Gastroenterology Consultants,SC: Diseases of the GI tract PEPTIC ULCER DISEASE [<<back | list all>>] An ulcer is an open sore in the lining of the stomach or intestine, much like mouth or skin ulcers. Peptic ulcers are usually caused by acid and pepsin. Acid is produced in the stomach to help digest and break down food before it enters the small intestine. Pepsin is a digestive stomach enzyme. Ulcers which occur in the stomach are called gastric ulcers, and duodenal ulcers occur in the first portion of the intestine. It is the acid that causes the ulcers in the stomach or bowel lining. The ulcers cause a burning pain in the upper abdomen. Some patients experience intense hunger or bloating. Antacids and milk can provide temporary relief. Some patients have no pain but have black stools, which can indicate the ulcer is bleeding. Bleeding is a very serious complication of ulcers. Diagnosis can be suspected from the patient's medical history, although it should always be confirmed by an upper intestinal endoscopy or barium x-ray. Ulcers are usually rechecked weeks after the initial endoscopy for dysplasia. Dysplasia may lead to cancer.