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Complications - Stomach ulcer

Complications of stomach ulcers are rare. But they can be serious when they happen.

Internal bleeding

Internal bleeding is the most common complication of stomach ulcers. It can happen when an ulcer develops at the site of a blood vessel.

The bleeding can be:

  • slow and long-term - this leads to anaemia and causes tiredness, breathlessness, pale skin and heart palpitations
  • rapid and severe – this causes you to vomit blood or have poo that is black and sticky

Talk to your GP if you have symptoms of anaemia that do not stop.

If they think you have complications, they may refer you to a gastroenterologist - a doctor who specialises in the digestive system.

Emergency action required: Call your GP immediately or go to the emergency department (ED) if:

  • you have symptoms of severe bleeding

In the hospital, a doctor will do an endoscopy to identify the cause of the bleeding. They can give you treatment during the endoscopy to stop the bleeding.

Your doctor may do a specialised procedure with x-ray guidance to stop a bleeding ulcer. In rare cases, you may need surgery to repair the affected blood vessel.

You may also need blood transfusions to replace the blood you have lost.


Perforation can be a serious complication of stomach ulcers. It's a rare complication that happens when the lining of the stomach splits open.

The bacteria that live in your digestive system can infect the peritoneum (lining of your abdomen). This is known as peritonitis.

The infection in the peritoneum can spread into the blood, causing sepsis. There is a risk of multiple organ failure if the infection spreads to other organs.

If peritonitis is not treated, it may result in death.

The most common symptom of peritonitis is sudden abdominal (tummy) pain. The pain gets worse over time.

Emergency action required: Contact your GP immediately or go to your nearest emergency department (ED) if:

  • you have sudden abdominal (tummy) pain

Gastric outlet obstruction

An inflamed (swollen) or scarred stomach ulcer can block food moving through your digestive system. This is called gastric outlet obstruction.

Symptoms can include:

  • repeated vomiting, with large amounts of vomit that contain undigested food
  • a constant feeling of bloating or fullness
  • feeling very full after eating less food than usual
  • unexplained weight loss

In hospital, your doctor can do an endoscopy to confirm the obstruction or blockage.

If swelling causes the blockage, your doctor may prescribe proton pump inhibitors (PPIs). These reduce stomach acid levels until the swelling goes down.

If scar tissue causes the blockage, you may need surgery.

Your doctor may do a procedure called endoscopic balloon dilation (EBD). They pass a small balloon to the site of the blockage using an endoscope. Then they inflate the balloon to widen the site of the blockage.

Content supplied by the NHS and adapted for Ireland by the HSE

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This project has received funding from the Government of Ireland’s Sláintecare Integration Fund 2019 under Grant Agreement Number 123.

Page last reviewed: 8 May 2021
Next review due: 8 May 2024