A stomach ulcer, also known as a gastric ulcer, is an open sore that forms on the protective lining of the stomach. This occurs when stomach acid erodes the mucosal layer, creating a wound. The duration a stomach ulcer lasts varies considerably, as many factors influence the healing process, including the underlying cause, individual health, and adherence to treatment.
Factors Influencing Healing Duration
The speed at which a stomach ulcer heals is significantly affected by its root cause. The two primary causes are infection with the bacterium Helicobacter pylori (H. pylori) and the prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or aspirin. H. pylori weakens the stomach’s protective lining, allowing acid to cause an open sore. NSAIDs, in contrast, directly irritate the stomach lining and hinder the body’s natural defense mechanisms.
The physical characteristics of the ulcer also play a role in healing time. Larger and deeper ulcers typically require more time to heal compared to smaller, more superficial ones. An ulcer’s location within the stomach can also influence healing. A person’s overall health, including chronic conditions like diabetes, can also impact healing.
Adherence to prescribed medical treatment is another significant factor. Consistent use of medications as directed helps reduce stomach acid and eradicate infections, creating an environment conducive to healing. Lifestyle choices, such as smoking and alcohol consumption, can significantly impede recovery.
Typical Healing Timelines
Under effective treatment, stomach ulcers caused by H. pylori typically begin to heal within several weeks. Treatment for H. pylori typically involves a combination of antibiotics and a proton pump inhibitor (PPI) for several weeks. Most stomach ulcers heal within four to eight weeks with consistent and appropriate medical intervention.
For ulcers induced by NSAIDs, healing usually occurs within a few weeks once the NSAID is discontinued and acid-reducing medication, such as a PPI, is started. PPIs work by significantly reducing the amount of acid the stomach produces, allowing the ulcer to heal naturally. These medications are commonly prescribed for four to eight weeks for NSAID-induced ulcers. Even if NSAID use cannot be stopped, ulcers may still heal with concurrent PPI treatment.
In some cases, especially with smaller, uncomplicated ulcers, healing can occur within two to three weeks. However, larger ulcers, defined as over 5 millimeters, may take up to eight to twelve weeks to fully heal, even with treatment. Regular follow-up, often with an endoscopy, helps confirm complete healing.
When Healing May Take Longer
Several factors can prolong the healing process of a stomach ulcer beyond typical timelines. Non-adherence to prescribed medication, such as not completing antibiotic courses for H. pylori, is a common reason for delayed healing or recurrence. Similarly, continued use of NSAIDs or other irritants like excessive alcohol and smoking can counteract the effects of medication and delay recovery.
Persistent H. pylori infection, especially if resistant to initial antibiotics, can also prolong healing. Complications like bleeding or perforation also extend healing time and require immediate medical attention.
Rarely, “refractory” ulcers do not heal despite standard treatment. Causes include persistent H. pylori, continued NSAID use, very large ulcers, or underlying conditions like Zollinger-Ellison syndrome. If symptoms persist or worsen despite treatment, it is important to consult a doctor, as these could be signs of complications or an ulcer that requires further investigation.