By Renova Hospitals
January 17, 2026
Ulcers Explained: Causes, Symptoms & Treatment of Mouth, Tongue and Stomach Ulcers
Overview
Ulcers are among the most commonly ignored health conditions because they often begin as small, painful sores that seem harmless. A person may notice discomfort while eating, mild burning pain, or mouth or stomach irritation and assume it will heal on its own. Many rely on home remedies or delay medical care, thereby allowing the ulcer to worsen.
Ulcers are not just surface wounds. They are open wounds caused by damage to the protective lining of the skin or mucosa. Depending on their location, ulcers can affect daily activities such as eating, speaking, and digestion. Some ulcers heal quickly, whereas others persist, recur frequently, or indicate underlying disease. They can take a long time to heal.
What Is the Role of the Digestive and Mucosal Lining?
The body’s mucosal lining acts as a protective barrier. In the mouth and throat, it protects tissues from trauma, bacteria, and irritants. In the stomach, the lining shields the organ from strong acids required for digestion.
When this protective layer is damaged by injury, infection, medications, stress, or acid exposure, ulcers can form. The exposed tissue becomes inflamed, painful, and slow to heal.
This explains why patients experience:
- Pain or burning sensation
- Difficulty eating or swallowing
- Bleeding or soreness
- Increased sensitivity to spicy or acidic foods
If the damage extends deeper, ulcers may bleed, become infected, or recur frequently.
What Are Ulcers?
Ulcers are open sores that develop when tissue breaks down and fails to heal properly. They can occur on the skin, inside the mouth, on the tongue, in the throat, or within the stomach and intestines.
Ulcers are broadly classified based on their location:
- Oral ulcers (mouth, tongue, throat)
- Gastric and duodenal ulcers (stomach and intestine)
The severity of an ulcer depends on:
- The cause of tissue damage
- Depth of the ulcer
- Duration before treatment
- The person’s immune and nutritional status
Types of Ulcers
Ulcers differ in cause, symptoms, and treatment depending on their location.
1. Mouth Ulcers (Oral Ulcers)
These occur on the inner cheeks, lips, gums, or palate. Common forms include aphthous ulcers, which are shallow, round, and painful.
Symptoms include:
- Burning or tingling before the ulcer appears
- White or yellow centre with a red border
- Pain while eating or speaking
2. Tongue and Throat Ulcers
A tongue ulcer can develop due to trauma, infection, or nutritional deficiency. A throat ulcer may cause pain while swallowing or speaking.:
- Sharp pain on tongue movement
- Difficulty swallowing
- Referred ear pain
Proper treatment of tongue ulcers depends on identifying the cause.
3. Stomach and Peptic Ulcers
A stomach ulcer or peptic ulcer occurs when acid damages the stomach or intestinal lining.
Symptoms include:
- Burning or gnawing abdominal pain
- Bloating or nausea
- Pain that worsens on an empty stomach
- Black stools or vomiting blood in severe cases
These ulcers require medical treatment to prevent bleeding or perforation.
What Are the Symptoms of Ulcers?
Ulcers present with distinct symptoms depending on location (oral, gastric, or duodenal), with pain as the hallmark symptom.
Oral Ulcers
- White/yellow sores with red borders on cheeks, lips, tongue, or gums.
- Sharp pain when eating, drinking, or speaking.
- Swelling, excess saliva, bad breath, and minor bleeding.
- Fever or swollen lymph nodes in severe cases.
Gastric (Stomach) Ulcers
- Dull, burning pain in the upper middle abdomen, worse after eating.
- Bloating, heartburn, nausea, vomiting, "coffee grounds".
- Appetite/weight loss, dark stools from bleeding.
Duodenal Ulcers
- Burning pain 2-3 hours after meals or at night.
- Relieved temporarily by food/antacids.
- Bloating, belching, feeling overly full, and fatigue.
Red-Flag Symptoms Requiring Urgent Care
- Persistent or worsening pain
- Bleeding from the mouth or in the stools
- Unintentional weight loss
- Difficulty swallowing
- Vomiting blood or black stools.
What Causes Ulcers?
The causes of ulcers vary by type, location, and individual health status. Ulcers develop when the protective lining of the mouth, tongue, throat, or stomach is damaged and cannot heal properly.
Common causes include:
- Physical trauma or biting
- Accidental cheek or tongue biting, sharp teeth, ill-fitting dentures, or dental procedures can injure the lining and trigger ulcer formation.
- Stress and fatigue
- Prolonged stress and insufficient sleep weaken the immune response and impede tissue repair, increasing the risk of ulcer development or recurrence.
- Nutritional deficiencies
- Low levels of iron, vitamin B12, or folate impair cell regeneration and are a common cause of recurrent mouth and tongue ulcers.
- Bacterial infections (H. pylori)
- Helicobacter pylori damages the stomach’s protective lining and is a major cause of peptic and stomach ulcers.
- Long-term painkiller use
- Frequent use of NSAIDs such as aspirin or ibuprofen reduces protective mucus in the stomach, increasing ulcer risk.
- Smoking and alcohol
- Tobacco and alcohol irritate the mucosal lining, delay healing, and increase acid production.
- Acid overproduction
- Excess stomach acid can erode the gastric or duodenal mucosa, leading to ulcer formation.
Understanding the causes of mouth and stomach ulcer formation helps guide treatment and prevent recurrence.
Are Ulcers Contagious?
Most ulcers are not contagious and do not spread from one person to another. However, the risk depends on the underlying cause of the ulcer.
- Non-infectious ulcers
- Ulcers caused by stress, nutritional deficiencies, trauma, acid damage, or medications cannot spread through contact.
- Infection-related ulcers
- Ulcers caused by viral or bacterial infections may spread through:
- Close personal contact
- Sharing utensils, cups, or toothbrushes
- Poor hand hygiene
- Stomach ulcers and H. pylori
- While the ulcer itself is not contagious, the Helicobacter pylori bacterium that causes some stomach ulcers can be transmitted through contaminated food, water, or saliva.
- Good oral hygiene reduces risk.
- Regular handwashing, avoiding the sharing of personal items, and maintaining oral hygiene help reduce the spread of infection-related ulcers.
Ulcer Diagnosis
Diagnosing ulcers is essential to determine their type, cause, and severity and to rule out serious underlying conditions. Because ulcers can occur in different locations, such as the mouth, tongue, throat, or stomach, doctors tailor investigations based on symptoms, duration, and response to initial treatment.
Clinical Examination
Doctors assess:
- Location, size, and appearance of the ulcer
- Pain pattern (with eating, swallowing, or at rest)
- Duration and frequency of recurrence
- Associated symptoms such as weight loss, bleeding, or fever
Persistent or non-healing ulcers require further evaluation.
Blood Tests
- Iron, vitamin B12, and folate levels
- Infection or inflammation markers
- Autoimmune indicators
- Anaemia due to chronic blood loss
Endoscopy (Upper GI Endoscopy)
Used to:
- Visualise stomach and duodenal ulcers
- Assess bleeding or scarring.
- Detect peptic ulcers
- Test for Helicobacter pylori
Biopsy
Done when:
- Ulcers persist beyond 2–3 weeks.
- Irregular edges or unexplained bleeding are present.
- Malignancy must be ruled out.
Helicobacter pylori Testing
- Breath test
- Stool antigen test
- Biopsy-based testing
Imaging Studies (When Needed)
- Detect perforation
- Assess the surrounding organs.
- Identify deep infections
Conditions That Mimic Ulcers
- Oral infections
- Acid reflux disease
- Oral cancer
- Inflammatory bowel disease
- Fungal infections
Persistent ulcers should always be evaluated.
Complications of Untreated Ulcers
If ulcers are not treated appropriately, they can lead to serious short- and long-term complications, including:
- Chronic pain
- Ongoing irritation and inflammation can cause persistent discomfort, affecting eating, speaking, and daily activities.
- Secondary infection
- Open ulcers can become infected by bacteria or fungi, delaying healing and worsening symptoms.
- Bleeding
- Ulcers may erode blood vessels, leading to bleeding from the mouth or gastrointestinal tract, which can cause anaemia.
- Scarring
- Repeated or deep ulcers can heal with scar formation, potentially affecting tissue function.
- Stomach perforation
- In severe gastric or peptic ulcers, the ulcer can create a hole in the stomach wall, which is a medical emergency.
- Malnutrition
- Pain, poor appetite, and impaired digestion can reduce food intake and nutrient absorption over time.
Early diagnosis and proper treatment significantly reduce the risk of these complications.
Ulcer Treatment
Treatment focuses on healing the ulcer and removing the cause.
Mild to Moderate Ulcers
- Topical medications and mouth ulcer gel
- Pain relief and anti-inflammatory medicines
- Nutritional supplementation
- Avoiding spicy and acidic foods
Severe or Recurrent Ulcers
- Prescription medications
- Antibiotics if infection is present
- Acid suppression therapy
- Hospital care for bleeding ulcers
Appropriate treatment of mouth ulcers and stomach ulcers prevents recurrence.
Living with Ulcers
Self-Care Tips
- Control conditions, such as diabetes or stress that exacerbate ulcers.
- Take PPIs and antibiotics exactly as prescribed.
- Avoid caffeine, alcohol, tobacco, spicy foods, and NSAIDs.
- Maintain a healthy weight with small, bland meals (oatmeal, bananas, yoghurt).
- Eat last meal 3-4 hours before bed.
- Manage stress through yoga, walking, and meditation; sleep 7-8 hours.
Emergency Signs
- Severe, unrelenting abdominal pain.
- Vomiting blood/coffee grounds.
- Black tarry stools.
- Fainting, dizziness, and shortness of breath.
- Unexplained weight loss, persistent
How to Prevent Ulcers?
Prevent ulcers with these crisp, daily habits to protect your mouth and gut.
Oral Hygiene
- Brush twice daily with a soft toothbrush; floss gently.
- Rinse with warm saltwater after meals.
- Choose yoghurt, bananas, oatmeal, and boiled veggies.
- Skip spicy, citrus, fried foods, chocolate, and fizzy drinks.
- Chew slowly; use a straw for lip sores.
Lifestyle Tweaks
- Quit tobacco; limit alcohol to 1 drink/day.
- Sleep 7-8 hours; de-stress with yoga/walks.
Medication Rules
- Use NSAIDs sparingly with food; prefer paracetamol.
- Treat H. pylori infections promptly.
When Should You Seek Medical Care?
While many ulcers heal spontaneously, medical evaluation is important when symptoms suggest complications or an underlying condition.
- An ulcer that does not heal within 2 weeks
- Frequent or recurring ulcers, especially in the same location
- Severe or increasing pain that interferes with eating or swallowing
- Bleeding from the mouth or blood in the stools
- Black stools or vomiting blood, which may indicate a stomach ulcer
- Difficulty swallowing or speaking
- Unexplained weight loss or fatigue
- Fever or signs of infection around the ulcer
- Ulcers occurring in children, elderly individuals, pregnant women, or people with weak immunity
Early medical care allows timely diagnosis, appropriate treatment, and prevention of serious complications.
Care at Renova Hospitals
Renova Hospitals offer comprehensive care for all ulcer types, ensuring personalised treatment from diagnosis to recovery. For oral ulcers, they provide targeted medications, such as soothing topical gels, alongside nutritional interventions to address deficiencies in vitamins B12, iron, or folate, thereby promoting faster healing and preventing recurrence.
Patients with peptic ulcers benefit from advanced diagnostics, such as endoscopy, to identify causes, including H. pylori infection or NSAID-induced damage, followed by acid suppression therapy with proton pump inhibitors (PPIs) to reduce gastric irritation.
In cases of persistent or complicated ulcers, the hospital implements close monitoring to prevent complications such as bleeding, perforation, or scarring and employs thorough infection control measures, including antibiotics, to ensure complete eradication. This integrated approach at Renova Hospitals minimises long-term complications and supports overall digestive health.
Disclaimer
This content is for general information only and does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified doctor for persistent or severe symptoms.
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