Can Ulcers Cause Diarrhea or Chronic Diarrhea?

Key takeaways:

• Ulcers may be the cause of diarrhea in certain cases, often alongside other symptoms.
• Understanding additional symptoms can help you figure out whether or not your diarrhea might be related to an ulcer.
• Recognizing when diarrhea is serious and knowing when to see your healthcare provider will help you get the most effective treatment and prevent complications.

Ulcers in your digestive tract can be associated with a variety of symptoms, including pain, nausea, and sometimes diarrhea. When diarrhea occurs in addition to an ulcer, it can be unsettling and uncomfortable, and you may wonder if the ulcer might be the cause. Let’s explore how ulcers might lead to diarrhea, other warning signs that you might have an ulcer, and options for relief.

Do ulcers cause diarrhea?

Ulcers, particularly if they are located in your stomach (gastric ulcers) or the first part of your intestine (duodenal ulcers), usually cause pain and discomfort rather than diarrhea. However, diarrhea can sometimes go along with ulcers, especially when complications arise, such as infection from Helicobacter pylori (H. pylori), a common bacterial cause of ulcers. Ulcer-related irritation can also affect your digestion, and in some people, this could lead to diarrhea.

Certain types of ulcers, including those resulting from inflammatory bowel disease (IBD), are more likely to be associated with chronic diarrhea. While not every person with an ulcer will experience diarrhea, if you have an underlying condition or develop complications, you might see an overlap of symptoms. Understanding when diarrhea might be related to ulcers will help you to get proper treatment and relief.

How ulcers can cause diarrhea

There are a few ways in which ulcers can cause diarrhea. When ulcers affect your stomach lining or your intestines, they can disrupt digestion. Here’s how:

• H. pylori Infection: Many ulcers are caused by an infection with the H. pylori bacteria, which can trigger inflammation and increase stomach acid production. This bacteria can also affect other parts of your digestive system, causing an imbalance that might lead to diarrhea.
• Medication side effects: If you have been diagnosed with an ulcer, you may have been prescribed medications, such as proton pump inhibitors (PPIs) and antacids, to reduce stomach acid and promote healing. Some of these medications can sometimes lead to mild digestive disturbances, including diarrhea.
• Inflammatory response: Ulcers that form from inflammatory conditions, such as Crohn’s disease or ulcerative colitis, are more likely to result in chronic diarrhea due to the ongoing inflammation throughout your digestive tract.
• Digestive tract disruption: The presence of ulcers, particularly those in your duodenum, can change the flow of digestive contents, and could cause symptoms like cramping, nausea, and diarrhea.

How to tell the difference between diarrhea from ulcers and other causes of diarrhea

Since diarrhea can be from other conditions besides ulcers, it’s helpful to note signs that might help you to tell the difference between diarrhea from an ulcer and diarrhea from some other cause:

• Pain and timing: Ulcers can often cause pain or burning in the stomach, which may be relieved or worsened by eating. If diarrhea follows episodes of pain in your stomach, it could be linked to an ulcer.
• Presence of blood or dark stools: Ulcers can sometimes bleed, and due to blood passing through your intestines, can cause dark or black stools. If you have an ulcer and have diarrhea that appears black or tarry, this may indicate that the ulcer is bleeding.
• Additional digestive symptoms: If you have ulcers, you might experience nausea, bloating, or a feeling of fullness, which can accompany diarrhea. This is especially true if there’s an H. pylori infection or you have inflammation in your digestive tract.
• Long-term medication use: If diarrhea happens after you begin taking medications for ulcers, such as protein pump inhibitors (PPIs), consider whether the diarrhea could be a side effect.

You should review your symptoms with your physician to be sure of the exact cause. This is especially urgent if you are seeing dark or black stools or blood.

Other warning signs of an ulcer

While diarrhea is not usually a primary symptom of an ulcer, certain other signs often go along with an ulcer and can help you and your healthcare provider in the diagnosis and management of your condition.

• Stomach pain: The pain of a stomach ulcer is usually felt between your chest and belly button. This pain is often described as burning or gnawing and it may come and go throughout the day.
• Nausea and vomiting: Ulcers can lead to nausea, especially in the morning or when your stomach is empty. Vomiting may also happen. If the ulcer is actively bleeding, there can be visible blood in the vomit. If you see blood in your vomit, you should see a physician immediately.
• Unexplained weight loss: Because ulcers can reduce your appetite or make eating painful, over time you could lose weight.
• Acid reflux and heartburn: With acid reflux, the acid from your stomach can get washed back into your esophagus (the food tube that leads from your mouth down to your stomach). This can cause a burning sensation in your chest and throat.

Other common causes of diarrhea

Diarrhea is a very common symptom with many causes besides ulcers. Understanding these causes can help you figure out if an ulcer is the likely source.

• Food sensitivities: If you have reactions to specific foods, especially dairy or gluten, you may experience diarrhea shortly after eating.
• Viral or bacterial infections: Stomach flu or infections, such as food poisoning, frequently lead to diarrhea as your body tries to get rid of the harmful microbes.
• Medications: Antibiotics, some pain relievers, and certain medications for managing ulcers can cause diarrhea as a side effect.
• Stress: High stress levels can sometimes cause an imbalance with your digestion and result in nausea and diarrhea.

When to see a doctor about diarrhea and ulcers

If you have continuing diarrhea, especially when it's combined with ulcer symptoms, you should get medical attention.

You should see a doctor if:

• You are having frequent diarrhea that doesn’t improve within a few days.
• You see blood or mucus in your stool.
• Your stomach pain and diarrhea are disrupting your daily life.

You should go to the emergency room if:

• You notice black or tarry stools, which could indicate bleeding.
• You have symptoms of dehydration like dizziness, extreme thirst, a dry mouth, weakness, and a rapid heart rate.
• You have severe stomach pain with vomiting and fever.

Questions to ask your doctor about diarrhea and ulcers

When you are discussing your symptoms with your doctor, here are some questions to consider asking:

• Could my diarrhea be caused by my ulcer or its treatment?
• Are there any dietary changes that could help manage my symptoms?
• Do you think I should be tested for H. pylori or other infections?
• What steps should I take to reduce the risk of complications from my ulcer?

These questions can help guide your discussion with your healthcare provider to create a more effective treatment plan.

How to treat or get relief from diarrhea when you have an ulcer

Managing diarrhea when you have an ulcer requires some adjustments. Here are some potential treatment methods:

• Medication adjustments: If the medications you are taking for ulcers seem to cause diarrhea, your physician may suggest alternatives or additional treatments to help ease your distress.
• Dietary modifications: You should limit or stop eating foods that aggravate ulcers, like spicy or acidic foods. Focusing on bland foods during a flare-up may help to reduce your symptoms.
• Hydration and electrolytes: Be sure you are staying hydrated, as bouts of diarrhea can cause your body to lose essential fluids. Drinking electrolyte solutions such as some sports drinks or Pedialyte ™ can help.

Frequently asked questions: diarrhea and ulcers

The combination of ulcers and diarrhea can be confusing at times. Here are answers to some common questions:

Do colon ulcers cause diarrhea?

Yes, ulcers in the colon are common in conditions like Crohn’s disease and can result in chronic diarrhea.

Can ulcers cause both diarrhea and nausea?

Yes, especially if there’s an H. pylori infection.

Do antibiotics for ulcers lead to diarrhea?

Yes, antibiotics used to treat H. pylori infections may upset the balance of your gut bacteria. This imbalance can sometimes lead to diarrhea.

Are older adults more likely to have diarrhea when taking ulcer medications?

Because many older adults are often on multiple medications and frequently have sensitive digestive systems, they may have an increased risk of diarrhea.

Managing your symptoms

While diarrhea is usually not the main symptom of ulcers, it can happen in some people, particularly if there is also an infection or an inflammatory condition such as Crohn’s disease. Knowing how to recognize the warning signs of an ulcer as well as understanding when to get medical advice can help you to get the right treatment and minimize any complications. Over time, managing your symptoms by doing things such as adjusting your diet or medications can help you to improve your overall digestive health.

General Medicine follows a strict editorial process, including using real experts to write our articles, vetted primary sources, fact-checking, a secondary medical review, and updates as necessary. This article was medically reviewed and fact checked by Dr. Lane Thaut, DO.

Sources

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National Center for Infectious Diseases (U.S.). Division of Bacterial and Mycotic Diseases, Health Communications Activity. Helicobacter pylori: Fact Sheet for Health Care Providers. 1998. CDC Stacks, https://stacks.cdc.gov/view/cdc/40603. Accessed 7 Nov. 2024.