Health Guide

Stomach ulcers: the signs, what causes them, and what to do next

“Ulcers” is what most Kenyans call this — a sore in the lining of the stomach. Here is what actually causes one, the signs to watch for, and a free way to check whether your symptoms match.

Written by Nichole Israel. Published 25 September 2026 · Last updated 25 September 2026. How we write what you read.

A stomach ulcer is an open sore in the lining of your stomach or the top of your small intestine. Kenyans usually just call it “ulcers.” The usual cause is a stomach infection called H. pylori, or long-term use of painkillers like ibuprofen or aspirin — not stress or spicy food alone. It's treatable once you know the cause.

Most stomach ulcers are caused by an infection (H. pylori) or by painkillers such as ibuprofen and aspirin — not by stress alone.
The classic sign is a burning or gnawing pain in the upper stomach, often worse on an empty stomach or a few hours after eating.
Symptoms alone can't confirm an ulcer — gastritis and acid reflux feel similar. A test or a doctor's exam is what actually tells you.
Most ulcers heal once the cause is dealt with. Left alone, a small number bleed or wear through the stomach wall, which is a medical emergency.

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Signs and symptoms of a stomach ulcer

Not every ulcer causes pain — some are only found because of a complication. When there are symptoms, the pattern is fairly recognisable:

A burning or gnawing pain in the upper stomach
Between your belly button and your breastbone, sometimes described as a dull ache rather than a sharp pain. It can last from a few minutes to a few hours, and can come and go for weeks at a time.
Pain with a pattern around eating
For some people the pain shows up a few hours after a meal or first thing in the morning, on an empty stomach. For others, eating itself brings on the pain, or eases it briefly. Which pattern you have is a clue worth noting, not a diagnosis on its own.
Bloating and frequent burping
A full, gassy feeling after meals, often written off as “just indigestion” for months or years before anyone asks what's actually causing it.
Heartburn (kiungulia)
A burning sensation that climbs from the stomach up towards the chest, sometimes with a sour taste in the mouth.
Nausea, especially in the morning
Feeling sick before you've eaten anything, sometimes severe enough to put you off breakfast entirely.
Feeling full quickly, or losing your appetite
Getting full after only a few bites, or eating less because food seems to bring on discomfort — over months, this can lead to losing weight without trying to.

Does this sound like your symptoms? Check for free

How do I know if it's an ulcer?

The symptoms above overlap with gastritis, acid reflux, and ordinary indigestion — plenty of things cause a burning stomach. Symptoms alone can't tell you which one you have; only a test or a doctor's exam confirms an ulcer specifically.

A sensible first step is working out how your own symptoms actually behave: when they started, what makes them worse, and whether any of the danger signs further down this page apply to you. UlCure's free check walks through exactly that in about two minutes and tells you honestly whether your pattern looks urgent, ulcer-like, or something else.

It won't diagnose you — no online tool can — but it's a faster, more structured version of the questions a clinic would start with, and it's free before you decide whether a test or a doctor's visit is the next step.

What causes stomach ulcers

Two things cause the large majority of stomach ulcers, and they often make each other worse.

The first is H. pylori, a bacterium that lives in the stomach lining. It is extremely common in Kenya — peer-reviewed studies consistently put adult prevalence above 65%, among the highest rates recorded anywhere — and it damages the stomach's protective mucus layer, letting acid burn through to the tissue underneath. The World Health Organization classifies H. pylori as a Group 1 cause of stomach cancer, which is one reason clearing the infection matters even when it isn't currently causing pain.

H. pylori spreads mainly through contaminated water and close household contact — shared cups and utensils, or water that hasn't been boiled. That's a large part of why it's so common here: it isn't about personal hygiene so much as everyday infrastructure realities in many Kenyan homes and neighbourhoods.

The second major cause is regular use of anti-inflammatory painkillers — ibuprofen, aspirin, and similar tablets bought over the counter for headaches, backache, or joint pain. These reduce the stomach's own defences, and using them often — or alongside an H. pylori infection — raises the risk further.

Smoking and heavy alcohol use don't usually cause an ulcer on their own, but both slow healing and make an existing ulcer worse.

Myth: stress and spicy food cause ulcers

Stress and spicy food can make ulcer pain feel worse, and stress genuinely changes how much acid your stomach makes — but on their own, they very rarely cause the ulcer in the first place. The idea that ulcers are purely “a stress disease” predates the discovery of H. pylori's role, and it still leads people to manage the wrong thing for years.

How H. pylori spreads at home, and how to stop it

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Ulcer, gastritis, or acid reflux?

These three overlap enough that even a clinician often can't tell them apart without a test. This is a rough guide to the pattern each one tends to follow — not a diagnosis.

Ulcer, gastritis, or acid reflux?
	Stomach ulcer	Gastritis	Acid reflux (heartburn)
Where it hurts	Upper stomach, sometimes spreading to the back	Upper stomach — a gnawing or “knotted” feeling	Behind the breastbone, moving up towards the throat
When it's usually worse	A few hours after eating, or on an empty stomach	Can flare with certain foods, alcohol, or painkillers	Lying down, bending over, or soon after a large meal
What else you might notice	Bloating, nausea, dark stool if it's bleeding	Nausea, loss of appetite, a “knotted” feeling	A sour taste in the mouth, a cough, a hoarse voice
Usual cause	H. pylori or painkillers	H. pylori, painkillers, or alcohol	The valve between the stomach and food pipe not closing properly

Can a stomach ulcer be dangerous?

Most stomach ulcers are not dangerous, and most people who get the cause treated recover fully. But left alone, a small number of ulcers bleed or wear right through the stomach wall — a perforation — and both are medical emergencies.

An ulcer that bleeds slowly over time can leave you anaemic — tired, pale, short of breath — without you noticing where the blood is going. An ulcer that bleeds suddenly, or perforates, needs a hospital immediately, not a pharmacy visit.

Go to a hospital today if:

• Vomiting blood, or vomit that looks like dark coffee grounds
• Black, tarry, or very dark stool
• Sudden, severe stomach pain that doesn't ease off
• Feeling faint, dizzy, or unusually weak
• Losing weight without trying to
• Trouble swallowing

Don't wait for a clinic appointment or try a home remedy first — go to the nearest hospital or call emergency services.

Source: NHS — Stomach ulcer: complications

Why ulcers keep coming back

A common story in Kenya: the pain eases after tablets from the chemist, then returns a few months later. This happens because acid-calming remedies quiet the pain without dealing with the underlying cause. If H. pylori is still there, or the painkillers that caused the damage are still being taken regularly, the ulcer comes back.

Getting tested for H. pylori, and being honest with a pharmacist or doctor about which painkillers you take and how often, is what actually breaks that cycle. It's a different question from “what do I take for the pain right now”, and it's the one that actually stops the pattern repeating.

What to do next

If what you've read here sounds like you, there are three sensible next steps.

Get tested
A stool or breath test confirms whether H. pylori is present — see our guide to testing in Kenya, including what it costs.
H. pylori testing in Kenya
Understand your treatment options
Treatment depends on what's causing the ulcer, not one tablet that works for everyone — see our ulcer treatment guide.
Ulcer treatment in Kenya
Eat in a way that reduces irritation
Certain everyday Kenyan foods and habits make symptoms worse while you sort out the cause — see our ulcer diet guide.
Ulcer diet — Kenyan foods

The fastest way to find out where you stand is the free Pona AI gut check: about two minutes of questions about your symptoms, with an honest answer about whether they look urgent, ulcer-like, or something else. If it points towards an ulcer, the Ulcure Plan gives you a step-by-step plan built from your own answers. The Ulcure Plan is KES 499 via M-Pesa.

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Two minutes, no sign-up. Pick whichever is closest.

Frequently asked questions

Are stomach ulcers contagious?

Not directly — but H. pylori, the bacterium behind most of them, spreads person to person through saliva, unclean water, and shared utensils. So it can spread within a household even though the ulcer itself doesn't pass from person to person.

Can an ulcer heal on its own?

A small, mild ulcer sometimes settles if the cause goes away — for example, stopping a painkiller that was causing it. But if H. pylori is present, it doesn't clear on its own, and the ulcer usually returns until the infection is dealt with.

Can ulcers cause back pain or chest pain?

Pain from a stomach ulcer can radiate towards the back, particularly with ulcers in the duodenum. Chest pain is more often heartburn or acid reflux — but new or severe chest pain can also be a heart problem, so treat it as an emergency until it's been checked.

Can ulcers cause diarrhea?

Not usually as a direct symptom, though some people notice looser stools alongside stomach pain. Black or very dark stool is different — that's a sign of bleeding, not ordinary diarrhoea, and needs urgent attention (see the danger signs above).

Is H. pylori the same thing as an ulcer?

No. H. pylori is the infection; a stomach ulcer is one possible result of it. Many people carry H. pylori for years with no ulcer and no symptoms at all.

Should I just buy something at the pharmacy for the pain?

An over-the-counter remedy can ease pain in the short term, but it won't tell you what's causing it or clear an H. pylori infection if that's the cause — which is exactly how the “pain goes away, then comes back” cycle above starts. Finding out the cause first is what actually resolves it.

Sources

This page is for educational purposes only. It does not constitute medical advice and should not replace consultation with a qualified healthcare professional. See our Health Disclaimer for full details.