treatment of painful conditions. In accordance with homeopathic literature, ingredients specifically address conditions characterised by nerve pain and spasms. Suggested for painful spasms of the neck and back, associated headaches and nerve pains.
  • A.Vogel Migraine Formula is a homeopathic medicine for the prevention and supportive treatment of headaches, and recurring headaches. In accordance with homeopathic literature, ingredients address spasms, tension, and support detoxification as well as address associated symptoms such nausea, visual disturbances and light sensitivity.
  • A.Vogel Arthritis Formula is a homeopathic medicine for the supportive treatment of age-related or degenerative joint pain and discomfort. In accordance with homeopathic literature, ingredients assist to address minor pain, stiffness, and discomfort of the joints including the hands and feet with specific aggravation by cold and wet weather.
  • A.Vogel Rheumatism Formula is a homeopathic medicine for the supportive treatment of rheumatism. In accordance with homeopathic literature, ingredients address symptoms such as mild to moderate pain and discomfort of red and swollen soft tissue within the musculoskeletal system such as muscles, tendons, fibrous tissue as well as nerve pain and rheumatism.

Stressed and need to support the nervous system? Consider the following supportive products:

  • Bio-Strath, a plasmolysed herbal yeast providing nutritional support to reduce fatigue and stress, strengthen the immune system and help recover from illness (convalescence).
  • A.Vogel Neuroforce is a homeopathic nerve tonic. The ingredients specifically address nervous tension and exhaustion during or after stressful events with hypersensitivity, agitation and restlessness. Indicated for emotional symptoms such as grief, tearfulness, anger, resentment, irritability, anticipation, fear and depressed mood. To support the nervous system during periods of stress, conflict or emotional strain or to use in situations of acute shock and trauma.
  • A.Vogel Nervousness Insomnia Formula is a homeopathic medicine for the supportive treatment of nervousness, nervous exhaustion and sleeplessness. In accordance with homeopathic literature, ingredients address symptoms such as restlessness, tension, anxiety, and nervous exhaustion which can lead to sleep problems.
  • A.Vogel Dormeasan is a herbal medicine for the relief of sleep disturbances, stress and anxiety. Ingredients support the nervous system by having a calming action and address symptoms such as restlessness and anxiety, and promote restful sleep.
  • A.Vogel Valeriana is a mild herbal sedative for the supportive treatment of nervous tension, anxiety, restlessness, irritability and sleeplessness.


Any ongoing stomach pain and discomfort needs to be professionally investigated, diagnosed, and treated. Although many cases of ‘ulcers’ are most likely indigestion or heartburn, one should not make this assumption without seeking medical advice, as peptic ulcers are serious medical conditions.

Knowing how to prevent peptic ulcers from forming, what to do to promote recovery, and support prescribed treatment goes a long way toward a successful and permanent recovery.