Many people ask, “can ulcer cause heartburn?” The answer is — yes, ulcers can produce symptoms that mimic heartburn. But ulcers and heartburn stem from different causes and require different treatments. Let’s explore the key differences between ulcers and heartburn.
What Is Heartburn?
Heartburn isn’t a heart issue at all. It is a burning or discomfort in your chest or throat. It often occurs after eating, especially when lying down or bending over. The sensation typically originates from acid reflux—when stomach acid flows back into the esophagus
Symptoms include:
- Burning behind the breastbone, often rising toward the throat
- Acid or sour taste in the mouth
- Occurrence within an hour of meals
- Can be triggered by foods that relax the esophageal valve, like spicy or fatty foods, chocolate, and citrus.
When this heartburn occurs two or more days per week, it’s diagnosed as Gastroesophageal Reflux Disease (GERD)
What Is a Stomach (Peptic) Ulcer?
A peptic ulcer is an open sore in the lining of your stomach (gastric ulcer), duodenum, or even esophagus in rare cases.
Main causes:
- Helicobacter pylori (H. pylori) infection: research says it affects 10–20% of people, with 10–20% developing ulcers.
- Prolonged use of NSAIDs (e.g., ibuprofen, naproxen)
Common symptoms:
- Burning stomach pain, often between meals or overnight.
- Indigestion, bloating, belching, and sometimes heartburn
- Severe cases: vomiting blood or black stools
Ulcers are not caused by stress or spicy foods, although such factors can worsen symptoms.
Can Ulcer Cause Heartburn?
Ulcers frequently overlap with heartburn-like symptoms—particularly indigestion and acid reflux. So yes—research says ulcers can indeed cause heartburn symptoms, but it doesn’t mean every heartburn is due to an ulcer.
Key Differences Between Ulcer Pain and Heartburn
Understanding the differences between heartburn and ulcer pain can help you better identify your symptoms and seek the right treatment:
Pain location: Heartburn typically causes a burning sensation in the chest or throat, often rising upward. In contrast, ulcer pain tends to occur in the upper abdominal area, specifically between the breastbone and navel.
Timing: Heartburn usually strikes shortly after meals—within an hour.. Ulcer pain, on the other hand, often appears between meals or at night and may temporarily improve after eating.
Symptoms: Heartburn can be accompanied by acid regurgitation, a bitter taste in the mouth, chronic cough, or hoarseness. Ulcers may cause bloating, belching, nausea, and in more serious cases, internal bleeding.
Affected areas, heartburn is related to the esophagus, as it results from acid reflux damaging the esophageal lining. Ulcers develop in the lining of the stomach or duodenum (the upper part of the small intestine).
Triggers: Heartburn is often triggered by large meals, lying down after eating, or consuming foods like spicy dishes, chocolate, and caffeine. Ulcers are most commonly caused by long-term NSAID use or infection with Helicobacter pylori (H. pylori).
Long-term risks: Chronic heartburn can lead to esophagitis, Barrett’s esophagus, or even esophageal cancer. Untreated ulcers can result in serious complications like bleeding, perforation of the stomach or duodenum, and an increased risk of gastric cancer.
By understanding these distinctions, you can work more effectively with your doctor to determine the right diagnosis and treatment plan.
Diagnosis
Heartburn: is typically diagnosed through a review of symptoms, pH monitoring, or endoscopy.
Ulcers: require endoscopy as well, but often include tests for H. pylori, such as breath, blood, or stool tests.
Can I Have Ulcers and Heartburn At The Same Time?
This is not uncommon. Studies have shown that people with chronic stomach issues can have both ulcers and acid reflux, especially if they have risk factors like H. pylori infection, NSAID use, or high stomach acid.
When to See a Doctor
- Heartburn persists more than twice weekly, or awakens you at night
- Ulcer symptoms: sharp abdominal pain, blood in vomit/stools, unexplained weight loss, or fainting
Conclusion
Heartburn and ulcers may share similar pain, but they are not the same. If you feel a burning sensation in your stomach or chest, track your symptoms carefully. What you feel, when it happens, and what helps can all point to the correct diagnosis. Don’t ignore stomach pain or chronic heartburn. Early treatment can prevent bigger problems and help you feel better faster.
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References
- The prevalence of Helicobacter pylori in peptic ulcer disease (Pubmed). https://pubmed.ncbi.nlm.nih.gov/8547530/
- What to know about ulcers vs. heartburn (medicalnewstoday). https://www.medicalnewstoday.com/articles/ulcer-vs-heartburn
- Stomach ulcers: overview (NHS). https://www.nhs.uk/conditions/stomach-ulcer/