Esophageal Ulcer: What It Is, Symptoms, and How to Treat It

If you’ve felt a burning pain in your chest that doesn’t go away with antacids, you might be dealing with an esophageal ulcer. It’s a sore that forms on the lining of the esophagus – the tube that carries food from your mouth to your stomach. Unlike a regular heartburn episode, an ulcer is a deeper wound that can bleed and cause real discomfort.

Common Signs You Shouldn’t Ignore

Most people notice a sharp, gnawing pain behind the breastbone, especially after meals. The pain may worsen when you lie down or bend over. Other clues include:

  • Difficulty swallowing or a feeling that food is stuck
  • Regurgitation of sour liquid
  • Unexplained weight loss
  • Occasional coughing or hoarseness

If any of these symptoms last more than a couple of weeks, call your doctor. Early detection can keep the ulcer from getting bigger.

Why Ulcers Form in the Esophagus

Most esophageal ulcers are caused by acid reflux – when stomach acid flows back up and irritates the esophagus. Chronic reflux can wear down the protective mucous layer, letting acid eat into the tissue. Other culprits include certain medications (like NSAIDs), infections such as Helicobacter pylori, and rarely, severe vomiting or smoking.

People with conditions like GERD (gastro‑esophageal reflux disease) are at higher risk. Even a simple habit like drinking a lot of coffee or alcohol can increase acid production and make the lining more vulnerable.

How Doctors Diagnose the Problem

To confirm an ulcer, most doctors order an upper endoscopy. A thin camera slides down your throat and lets the doctor see the sore directly. They might also take a tiny tissue sample (biopsy) to rule out infection or cancer.

In some cases, a barium swallow X‑ray can show a clear picture of the esophagus, but it’s less detailed than an endoscopy.

Treatment Options That Really Work

The main goal is to stop acid from damaging the esophagus and let the ulcer heal. Doctors usually prescribe:

  • Proton‑pump inhibitors (PPIs) like omeprazole – these cut acid production dramatically.
  • H2 blockers – a milder option that still reduces acid.
  • Antacids – for quick, short‑term relief.

If you’re taking NSAIDs, stop them and switch to an alternative pain reliever. For infections, a short course of antibiotics can clear the problem.

Lifestyle Changes to Speed Healing

Medications help, but lifestyle tweaks seal the deal. Try these simple steps:

  • Eat smaller meals and avoid eating within three hours of bedtime.
  • Raise the head of your bed 6‑8 inches to keep acid down while you sleep.
  • Cut back on caffeine, alcohol, chocolate, and spicy foods.
  • Quit smoking – it weakens the esophagus’s natural defenses.
  • Maintain a healthy weight; excess belly fat pushes stomach acid upward.

Sticking to these habits not only speeds up healing but also prevents new ulcers from forming.

When to Seek Emergency Help

Most ulcers can be managed with outpatient care, but watch for warning signs that need urgent attention:

  • Vomiting blood or material that looks like coffee grounds
  • Black, tarry stools (sign of internal bleeding)
  • Severe chest pain that radiates to the arm or jaw
  • Sudden difficulty swallowing liquids

These symptoms could indicate a bleeding ulcer or another serious condition that requires immediate treatment.

Bottom line: an esophageal ulcer is a painful but treatable condition. With the right meds, a few lifestyle tweaks, and prompt medical care, you can get back to eating, sleeping, and living without that constant burning feeling.