Ulser perut (stomach ulcer) is a sore in the lining of the stomach or the first part of the small intestine. The main symptom is a burning pain in the upper tummy that is often worse at night. Most ulcers are caused by H. pylori bacteria or by anti-inflammatory painkillers such as ibuprofen, not by spicy food or stress, and most heal with treatment. This guide explains the tanda ulser perut, the danger signs of bleeding, the causes, how common H. pylori is in Malaysia, tests, cara merawat ulser perut, and what to eat.
Call 999 or go to the emergency department if you vomit blood or vomit that looks like ground coffee, your poo is black, sticky and very smelly, or you have sudden severe tummy pain. These can be signs of a bleeding ulcer or a hole in the stomach.
Apa itu ulser perut?
According to the NHS, stomach ulcers (also called peptic or gastric ulcers) are sores in the stomach. Ulcers can also form in the duodenum, the first part of the small intestine, where they are called duodenal ulcers. Cleveland Clinic says duodenal ulcers make up almost 80% of peptic ulcers and stomach ulcers almost 20%.
Ulcers can be serious, but the NHS says most people recover with treatment.
In Malaysia. A study of first-time gastroscopies at University of Malaya Medical Centre over 20 years found that ulcers have become less common: duodenal ulcers fell from 21.1% of patients in 1989 to 1990 to 5.0% in 2009 to 2010, while stomach ulcers fell from 11.9% to 9.9%. Over the same period, H. pylori infection fell from 51.7% to 11.1% of patients, and a smaller share of ulcers were linked to H. pylori.
Tanda ulser perut (symptoms)
The NHS says the main symptom of a stomach ulcer is tummy pain. The pain:
- is usually in the upper part of your tummy;
- may feel like burning;
- is often worse at night.
The NIDDK (US National Institute of Diabetes and Digestive and Kidney Diseases) says the pain can be anywhere between your belly button and breastbone, may be dull or burning and may come and go. For some people it happens when the stomach is empty and eases for a short time after eating; for others, eating makes it worse.
Other symptoms include indigestion, heartburn, bloating, burping, feeling full too soon or uncomfortably full after a meal, and feeling or being sick. Many people have no symptoms until a complication develops; Cleveland Clinic says this applies to up to 70% of people with peptic ulcer disease.
See a doctor if you have indigestion that does not go away with treatment or tummy pain that keeps coming back. The NHS advises an urgent appointment if you have ulcer symptoms and your tummy pain is getting worse or does not go away, you have lost your appetite or lost weight without trying, you feel full after a very small amount of food, it feels like there is a lump in your tummy, it is painful or difficult to swallow, you keep being sick, or you feel tired all the time.
Danger signs: when to go to the emergency department
According to the NHS and the NIDDK, call 999 or go to the emergency department if:
- you are vomiting bright red blood, or your vomit looks like ground coffee;
- your poo has blood in it, or is black, sticky and very smelly;
- you have sudden, severe tummy pain that does not go away, or it is painful to touch your tummy;
- you feel dizzy or faint, or have a fast pulse;
- you have chest pain that started suddenly (see our guide to sakit dada).
Do not drive yourself. Ask someone to take you or call an ambulance, and bring any medicines you take.
Punca ulser perut (causes)
The NHS and the NIDDK say the 2 most common causes are:
- Helicobacter pylori (H. pylori) infection. The NIDDK says researchers are still studying how it spreads; it may pass from person to person through contact with vomit, stool or saliva, or through contaminated food or water.
- Anti-inflammatory painkillers (NSAIDs) such as aspirin, ibuprofen and naproxen. The NIDDK says the risk is higher if you take them for a long time, take high doses or more than 1 NSAID, take them with certain other medicines such as corticosteroids, or also have H. pylori.
Ulcers are also more common in people who smoke, and the risk increases as you get older, according to the NHS. Less common causes include other infections, some medicines such as corticosteroids when taken with NSAIDs, and certain illnesses.
Spicy food and stress: myth or fact? Cleveland Clinic says foods do not cause peptic ulcers, although spicy or acidic food can make symptoms worse. The NHS says stress, anxiety and depression can make symptoms worse, so managing stress is part of looking after yourself, but the main causes to check for are H. pylori and NSAIDs.
If you often take NSAIDs, including for period pain, the NHS advises speaking to a doctor first; see our guide to senggugut for other ways to ease period pain.
H. pylori in Malaysia
How common H. pylori is in Malaysia depends on the community. A 2018 review by Goh Khean-Lee of the University of Malaya reported that:
| Community | Estimated H. pylori prevalence |
|---|---|
| Malaysian Indians | More than 50% |
| Malaysian Chinese | 40% to 50% |
| Malays | About 10% to 20% |
The review suggests the infection mainly spreads within communities, reflecting rates in the countries of origin of each group. Most people with H. pylori have no symptoms, according to Cleveland Clinic, but it can cause ulcers, and the NHS says untreated H. pylori increases the risk of stomach cancer. If you have ulcer symptoms or ongoing indigestion, ask your doctor about an H. pylori test.
Ulser perut, gastrik or GERD?
Ulcers, gastritis (gastrik) and acid reflux (GERD) can cause similar upper tummy symptoms and often overlap. According to the NHS, ulcer pain is usually a burning pain in the upper tummy that is often worse at night, while acid reflux mainly causes heartburn, a burning feeling in the middle of the chest, with symptoms often worse after eating, when lying down and when bending over. Because the symptoms overlap, you cannot tell them apart for sure without tests. For the differences, pharmacy treatments and trigger foods, see our guide to gastrik. For other causes of tummy pain, see our guide to sakit perut.
Tests for a stomach ulcer
According to the NHS and the NIDDK, a doctor may ask about your symptoms and medicines, feel your tummy, and arrange tests:
- urea breath test for H. pylori: you swallow a special drink or capsule, then breathe into a container;
- stool test for H. pylori;
- blood test, to check for signs of H. pylori or complications;
- gastroscopy (upper endoscopy): a thin, flexible tube with a camera is passed through your mouth into your stomach to look for an ulcer and take small tissue samples.
Tip: NICE (the UK's National Institute for Health and Care Excellence) advises a 2-week break from proton pump inhibitors (PPIs, such as omeprazole) before a breath or stool test for H. pylori, because they can affect the result. Tell your doctor if you have been taking acid-reducing medicine.
Cara merawat ulser perut (treatment)
The NHS says treatment depends on the cause and usually lasts from 1 week to 2 months. Cleveland Clinic says most peptic ulcers heal within a few weeks. NICE recommends:
| Situation | Usual treatment | Things to know |
|---|---|---|
| Ulcer with H. pylori | A 7-day, twice-daily course of a PPI with 2 antibiotics, such as amoxicillin plus clarithromycin or metronidazole (eradication therapy) | Take every dose: the NIDDK warns that stopping early can leave bacteria behind and lead to antibiotic resistance. NICE advises a breath test 6 to 8 weeks after starting treatment to check H. pylori has gone |
| Ulcer from NSAIDs | Stop the NSAID where possible and take a full-dose PPI (or an H2 blocker) for 8 weeks | If H. pylori is also present, eradication therapy follows. If you must keep taking an NSAID, your doctor may prescribe a PPI alongside it |
| Ulcer without H. pylori, not taking NSAIDs | A full-dose PPI or H2 blocker for 4 to 8 weeks | Doctors may look for less common causes if the ulcer does not heal |
For a stomach ulcer with H. pylori, NICE also advises a repeat gastroscopy 6 to 8 weeks after starting treatment, depending on the size of the ulcer. If symptoms come back, the NHS says you may need a different medicine or to keep taking medicine for longer. Complications such as bleeding are treated in hospital, often during an endoscopy.
Antacids from a pharmacy can quickly relieve symptoms for a few hours, but the NHS says they do not treat the underlying cause and long-term use is not recommended.
Makanan untuk ulser perut: food and daily habits
The NIDDK says research has not found that diet plays an important role in causing, preventing or treating ulcers, and doctors do not recommend a special diet or avoiding specific foods to treat them. But some habits can ease symptoms. The NHS suggests:
| Do | Avoid |
|---|---|
| Eat smaller meals | Food or drink that triggers your symptoms, which can include fatty or spicy food, coffee and chocolate |
| Have your evening meal 3 to 4 hours before bed | Taking anti-inflammatory painkillers such as ibuprofen without speaking to a doctor |
| Try to keep to a healthy weight | Smoking: the NIDDK says it can slow ulcer healing |
| Take steps to manage stress | Drinking too much alcohol |
Complications of an untreated ulcer
The NHS says an untreated stomach ulcer can lead to serious problems that may be life threatening:
- bleeding from the stomach or intestine;
- iron deficiency anaemia caused by slow bleeding (see our guide to kurang darah);
- a hole in the stomach (perforation), which can cause peritonitis, a serious infection of the inner lining of the tummy;
- a higher risk of stomach cancer from untreated H. pylori infection (see our guide to kanser perut).
How to prevent stomach ulcers
The NIDDK suggests these steps to lower your risk:
- stop smoking, if you smoke;
- use NSAIDs only as advised. If you need them long term, your doctor may change the type or dose, shorten the course, or add a PPI;
- if you need long-term NSAIDs, ask about testing and treating H. pylori before you start;
- if you have had an ulcer, make sure the cause, such as H. pylori, has been treated, to lower the chance of another ulcer.
Frequently asked questions (FAQ)
Apa itu ulser perut (what is a stomach ulcer)?
Ulser perut (stomach ulcer or peptic ulcer) is a sore in the lining of the stomach or the first part of the small intestine (the duodenum). According to the NHS, the main causes are infection with Helicobacter pylori (H. pylori) bacteria and regular use of anti-inflammatory painkillers (NSAIDs) such as ibuprofen. They can be serious, but most people recover with treatment.
Apa tanda ulser perut (what are the symptoms)?
The main symptom is tummy pain, usually in the upper part of the tummy. The NHS says it may feel like burning and is often worse at night. Other symptoms include indigestion, heartburn, bloating, feeling full too soon and feeling or being sick. Many people with an ulcer have no symptoms until a complication happens.
What are the danger signs of a bleeding ulcer?
Call 999 or go to the emergency department if you vomit bright red blood or vomit that looks like ground coffee, your poo is black, sticky and very smelly or has blood in it, you have severe tummy pain, it is painful to touch your tummy, or you feel dizzy or faint. Do not drive yourself.
Can spicy food or stress cause a stomach ulcer?
No. Cleveland Clinic says foods do not cause peptic ulcers, and the US National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) says diet has not been found to play an important role in causing or treating them. The main causes are H. pylori and NSAIDs. However, spicy or fatty food, coffee and alcohol can make symptoms worse in some people, and the NHS says stress, anxiety and depression can make symptoms worse.
Cara merawat ulser perut: how is a stomach ulcer treated?
Treatment depends on the cause. If you have H. pylori, NICE recommends a 7-day, twice-daily course of a proton pump inhibitor (PPI) with 2 antibiotics. Ulcers caused by NSAIDs are treated by stopping the NSAID where possible and taking a PPI for 8 weeks. The NHS says treatment usually lasts from 1 week to 2 months, and you may need a test afterwards to check it has worked.
Is H. pylori common in Malaysia?
It depends on the community. A review by University of Malaya researchers reported that more than 50% of Malaysian Indians and 40% to 50% of Malaysian Chinese have H. pylori, compared with about 10% to 20% of Malays. A long-term study at University of Malaya Medical Centre found that H. pylori and peptic ulcers have both become less common over 20 years.
Can a stomach ulcer come back?
Yes. Cleveland Clinic says H. pylori can come back and ulcers may return if the cause is not addressed. To lower the risk, finish all your antibiotics, have a follow-up test if your doctor advises it, stop smoking, and do not take anti-inflammatory painkillers such as ibuprofen without speaking to a doctor first.
Disclaimer
This article is for general information only and is not a substitute for advice, diagnosis or treatment from a doctor. Health supplements are not intended to diagnose, treat, cure or prevent any disease.
References
- Stomach ulcer — NHS
- Symptoms and causes of peptic ulcers — NIDDK
- Diagnosis of peptic ulcers — NIDDK
- Treatment for peptic ulcers — NIDDK
- Eating, diet and nutrition for peptic ulcers — NIDDK
- Heartburn and acid reflux — NHS
- Antacids — NHS
- Peptic ulcer disease — Cleveland Clinic
- Gastro-oesophageal reflux disease and dyspepsia in adults: investigation and management (CG184) — NICE
- Goh KL. Lessons learnt from the epidemiology of Helicobacter pylori infection in Malaysia. J Gastroenterol Hepatol. 2018;33(6):1177-1184
- Leow AH, et al. Time trends in upper gastrointestinal diseases and Helicobacter pylori infection in a multiracial Asian population: a 20-year experience over three time periods. Aliment Pharmacol Ther. 2016;43(7):831-837
