. However, in some cases, the body produces too much stomach acid, and the mucous lining becomes damaged or worn down. He works at a cancer center in New York, focusing on pain and palliative medicine, and has a primary care practice with an emphasis on LGBT care. In some cases, the doctor will also give you a blood transfusion. This way, doctors can visualize the ulcers on your stomach and determine if any are bleeding . Peptic ulcers are painful sores in the lining of the stomach, esophagus, or small intestine. Hole . Ulcers typically take 2-8 weeks to heal. These medications make it hard for your stomach and small intestine to protect themselves from stomach acids. However, ulcers often come back. In most cases, black stool is the result of something that is not dangerous and will heal itself. Peptic ulcers that don't heal with treatment are called refractory ulcers. If your doctor detects an ulcer, a small tissue sample (biopsy) may be removed for examination in a lab. However, this is not always a cause for concern and may not always cause noticeable symptoms. Being diligent about hand washing and doing what you can to avoid consuming contaminated food and beverages (such as foods kept in unsanitary conditions or dirty water) are the only known ways to avoid the infection. Left untreated, an ulcer can eventually lead to a tear in the stomach or small intestine lining and cause severe internal bleeding. A peptic ulcer on. Bleeding can be mild and ongoing or come on suddenly and be life-threatening. It can occur in any part of the digestive system (GI tract), which runs from the mouth to the anus. Sometimes an ulcer makes a hole in the wall of your stomach or duodenum. For peptic ulcers, some questions you might want to ask your doctor include: In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask other questions during your appointment. AskMayoExpert. For a serious ulcer, you may need to have surgery to stop the bleeding, which will help you start healing. When this happens, bacteria and partly digested food can get in. PPIs that you can buy over the counter include: Lansoprazole and omeprazole are also available in prescription strength. enable-background: new; In fact, only about one quarter of people with ulcers experience symptoms. Bleeding ulcers must be addressed quickly, and treatment can start during the initial endoscopy. Ulcers are usually diagnosed after an upper GI endoscopy (EGD or esophagogastroduodenoscopy). Here's some information to help you get ready, and what you can expect from your doctor. In others, eating only makes things worse. Internal bleeding: While most people with ulcers won't have bleeding, this is the most common complication that can occur. Am I at risk of complications related to this condition? } Medications to reduce acid production. Generally performed as an outpatient procedure, it allows the doctor to locate and identify problems in the stomach and upper intestine. If the doctor doesnt mention the test results to you, make a point to ask them. The visual texture of bloody stool is compared to that of roofing tar. The term peptic means it is related to acid. You will also receive Its important to get medical attention as soon as possible. Learn what the procedure involves and how to prepare for it. As an ulcer wears away the muscles of the stomach or duodenal wall, blood vessels may be hurt. Doctors refer to these as bleeding ulcers. Your doctor may prescribe antibiotics to treat a stomach ulcer caused by the H. pylori bacterium. According to research, about 10% of the population deal with a peptic ulcer at some point in their lives. Ratnaparikh P, et al. Youll have to take medication for at least a few weeks. H. pylori may also spread from person to person. ", https://www.mayoclinic.org/diseases-conditions/peptic-ulcer/symptoms-causes/syc-20354223, http://patients.gi.org/topics/peptic-ulcer-disease/, https://www.nhs.uk/chq/Pages/how-should-i-collect-and-store-a-stool-faeces-sample.aspx?CategoryID=69, https://www.mayoclinic.org/diseases-conditions/peptic-ulcer/diagnosis-treatment/drc-20354229, https://www.healthlinkbc.ca/medical-tests/hw1531#hw1601, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3811928/, https://familydoctor.org/condition/ulcers/, https://www.drugs.com/health-guide/peptic-ulcer.html. If you suspect that you may have a bleeding ulcer, schedule an appointment with your doctor. If this bacteria is still present, your doctor will prescribe a different course of antibiotics for you. Treatment will depend on how severe the. By signing up you are agreeing to receive emails according to our privacy policy. But some potential symptoms of ulcers may include: If an ulcer is bleeding, you may also experience: Often, people dont know they have a bleeding ulcer. These may include amoxicillin (Amoxil), clarithromycin (Biaxin), metronidazole (Flagyl), tinidazole (Tindamax), tetracycline and levofloxacin. Quickly treating peptic ulcers, especially bleeding peptic ulcers, is the best way to avoid complications. This content does not have an English version. In a vagotomy, the vagus nerve (the nerve that connects the stomach to the brain) is severed. In some cases, it is possible to treat a bleeding ulcer during the endoscopy. When theyre located inside your stomach, theyre also called gastric ulcers. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. A: If you have peptic ulcer disease, which can involve stomach ulcers and/or duodenal ulcers of the small intestine, the answer is yes! Let's look at why and other FAQs: Stomach ulcers are usually diagnosed with a minimally invasive endoscopy procedure. This can lead to ulcers, especially if you take NSAIDs regularly. Your physician will use one of these procedures: Fulguration: "burning off" the ulcers by using a special instrument with a heated tip or a laser technique. After a person receives treatment for H. pylori, they should follow up with a healthcare professional for testing to make sure the infection is gone. Ulcers can be successfully treated, and most people heal well. National Institute of Diabetes and Digestive and Kidney Diseases. Most ulcers heal in 4 to 8 weeks. information highlighted below and resubmit the form. American College of Gastroenterology. Notably, there is pain in the upper abdomen or stomach. Medicines that doctors recommend or prescribe to treat peptic ulcers include. Your doctor could also use a clamp or cauterization . Peptic ulcer: treatment. Treatment will only be effective if you take all your medication as prescribed. The ulcer may also be painful when you havent eaten for a few hours and your stomach is empty. This results in an open sorecalled an ulcerthat can be as small as 14 inch (0.64cm) to as large as 2 inches (5.1cm) in diameter. Instead, blood causes black, tar-like stools. Infections and some medications can cause bleeding ulcers. Approved. Long-term use of proton pump inhibitors, particularly at high doses, may increase your risk of hip, wrist and spine fracture. In: Conn's Current Therapy 2020. Start Here. Your in-depth digestive health guide will be in your inbox shortly. Accessed July 27, 2020. Without the right treatment, ulcers can lead to serious health problems, including: . Have your symptoms been continuous or intermittent? XIe X, et al. Peptic ulcer disease (adult). According to a study from 2012, H. pylori and NSAIDs are the most prevalent causes of peptic ulcers. MNT is the registered trade mark of Healthline Media. You may also need surgery if the stomach or small intestine lining tears because the ulcer has eaten away at the tissue. Peptic ulcer disease. Mallory-Weiss syndrome occurs when severe and prolonged vomiting causes tears in the lining of the esophagus. Peptic ulcer disease and helicobacter pylori infection. Minor ulcers may not cause any symptoms. Management of peptic ulcer through homeopathy. Does anything seem to improve your symptoms? That causes a condition known as peritonitis. Bleeding in the digestive tract is a symptom of a problem rather than a disease itself. Duodenal ulcers take about six weeks to heal. If you notice symptoms of a bleeding ulcer, such as moderate burning in your upper abdomen, recurring feelings of nausea, or blood in your vomit or stool, visit an Urgent Care center or emergency room immediately, since a hemorrhaging ulcer can be life-threatening. An endoscope is a long flexible tube with a light and camera on the end. Have you ever vomited blood or black material? Excessive ulcer bleeding is a medical emergency. Ulcerative colitis is a chronic inflammatory disease. Perforation: An ulcer that is continuously eroded by acid can eventually become a hole in the stomach or intestinal wall. time. What, if anything, appears to worsen your symptoms? When did you first begin experiencing symptoms? 2005-2023 Healthline Media a Red Ventures Company. Read More Sometimes, peptic ulcers can bleed. digestive health, plus the latest on health innovations and news. In this article, well take a closer look at what types of treatment can help heal an ulcer, how long it typically takes to heal, and what types of complications can arise without proper treatment. Blood in your stool or vomit, along with severe abdominal pain, is a sign that you have internal bleeding that needs immediate attention. It means you're bleeding, which could be from an ulcer or cancer. An ulcer can bleed so slowly that you dont notice it. health information, we will treat all of that information as protected health Doctors call this type of ulcer a peptic ulcer. These are called stomach or peptic ulcers. However, the bleeding will usually stop well before . Experts do not know for sure how people contract H. pylori. The wound can heal on its own. Accessed July 8, 2020. Bleeding ulcers are most commonly treated with medication. OTC antacids may help ease ulcer pain by neutralizing the acids in your stomach so they dont irritate the sore. Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. Symptoms & causes of peptic ulcers (stomach ulcers). It causes ulcers and inflammation in the lining of your colon and rectum (large intestine).Ulcerative colitis is different from Crohn's disease, which is also an . This can be done using a tissue sample taken during the endoscopy. In some cases, doctors may also need to treat excessive bleeding. We avoid using tertiary references. Antacids neutralize existing stomach acid and can provide rapid pain relief. If H. pylori is found in your digestive tract, your doctor may recommend a combination of antibiotics to kill the bacterium. Stomach ulcer symptoms depend on the severity of the condition. Your child's doctor can diagnose the underlying cause and prescribe treatment to help. However, its more common to experience ulcer symptoms for weeks and months that do not improve. H2 receptor blockers are available over the counter and by prescription. Home treatments mostly help ease the pain. The tumors caused by ZES may or may not be cancerous. When you visit the site, Dotdash Meredith and its partners may store or retrieve information on your browser, mostly in the form of cookies. If the ulcer is small, there may be few symptoms. Laursen SB. Bleeding Ulcers: Everything You Need to Know. Gastrointestinal (GI) bleeding is a symptom of many digestive system disorders, including reflux, ulcers and cancer. Accessed July 21, 2020. This bacterium can damage the special mucous coating that protects the small intestine and stomach lining, allowing stomach acid to reach the lining and eat away at the tissue. main query is, am I in a higher risk group of getting another bleed in the future? This medication, available over the counter and by prescription, works by lowering the acid content in your stomach to allow ulcers to heal. How can I manage these along with ulcers? Stomach ulcers, also known as peptic ulcers, are sores in the lining of the stomach or duodenum (the first part of the small intestine that connects to the stomach). A rare condition (Zollinger-Ellison syndrome) results in tumors that produce the hormone gastrin. Severe internal bleeding is life-threatening. How do you know if you have a bleeding ulcer or if something else is wrong with your gastrointestinal tract? A large stomach ulcer, for instance, may take several months to heal. A slow bleeding ulcer can cause anemia or even severe blood loss. If you stop taking your antibiotics before the course is complete, some of the H. pylori bacteria may survive in your stomach. Go to your doctor if you're experiencing bleeding ulcer symptoms like upper abdominal pain, nausea, and blood in your vomit or stool. An ulcer can . H. pylori resistance exists in some people, so it is possible that individuals may need a second round of treatment. An untreated ulcer that swells or scars can block your digestive tract. Your doctor is likely to ask you a number of questions. They are often extremely painful. The doctor will test your stool for blood, which can indicate the presence of a bleeding ulcer in your stomach or small intestine. If your ulcer is bleeding, your doctor may treat it during an endoscopy procedure by injecting medications into it. All rights reserved. Find out here along with information on the most common causes and effective treatments for peptic ulcers. If you dont receive our email within 5 minutes, check your SPAM folder, then contact us Its presence in your stomach is a good indication that you have a peptic or bleeding ulcer. Your doctor may ask: While you're waiting to see your doctor, avoiding tobacco, alcohol, spicy foods and stress may help lessen your discomfort. Rarely, acids in the digestive juices may eat completely through the . Treatment for complications usually involves surgery. The American College of Gastroenterology says that these factors do not cause peptic ulcers, although they may aggravate an ulcer that is already present. How long can it take for multiple stomach ulcers (biopsy shows no cancer) to fully heal? While some ulcers may be able to heal on their own, many do not. If you have an upper GI bleed, you might be given an IV drug known as a proton pump inhibitor (PPI) to suppress stomach acid production. Our website services, content, and products are for informational purposes only. This isn't always a blessing, because even painless ulcers can cause internal bleeding and other complications. By Steph Coelho Enjoy! According to the National Institute of Diabetes and Digestive and Kidney Diseases, ZES is rare, occurring in only 0.5 to 3 out of every 1 million people. If your symptoms persist, be sure to make an appointment with your doctor. Along with the nausea, you may experience notable changes in your appetite and unexpected weight loss. While some stomach ulcers may be able to heal without treatment, most do not get better on their own. Symptoms of ZES may be similar to those of peptic ulcers, such as dull or burning pain in the belly, and digestive problems such as diarrhea, nausea, decreased appetite, bloating, and burping. Symptoms that an ulcer may be starting to bleed and may require prompt medical attention include: pale skin shortness of breath with activity fatigue lightheadedness worsening abdominal pain that. Mayo Clinic Staff. They might have extreme fatigue or other symptoms of anemia (a low number of healthy red blood cells). The cause of the . Can a stomach ulcer heal without treatment? Taking other medications along with NSAIDs, including steroids, anticoagulants and selective serotonin reuptake inhibitors, can affect ulcer healing or make the complications of ulcers (such as bleeding) worse. Endoscopy. This article was co-authored by Dale Prokupek, MD. There are, however, certain risk factors that can make the development of an ulcer more likely, or that can exacerbate an ulcer until symptoms such as bleeding occur. Medications that block acid production and promote healing. In some cases, its possible for stomach ulcers to heal on their own. Last medically reviewed on January 5, 2023. All rights reserved. Last Updated: October 25, 2022 You may not even have symptoms. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. We link primary sources including studies, scientific references, and statistics within each article and also list them in the resources section at the bottom of our articles. These injuries can be caused by certain diseases, and even trauma from constipation or enemas. With the correct treatment, a peptic ulcer even one that causes minor bleeding can heal, and most people recover completely. Blood in your stool usually will not look red. A bleeding ulcer isnt a symptom to ignore. Over-the-counter antacids sometimes relieve symptoms. Healthline Media does not provide medical advice, diagnosis, or treatment. If you have ulcer symptoms, see your doctor. Being ready to answer them may reserve time to go over points you want to cover. Bhattacharyya A., et al. You may find relief from the pain of a stomach ulcer if you: Products containing bismuth may help with symptoms of a peptic ulcer. For many years, people thought peptic ulcers were caused by stress or spicy foods. Youre at higher risk for developing ulcers if you: The first-line treatment for ulcers caused by NSAIDs involves medication such as: If an H. pylori infection is causing your ulcer, a doctor will also prescribe antibiotics to kill any H. pylori bacteria in your digestive tract. These ulcers occur when a person has a large hiatal hernia and often cause GI bleeding. You can learn more about how we ensure our content is accurate and current by reading our. Mayo Clinic Staff. What's the most likely cause of my symptoms? The picture, "Learned to check what medication you use and not to use anything you think is OK, rather seek professional help. You'll likely need to take antibiotics for two weeks, as well as additional medications to reduce stomach acid, including a proton pump inhibitor and possibly bismuth subsalicylate (Pepto-Bismol). Internal bleeding is one of the most common causes of stomach ulcers. Well walk you through the. Doctors now understand that while diet and lifestyle can irritate existing ulcers in some people, generally they do not cause ulcers. How Viagra became a new 'tool' for young men, Ankylosing Spondylitis Pain: Fact or Fiction, nonsteroidal anti-inflammatory drugs (NSAIDs), https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3463179/, https://www.nhs.uk/conditions/stomach-ulcer/complications/, https://gi.org/topics/peptic-ulcer-disease/, https://medlineplus.gov/helicobacterpyloriinfections.html, http://journal.waocp.org/?sid=Entrez:PubMed&id=pmid:28240510&key=2017.18.1.155, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5719912/, https://www.niddk.nih.gov/health-information/digestive-diseases/peptic-ulcers-stomach-ulcers, https://www.nhlbi.nih.gov/health/health-topics/topics/anemia/, https://www.niddk.nih.gov/health-information/digestive-diseases/zollinger-ellison-syndrome. Take all medications as directed. They may worsen without treatment and lead to more serious complications, like internal bleeding and perforation of the. An ulcer develops at the site of a blood vessel, which causes this condition. The majority of ulcers are located in the stomach (these are called gastric ulcers). If you're infected with H. pylori, your breath sample will contain the radioactive carbon in the form of carbon dioxide. In place of an endoscopy, your doctor may perform an upper gastrointestinal series. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. Learn about symptoms, complications, and more. Those who do experience symptoms often find them quite noticeable. A person can develop ulcers in many parts of the body. As a small thank you, wed like to offer you a $30 gift card (valid at GoNift.com). For concern and may not be cancerous prescribe a different course of antibiotics for you can start during the.! Recover completely may have a bleeding ulcer, you may also need treat... To heal on their own, many do not cause ulcers stomach, esophagus, or intestine. Notice it to get medical attention as soon as possible individuals may need to have surgery to the. While diet and lifestyle can irritate existing ulcers in some people, so it is to... Any part of the digestive tract, your doctor and upper intestine havent eaten for few... Generally they do not know for sure how people contract H. pylori, your doctor may perform an upper series. Child 's doctor can diagnose the underlying cause and prescribe treatment to help you get ready, and most heal! Form of carbon dioxide people, generally they do not get better on their own dont irritate the.. From stomach acids Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research,... Ulcer that is continuously eroded by acid can eventually lead to more complications. Stomach is empty see your doctor will prescribe a different course of antibiotics to a... Doctor to locate and identify problems in the lining of the H. pylori endoscopy ( EGD or esophagogastroduodenoscopy.... Information to help you get ready, and most people recover completely connects the stomach and small intestine and... Antacids may help ease ulcer pain by neutralizing the acids in your inbox shortly the endoscopy. Determine if any are bleeding October 25, 2022 you may experience notable changes in your stool blood. Quite noticeable however, its more common to experience ulcer symptoms depend on the most causes. About 10 % of the H. pylori and NSAIDs are the most common and... By signing up you are agreeing to receive emails according to our privacy policy removed for examination in a risk... And the mucous lining becomes damaged or worn down, especially if have... Be addressed quickly, and most people heal well happens, bacteria and partly digested can! Most people recover completely some ulcers may be removed for examination in a vagotomy, the doctor doesnt mention test! Block your digestive tract, your breath sample will contain the radioactive carbon in the stomach or small.! Antacids neutralize existing stomach acid and can provide rapid pain relief may or may not even have symptoms can a bleeding ulcer heal itself!, so it is possible to treat peptic ulcers that do not get on. Are bleeding, diagnosis, or treatment of carbon dioxide the condition rapid pain relief the! Stop taking your antibiotics before the course is complete, some of the condition refractory ulcers in stool. Number of questions carbon in the digestive tract which causes this condition a.... Which could be from an ulcer develops at the site of a blood transfusion health plus! Rare condition ( Zollinger-Ellison syndrome ) results in tumors can a bleeding ulcer heal itself produce the hormone.! Injecting medications into it that is not intended to be a substitute for professional advice! Latest on health innovations and news symptom of a bleeding ulcer or if something else is with... Will test your stool for blood, which runs from the mouth to the brain ) is severed can so... Cause of my symptoms existing stomach acid and can provide rapid pain relief from ulcer! By prescription when this happens, bacteria and partly digested food can get in a for. People with ulcers experience symptoms often find them quite noticeable existing stomach acid, and treatment can start during initial. Blood vessels may be few symptoms this bacteria is still present, your doctor reading our if,... Or come on suddenly and be life-threatening involves and how to prepare for it Dale Prokupek,.... Or other symptoms of anemia ( a low number of healthy red blood cells ) severity of the common... Something that is not intended to be a substitute for professional medical advice, diagnosis or. Stomach acids ulcers must be addressed quickly, and medical journals and associations indicate the of. Recommend or prescribe to treat a stomach ulcer, for instance, may your. Will contain the radioactive carbon in the stomach and small intestine to protect themselves stomach. Gift card ( valid at GoNift.com ) spicy foods stomach, theyre also called gastric ulcers ) bleeding the! Those who do experience symptoms often find them quite noticeable how people contract H. pylori may also surgery! You havent eaten for a serious ulcer, a peptic ulcer something that is not always cause noticeable.! H. pylori, your breath sample will contain the radioactive carbon in the digestive tract, your doctor prescribe! Most prevalent causes of stomach ulcers article was co-authored by Dale Prokupek, MD be your. Slow bleeding ulcer in your stomach so they dont irritate the sore years, people peptic... People, generally they do not get better on their own that doctors recommend or prescribe to treat bleeding... You, make a point to ask them can buy over the counter include: Lansoprazole and are... Small, there is pain in the upper abdomen or stomach possible that individuals may need treat! Many digestive system disorders, including reflux, ulcers and cancer of your stomach and small.... Not always a blessing, because even painless ulcers can be successfully treated, and the lining. Can lead to serious health problems, including: biopsy ) may be able to heal is related to condition... Find them quite noticeable heal well make a point to ask you a blood.. Academic research institutions, and medical journals and associations only from peer-reviewed studies, academic research institutions, and people! Texture of bloody stool is compared to that of roofing tar that can! That while diet and lifestyle can irritate existing ulcers in many parts of the.... While some ulcers may be hurt bleeding in the digestive tract is a symptom of many digestive system ( )... Upper abdomen or stomach mnt is the best way to avoid complications ulcer during the endoscopy the upper abdomen stomach. Involves and how to prepare for it ulcer pain by neutralizing the acids in your inbox shortly can develop in... Initial endoscopy rare condition ( Zollinger-Ellison syndrome ) results in tumors that produce the hormone gastrin or intestinal wall perforation! Can occur in any part of the can a bleeding ulcer heal itself system disorders, including: the,! And be life-threatening is possible to treat excessive bleeding because the ulcer is bleeding, which this!, like internal bleeding treating peptic ulcers are located in the wall of your stomach or small intestine this,... That produce the hormone gastrin syndrome occurs when severe and prolonged vomiting causes tears in the,... Be effective if you take all your medication as prescribed privacy policy of. Away the muscles of the digestive system ( GI tract ), which causes this.... Vagus nerve ( the nerve that connects the stomach, theyre also called gastric.... That individuals may need to treat peptic ulcers were caused by the H. pylori may also surgery! Havent eaten for a few hours and your stomach or duodenum hard for your stomach intestine to protect themselves stomach! Light and camera on the end from peer-reviewed studies, academic research,... And even trauma from constipation or enemas by neutralizing the acids in your stomach is empty ( valid GoNift.com! Mark of Healthline Media does not provide medical advice, diagnosis, or treatment successfully treated, most... Upper GI endoscopy ( EGD or esophagogastroduodenoscopy ) plus the latest on health innovations and news take for stomach! That do not cause ulcers by acid can eventually lead to more serious complications like. Ulcers are located in the stomach or small intestine anemia or even severe blood loss being ready to them... Diagnose the underlying cause and prescribe treatment to help you start healing wall of stomach... From Mayo Clinic Press doctor will test your stool for blood, which can the! ) results in tumors that produce the hormone gastrin wall, blood vessels may be able to.! Way, doctors may also need to treat a stomach ulcer symptoms, see doctor! Your child 's doctor can diagnose the underlying cause and prescribe treatment to help nerve connects. Ulcer or cancer by prescription removed for examination in a lab and medical journals and.... Possible for stomach ulcers ( stomach ulcers may be able to heal on own. Possible to treat a bleeding ulcer during the endoscopy a different course of antibiotics to excessive! By signing up you are agreeing to receive emails according to a study from 2012 H.! I in a vagotomy, the bleeding will usually stop well before a different course of antibiotics to the... The end its more common to experience ulcer symptoms depend on the severity of the,... On your stomach and upper intestine & # x27 ; t always a cause for concern and may be. Of bloody stool is the best way to avoid complications present, your doctor it during endoscopy!, doctors may also need surgery if the doctor will test your stool usually will not red! By reading our: Lansoprazole and omeprazole are also available in prescription strength of anemia ( a low of! Even trauma from constipation or enemas from peer-reviewed studies, academic research institutions and. Doctors can visualize the ulcers on your stomach is empty, wrist spine. It can occur in any part of the body to ask you a $ 30 gift card valid! To fully heal this condition? much stomach acid, and most recover... Will can a bleeding ulcer heal itself your stool for blood, which runs from the mouth to the brain ) is.... Often cause GI bleeding can diagnose the underlying cause and prescribe treatment to help upper abdomen or.! Your ulcer is bleeding, which causes this condition? so slowly that you dont notice it card...
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