Skip to main contentLast updated: 27-Oct-2026
Dr Harsh Shah
MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Registered with Gujarat Medical Council, Reg. No. G-38738
Gastro & Cancer Surgeon
Apollo Hospital, Bhat, Gandhinagar · Gota OPD, Ahmedabad · 18 years of experience
★★★★★ Google: 4.89 from 216 reviews (Gota clinic) · 4.94 from 18 reviews (Apollo, Bhat)
In short
An ulcer forms when the stomach lining loses its own protection. Pain tablets switch that protection off through the whole body, whatever way you take them.
These ulcers often do not hurt. The first sign may be black stool or vomiting blood, especially in people past sixty.
Safety means asking if you need the tablet, adding an acid tablet for cover, and testing for H. pylori first.
The full care plan for ulcers is on the peptic ulcer treatment in Ahmedabad page. This post explains what goes wrong inside the stomach. It also covers why pain tablets are a common cause, and how to stay safe.
Acid is needed for an ulcer, but it is rarely enough. Most people with plenty of acid never get one. The real fault is a weak lining.
The stomach sits in a bath of strong acid. It survives because the lining has several layers of protection. An ulcer is a spot where those layers failed and acid then ate into the wall.
| Protects the lining | Wears the lining down |
|---|---|
| A thick coat of mucus | Acid and the digestive juice pepsin |
| Bicarbonate, which keeps the surface close to neutral | H. pylori germ |
| Good blood flow, which washes away acid and brings repair | Pain tablets such as diclofenac and ibuprofen |
| Fast regrowth of surface cells after a small injury | Smoking, heavy alcohol and severe illness |
One family of natural chemicals, the prostaglandins, runs most of this protection. They help make mucus and bicarbonate, keep blood flowing, and speed repair. Take them away and every layer weakens at once.
Pain tablets work by blocking the body’s prostaglandins. That relieves pain, but it also removes the stomach’s own shield. The harm comes through the blood, not just from contact.
Aspirin works the same way, even in the small daily dose taken for the heart. It is a common hidden cause of a bleeding ulcer.
Pain tablets also hide pain. A person can have an ulcer for weeks without any burning or ache. The first sign is then black stool, vomiting blood or sudden weakness.
If this happens, go to an emergency department. What a scope does for a bleeding ulcer is explained in bleeding ulcer: how a scope stops the bleed.
Risk rises with age, dose and the other medicines you take. Doctors sort people into three groups, and the group decides what cover you need.
| Group | Who is in it | Usual advice |
|---|---|---|
| Lower risk | Under sixty-five, a short course, no earlier ulcer, no other risk medicines | The lowest dose for the shortest time |
| Medium risk | Over sixty-five, a high dose, an old uncomplicated ulcer, or aspirin, steroid or blood-thinner use | An acid tablet taken with the pain tablet, or a different class of pain tablet |
| Higher risk | An earlier ulcer that bled or burst, or two or more medium-risk signs | Avoid pain tablets if at all possible. If one is vital, use the safest type with an acid tablet |
A pain tablet with a steroid, an aspirin or a blood thinner is an especially risky mix. It is a common story behind the older patient who arrives with a bleed. H. pylori adds to the risk, as explained below.
Pain tablets are sold in India without a prescription. Many people take them for months and do not count them as medicines. A careful list of everything you swallow is the first step.
Bring every strip, bottle and packet to the visit. People often do not think of these as medicines until asked directly.
You do not always have to stop. You have to match the cover to the risk. An acid tablet is the most reliable protection for the stomach and the first part of the bowel.
An acid tablet protects the stomach, not the small bowel. A long course of pain tablets can still hurt the gut further down. It may show only as a low blood count.
The germ and the tablet are separate causes, and together they add up. If you must take pain tablets for a long time, test for the germ before you start.
How the germ is cleared and proved gone is in found H. pylori: the 14-day medicines, step by step.
Why the germ is so common is in H. pylori is common in India: why do few get ulcers.
If aspirin was prescribed for a stent or a heart attack, stopping it can be dangerous. Ask your doctors how to protect the stomach, not how to give up the aspirin.
The steps after a bleed or a hole are in what happens after an ulcer bleed or hole.
Most ulcers come from the germ or from pain tablets. A few have another cause, and a stubborn ulcer is a reason to look for it.
A stomach ulcer is usually checked with a biopsy and a repeat scope after healing. If your ulcer keeps returning, or the pain is new and you are unsure what it is, start with stomach pain: is it an ulcer.
Yes. The harm comes through the blood, not only from touching the lining. An injection or a coated tablet does not make a pain tablet safe for the stomach.
Paracetamol seldom injures the lining at normal doses. It does not reduce swelling the way other pain tablets do, so it may not suit every pain.
Not on your own. Stopping it can be dangerous. Your doctors usually add an acid tablet and restart aspirin soon after a bleed is controlled.
It is cover for your stomach. The acid tablet is the most reliable way to prevent a pain-tablet ulcer. It is chosen when your risk is medium or higher.
Yes. A long course can injure the small bowel too. An acid tablet does not protect it, and the sign may only be a low blood count.
Yes, especially if you have had an ulcer. The germ and the tablet add to each other. Clearing the germ lowers the risk, but you may still need an acid tablet.
The full range of care is on the peptic ulcer treatment page. For questions before you travel, call +91-63555-64601.
Shah’s Gastro, Cancer & Robotic Surgery Centre, Gota, Ahmedabad
Consultation, review of endoscopy, biopsy and scan reports, second opinions and follow-up.
Apollo Hospital, Bhat, Gandhinagar
Apollo Hospital International Limited, GIDC Bhat Industrial Estate, Bhat, Gandhinagar. Endoscopy and biopsy, CT scans, surgery for stomach and duodenal disorders, and inpatient care.
A stomach ulcer from pain tablets can hide for months and show itself as a bleed. If you take pain tablets often, or you are worried about a tablet you have taken for years, send us the list. We look at it with you and decide what is safe after examination. Call +91-63555-64601 Send your tablet list before the visit
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