What does a painful ulcer feel like? Unveiling the Symptoms

September 28, 2025 •

4 min read

According to Yale Medicine, roughly 6% of Americans are diagnosed with peptic ulcers each year. If you are experiencing persistent abdominal pain, you might be asking: What does a painful ulcer feel like? The discomfort is typically described as a gnawing or burning sensation in the upper abdomen.

Quick Summary

A painful ulcer commonly manifests as a burning or gnawing pain in the upper abdomen, often between the breastbone and belly button. This discomfort can intensify when the stomach is empty, after eating, or at night, and may be accompanied by bloating, nausea, and changes in appetite.

Key Points

Gnawing or Burning Pain: The most common sensation of a painful ulcer is a localized gnawing or burning pain in the upper abdomen, between the breastbone and belly button.
Empty Stomach Pain: Pain often increases when the stomach is empty, typically between meals or at night, for many people with peptic ulcers.
Accompanying Symptoms: Beyond pain, ulcers can cause bloating, belching, nausea, vomiting, loss of appetite, and unintentional weight loss.
Timing is Key: Ulcer pain can come and go in waves, lasting for minutes to hours, and may be temporarily relieved by food or antacids.
Red Flag Symptoms: Severe bleeding (black, tarry stools; coffee-ground vomit), sudden sharp abdominal pain, and unexplained fatigue require immediate medical attention.
Gastric vs. Duodenal: The timing of pain relative to meals can sometimes differ between ulcers in the stomach (gastric) and upper small intestine (duodenal).
Not Always Painful: Some ulcers are 'silent' and may not cause noticeable symptoms until a serious complication arises.

Understanding the Distinct Sensation of Ulcer Pain

While stomach pain is a common ailment, the discomfort from a painful ulcer is often described with specific characteristics that help distinguish it. Unlike a general ache, ulcer pain is typically localized to the upper-middle abdomen, a concentrated area between the breastbone and the belly button. This isn't a simple discomfort; it's a persistent, gnawing, or burning sensation, often likened to an acid burn from the inside. This feeling occurs because the stomach's protective lining has been eroded, allowing digestive acids to irritate the open sore.

The Timing and Triggers of Ulcer Discomfort

The timing of ulcer pain can be a key indicator. For many, the pain intensifies when the stomach is empty, such as between meals or in the middle of the night. This happens because the absence of food allows stomach acid to more directly aggravate the ulcer. Conversely, some people with duodenal ulcers may find temporary relief by eating, as food can act as a buffer against the acid. This relief is often short-lived, with the pain returning as the stomach empties again. Over time, the pain can come and go in persistent waves, lasting anywhere from a few minutes to several hours, sometimes for weeks or even months.

Other Accompanying Symptoms to Watch For

Beyond the central abdominal pain, ulcers can produce a range of other symptoms that affect digestion and overall well-being. These secondary signs are also important for identifying a potential ulcer:

Bloating and Belching: An ulcer can cause inflammation that slows down the digestive process, leading to a feeling of uncomfortable fullness or bloating, even after consuming a small amount of food.
Nausea and Vomiting: The irritation of the stomach lining can lead to persistent nausea. In more severe cases, this may lead to vomiting. If vomit appears bloody or looks like coffee grounds, it could signal internal bleeding and requires immediate medical attention.
Changes in Appetite and Weight: The combination of pain, bloating, and nausea can significantly reduce a person's appetite. This can result in unintentional weight loss over time.
Heartburn and Acid Reflux: Ulcers can sometimes be mistaken for heartburn, as they can cause a burning sensation in the chest. However, if your regular heartburn remedies are no longer effective, it could be a sign of a deeper issue.

Differentiating Painful Ulcers: Gastric vs. Duodenal

While both types of peptic ulcers can cause similar symptoms, their pain patterns can sometimes differ. Understanding these variations can provide more clues as to the ulcer's location.


Feature	Gastric Ulcer	Duodenal Ulcer
Location	Stomach lining	Upper small intestine (duodenum)
Pain Timing	Often worsens immediately or shortly after eating	Often improves temporarily after eating
Empty Stomach	Not typically affected in the same way	Pain often worsens or appears when stomach is empty, including at night
Pain Characteristics	Gnawing, burning, or aching	Gnawing, burning, or aching
Relief Mechanism	Eating may not provide relief or can worsen it	Eating or antacids typically provide temporary relief

Potential Complications and When to Seek Medical Help

If left untreated, a painful ulcer can lead to serious complications. These signs are red flags that require urgent medical attention:

Bleeding: A bleeding ulcer can cause stool to become black and tarry due to digested blood. It can also lead to vomiting blood or what looks like coffee grounds. Slow, chronic bleeding can result in anemia, causing fatigue, shortness of breath, and pale skin.
Perforation: In rare but serious cases, an ulcer can eat a hole through the wall of the stomach or small intestine. This can lead to a severe infection of the abdominal cavity (peritonitis), causing sudden, sharp, and severe abdominal pain, a life-threatening emergency.
Obstruction: Swelling and scarring from an ulcer can block the passage of food through the digestive tract. This can cause persistent nausea, vomiting, and a feeling of early fullness.

It is critical to seek medical evaluation if you experience persistent abdominal pain or any of these severe symptoms. A healthcare professional can determine the cause of your discomfort and create an appropriate treatment plan. For more in-depth medical information on peptic ulcers, refer to the National Institute of Diabetes and Digestive and Kidney Diseases.

Conclusion: Addressing the Pain and Finding Relief

Knowing what does a painful ulcer feel like is the first step toward finding relief. The classic gnawing or burning pain, combined with other symptoms like bloating, nausea, and changes in appetite, should prompt a visit to a healthcare provider. While many ulcers are treatable with medication and lifestyle adjustments, ignoring the signs can lead to serious complications. Timely diagnosis and treatment are essential for healing the ulcer and restoring your digestive health, allowing you to move past the discomfort and get back to your normal life.

Frequently Asked Questions

Ulcer pain is typically a localized gnawing or burning sensation in the upper abdomen, unlike general stomach pain. It often has a distinct timing, worsening with an empty stomach or at night. Other symptoms like nausea, bloating, and heartburn can also point toward an ulcer.

Yes, there can be subtle differences. While both gastric (stomach) and duodenal (small intestine) ulcers cause similar discomfort, duodenal ulcer pain often improves temporarily after eating, while gastric ulcer pain may feel worse immediately or shortly after a meal.

The burning sensation from an ulcer is often described as an internal acid burn, concentrated in the upper abdomen. This feeling occurs because the protective lining is compromised, allowing stomach acid to irritate the open sore.

While stress and spicy foods were once blamed for ulcers, modern medicine knows they don't cause them directly. However, they can potentially worsen ulcer symptoms by increasing stomach acid production or exacerbating the irritation.

Worsening symptoms can include more frequent or severe pain, increased nausea and vomiting, or the development of more serious signs like bloody or black stools, coffee-ground-like vomit, or unexplained dizziness and fatigue.

Yes, sometimes the gnawing or burning pain from an ulcer can radiate through to the back. This is more common in ulcers that have penetrated deeper layers of the stomach or intestinal wall.

If you suspect a painful ulcer, it is important to see a healthcare provider for a proper diagnosis. They can recommend appropriate treatment, which may include medication to reduce stomach acid and address the underlying cause, such as an H. pylori infection.