Hemorrhagic Peptic Ulcer Experience｜Fasting Pain, Black Stools, Emergency Endoscopy, and 6 Years of Recurrence-Free Life

Six years ago, I was rushed to a university hospital emergency room due to a hemorrhagic peptic ulcer, and underwent emergency endoscopic clip hemostasis. The doctor told me, “You were on the verge of perforation.”

Today, I live a comfortable daily life without any special medication and have been recurrence-free for six years.

Summary of This Story

I received emergency endoscopy and clip hemostasis due to a hemorrhagic peptic ulcer.
The culprit was not H. pylori or painkillers, but smoking.
Quitting smoking + morning fasting care have kept me recurrence-free for six years.

Contents Covered

Why fasting pain repeated for years
Why antacids only helped temporarily
Key differences that showed it was an ulcer, not gastritis
Black stools and warning signs of hemorrhagic ulcers
Emergency endoscopy, clip hemostasis, and near-perforation
Why smoking was the main culprit
Six years recurrence-free with smoking cessation + morning routine

Early gastric ulcer symptoms: bloating on an empty stomach

1. Early Symptoms – Fasting Discomfort and Heaviness

Q. My stomach feels uncomfortable. (Fasting pain)

On an empty stomach in the morning, I repeatedly felt fullness, heaviness, and a pressing discomfort in my upper abdomen, sometimes even slightly short of breath.

Eating bread or a small snack relieved the symptoms temporarily, but this repeated over a long time.

A. Why does this pattern resemble peptic ulcers rather than gastritis?

1️⃣ Fasting pain is common in ulcers

In peptic ulcers (especially duodenal ulcers), fasting allows stomach acid to directly irritate the ulcer site.
Eating temporarily dilutes the acid and acts like a physical protective layer, relieving discomfort.

In contrast, gastritis often causes post-meal bloating, heartburn, or discomfort after certain foods.

2️⃣ Ulcers can occur without heartburn

Ulcer pain is often perceived as heaviness, fullness, or pressure, rather than a burning sensation.
Some people even feel difficulty breathing due to upper abdominal tightness.

3️⃣ Repeated symptoms over years are significant

Gastritis fluctuates with stress, diet, or physical condition.
Peptic ulcers, however, do not heal naturally without treatment, and the same pattern can repeat for months or years.

Summary:

Recurrent fasting pain relieved by food, persisting for years, aligns more closely with peptic ulcer patterns than simple gastritis.

2. liquid antacids (Self-Treatment)

Q. I live with liquid antacids.

Whenever my stomach felt too heavy, taking liquid antacids would relieve the symptoms almost immediately. However, this only lasted for a short time. After a while, the same discomfort would return, so I always carried liquid antacids with me.

A. Why do liquid antacids provide quick relief?

liquid antacids act more like “emergency relief” rather than true treatment medication.

Temporarily neutralizes stomach acid
Coats the stomach lining to reduce irritation

This quickly alleviates bloating, heaviness, and discomfort after intake.

This is similar to sprinkling water on a fire. The flames temporarily subside, but the underlying cause remains.

Why symptoms recur despite antacids:

1️⃣ The ulcer wound remains

Peptic ulcers are actual wounds in the stomach lining.
liquid antacids do not heal the underlying wound.

2️⃣ Acid production is not reduced

liquid antacids neutralize existing acid, but do not suppress acid secretion.
True treatment, such as PPIs, reduces acid production itself.

3️⃣ If H. pylori is present

Without eradication therapy, antacids cannot eliminate the root cause, so symptoms keep recurring.

Key point:

Temporary relief after antacid intake is not a sign of healing, but a signal that deep wounds remain.

3. PPIs and Initial Digestive Discomfort

Q. Taking peptic ulcer medication makes digestion difficult. (PPI Indigestion)

When taking PPIs, I felt slower digestion, had to chew thoroughly and eat slowly.

A. Why does PPI treatment feel uncomfortable initially?

1️⃣ Reduced stomach acid slows digestion

PPIs suppress acid strongly, which is essential for wound healing.
But acid is also required for protein breakdown, sterilization of food, and gastric emptying signals.
Reduced acid causes food to stay longer in the stomach, producing bloating, heaviness, and increased burping.

2️⃣ Those with fasting-pain type ulcers feel this more

Patients who had discomfort when fasting often have high acid or sensitivity.
Sudden acid reduction via PPI causes adjustment-related discomfort.

3️⃣ This is an adaptation, not a side effect

Usually occurs within the first 1–2 weeks and gradually subsides.
Doctors often explain: “It may feel heavy at first, but PPIs are necessary for ulcer healing.”

Summary:

PPIs are “wound-healing medication”, unlike antacids which only relieve symptoms temporarily.
Initial digestive discomfort does not mean the medicine is ineffective.

Comparison of gastric mucosal damage between gastritis and gastric ulcer

4. Gastritis vs Peptic Ulcer – Differences in Mucosal Damage

Q. How do I know if it’s gastritis or a peptic ulcer?

A. Gastritis = reaction, Ulcer = injury

1️⃣ Gastritis Causes – Weak response to irritants

Stress, fatigue
Irregular meals
Alcohol, coffee, spicy food
Overeating, late-night snacks
H. pylori may or may not be present

Features:

Causes are variable and often improve with lifestyle adjustments
May occur even without excessive acid

Gastritis often shows the pattern: “appears when condition is bad, subsides when well.”

2️⃣ Peptic Ulcer Causes – Attack overcomes defense

H. pylori infection
Long-term NSAID use
Excess acid + weakened mucosal defense

Additional factors:

Smoking, chronic alcohol, stress
One strong cause usually persists and keeps the ulcer active

Features:

Strong, persistent cause
Does not heal spontaneously
Requires proper treatment to prevent recurrence

Key point:

Gastritis can improve with care; peptic ulcers persist if the main cause continues.

3️⃣ H. pylori as a deciding factor

Gastritis: can occur without H. pylori
Ulcer: often associated with H. pylori
Without eradication therapy, ulcers can recur repeatedly

5. “One Strong Cause” – Meaning

Q. What exactly does “one strong cause” mean?

What does it mean that one strong cause acts continuously?
Does it mean that among the multiple causes of peptic ulcers, only one is the cause?

A. The precise meaning of “one strong cause”

There are multiple causes of peptic ulcers, but often there is one key cause that plays the main role.

In other words, several factors may be involved, but there is usually a central cause that actually creates and sustains the ulcer.

1️⃣ When Helicobacter pylori is the main cause

H. pylori: key cause
Stress, diet: contributing factors
In this case, no matter how much you adjust your diet or stop drinking alcohol,

👉 if the bacteria are not eradicated, the ulcer keeps recurring.

2️⃣ When NSAIDs are the main cause

Long-term NSAID use: key cause
Age, smoking, weakened stomach lining: contributing factors
Even if you take PPIs,

👉 if you continue taking NSAIDs, the ulcer may not heal well or will recur.

3️⃣ Multiple factors exist but one is central

H. pylori + smoking + stress
But if H. pylori is not removed,

👉 it becomes the continuously acting key cause.

So, the important point is “continuous action”, not the number of causes.

Gastritis: irritants come and go
Peptic ulcer: damaging factors act every day, continuously

This is why ulcers form, don’t fully heal, and recur in the same pattern.

In summary:
❌ “Peptic ulcers have only one cause” → Incorrect
⭕ “Among multiple causes, the key cause acts continuously” → Correct
⭕ Removing this key cause is essential for complete healing.

6. Smoking as a Main Cause

Q. Can smoking be one strong cause of peptic ulcers?

My test results showed no H. pylori, and I don’t take painkillers regularly.
I do drink occasionally and smoke—could smoking be the main cause of my ulcer?

A. Can smoking really be the main cause of peptic ulcers?

Many people think:

"I don’t drink much, I don’t take NSAIDs, and I don’t have H. pylori.
Could smoking really cause an ulcer?"

But in reality, smoking alone can cause peptic ulcers, and it also prevents them from healing well.

How smoking contributes to peptic ulcers:

1️⃣ Directly weakens the stomach’s defense
Nicotine reduces blood flow in the gastric mucosa and decreases mucus and bicarbonate secretion.

👉 This weakens the stomach’s protective “shield.”
Even normal levels of stomach acid can then easily damage the lining.

2️⃣ Increases acid secretion
Nicotine stimulates the vagus nerve, increasing gastric acid production.

👉 The result is stronger attack + weaker defense → an environment prone to ulcers.

3️⃣ Prevents healing once an ulcer forms
Smoking reduces blood flow to the ulcer, slowing tissue regeneration.
Even if you take PPIs,

👉 continued smoking can prevent the ulcer from healing properly.

This is why doctors often say: “Smoking is a bigger problem than medication.”

When there’s no H. pylori or NSAID use
In these cases, the impact of smoking becomes even more significant.
If symptoms keep recurring without other strong causes,

👉 smoking is very likely the continuously acting key cause.

Clinical observations:

Quitting smoking noticeably speeds up recovery even on the same medication.
Continuing to smoke leads to higher recurrence rates and longer treatment periods.

So in practice, doctors often consider quitting smoking more important than how well you take medication.

👉 Smoking can have a much more direct effect than alcohol on the development and recurrence of peptic ulcers.

7. Recurrence Despite Medication

Q. My peptic ulcer keeps recurring even after taking medication.

During a health check-up, a stomach X-ray suggested a peptic ulcer, so I took medication for 3 months.

The ulcer symptoms disappeared, and I thought it was healed, but it has recurred.
During this time, I didn’t change any lifestyle habits such as drinking or smoking.

A. Why did the ulcer recur even after 3 months of medication?

1️⃣ The medication may have only “covered up the wound”
Drugs like PPIs reduce stomach acid, creating an environment where the ulcer can heal.

While taking the medication, you feel better and symptoms decrease.
But if the cause of the ulcer remains, once the medication is stopped or its effect decreases,

👉 the same area can get damaged again.

2️⃣ Not changing lifestyle habits is key
This is the most important factor.
Especially smoking, frequent drinking, or irregular meals—
even one of these continuing can undo the “healing environment” created by the medication every day.

In practice, doctors often see:
"The patient took the medicine well, but kept smoking,"

In such cases, the recurrence rate is quite high.

What this situation indicates
This is not just a matter of “the medicine didn’t work.”
It signals that:

✔ There is a persistent cause of the ulcer
✔ Medication alone cannot solve it
✔ There is a possibility of recurrent ulcers

Considering all the factors discussed so far, smoking is very likely the key cause in this case.

In summary:
Recurrence after 3 months of treatment is not abnormal.
Since the cause hasn’t been removed,

In this situation, it’s more important to adjust the treatment strategy than to just change the medication.

Black stool melena symptom warning sign of bleeding gastric ulcer

8. Emergency Signals: Black Stools (Melena)

Q. One day, I suddenly noticed black stools.

One day, when I went to the bathroom, I saw black-colored stools. I thought, “It will be okay,” but it continued for 2–3 days. On the fourth day, a large amount of black liquid stool filled the toilet, which even shocked me by how much there was.

I went to work that day, but I felt a bit dizzy, possibly due to blood loss.

A. What does this symptom indicate?

Black-colored stools (melena): This is almost a definite sign that bleeding has occurred in the upper stomach or duodenum.
The pattern of 2–3 days followed by a large amount on the fourth day: This is not minor bleeding, but ongoing active bleeding.
Dizziness: Indicates reduced blood volume, anemia, or low blood pressure.

When these two signs occur together, “wait and see” is not an option.

The severity of this situation is significant:

This is considered upper gastrointestinal bleeding (UGIB).
The most common cause at this stage is a hemorrhagic peptic ulcer.

Particularly dangerous points:

History of suspected ulcers from previous screenings
Recurrence after medication
No lifestyle changes
Melena + dizziness

From a medical perspective, these symptoms are considered an emergency and require immediate hospital care.

A very important point from this story:

Many people say, “I wasn’t in pain.”
Hemorrhagic peptic ulcers often do not cause pain, which makes them more dangerous.
Pain may be absent, but black stools and dizziness can appear first, signaling severe bleeding.

Q. I went to a local clinic.

When I visited a local clinic, the doctor said that they couldn’t treat me there and wrote a referral, telling me to go immediately to the emergency room at a university hospital.

I only felt a little dizzy and had no pain, so I was a bit puzzled about why I needed to go to the ER, but I went to a university hospital anyway.

A. Why couldn’t the local clinic treat you?

1️⃣ You were already in the stage of a “bleeding peptic ulcer.”

Black stools for several days,
Large volume of black liquid stool on the 4th day,
Accompanied by dizziness

This is not a simple ulcer—it indicates a high likelihood of active bleeding.

At this stage, medication alone ❌ or outpatient treatment ❌ is insufficient.

2️⃣ The required treatment involves “emergency care + procedures.”
In this situation, the following are usually necessary:

Emergency blood tests (hemoglobin level)
Intravenous fluids, blood transfusion if needed
Emergency upper endoscopy
Endoscopic hemostasis (clips, cauterization, injection, etc.)

👉 These treatments require university hospital-level facilities and an emergency system, which is why the doctor said: “We can’t treat you here. Go to the ER immediately.”

Why going to a university hospital ER was important

a university hospital can perform emergency endoscopy, blood transfusions, and ICU-level care.
Acting without delay was critical.

Additional points about bleeding peptic ulcers:

Sometimes, bleeding starts slowly and then suddenly becomes massive.
If you had been at home or work at that moment,

👉 the situation could have been much more dangerous.

A very important point:
Many people say, “I wasn’t in pain.”

But bleeding peptic ulcers often don’t cause pain.
No pain ❌
Instead: black stool, dizziness, fatigue—which makes them even more dangerous.

Moments where this could have been missed:

Ignoring melena for several days
Thinking “It’ll be fine” and going to work

However, the decisions to:

Be referred immediately from the local clinic
Go directly to a university hospital ER

👉 were the decisive factors that prevented the situation from worsening significantly.

Bleeding gastric ulcer emergency endoscopy clip hemostasis treatment

9. Emergency Endoscopy and Clip Hemostasis

Q. I received emergency treatment at a university hospital and was hospitalized for 3 days.

As soon as I arrived at a university hospital, I underwent emergency endoscopy, during which the doctor sprayed some liquid on my stomach and placed 6–7 clips. I was told by the doctor that my stomach was “on the verge of perforation.”

A. What was done during the emergency endoscopy?

1️⃣ The “liquid” sprayed on the stomach
This is usually one of the following:

Epinephrine (adrenaline) injection: constricts the bleeding vessels and helps stop the bleeding
Hemostatic solution: helps clear the field of view and reduces bleeding

👉 In other words, this is the first step to stop active bleeding.

2️⃣ Placing 6–7 clips
This is very important.

Clips physically clamp the bleeding vessels.
Placing 6–7 clips indicates:
✔ The bleeding area was wide
✔ Multiple vessels were exposed
✔ The ulcer was deep

👉 This suggests it was not a simple ulcer, but an actively bleeding and deep ulcer.

What the doctor meant by “on the verge of perforation”

Stomach perforation: the stomach wall is completely pierced, allowing contents to leak into the abdominal cavity—a life-threatening situation requiring immediate surgery.
“On the verge of perforation” means the ulcer had almost penetrated through the muscular layer, leaving only a very thin wall.

👉 In other words, if treatment had been delayed even slightly, a hole could have formed in the stomach.

Why the emergency endoscopy was decisive

If you had gone to the hospital later, waited, or gone to a hospital that couldn’t perform emergency endoscopy,
The next step could have been massive bleeding leading to shock or emergency open surgery.

👉 Successfully stopping the bleeding with 6–7 clips essentially prevented surgery at the last moment.

10. It Didn’t Hurt, but It Was Dangerous

Q. I was discharged after 3 days of emergency treatment.

Although there was bleeding, it really didn’t hurt.

During the 3-day hospitalization, I had about 4 endoscopies and was discharged.
The attending physician emphasized that smoking was the single most important and harmful cause and strongly advised me to quit.

Of course, tests showed no H. pylori.

A. Typical characteristics of bleeding peptic ulcers

1️⃣ “There was bleeding, but it hardly hurt”

This is not unusual; in fact, it is quite typical.

Why can bleeding ulcers be painless?

As ulcers deepen, the surface nerves may become desensitized.
Often, vessel involvement → bleeding occurs before pain.
Therefore, black stools (melena) and dizziness often appear before any pain, which is why doctors are particularly concerned.

👉 The danger: “Patients don’t come because it doesn’t hurt.”

2️⃣ Having 4 endoscopies during hospitalization

This is not excessive.
It indicates that the bleeding was not a one-time event, and the risk of rebleeding was very high.
After emergency hemostasis on the first endoscopy, doctors repeatedly check:
- Whether bleeding recurs
- Whether clips remain in place
- Whether vessels are re-exposed

👉 For ulcers on the verge of perforation with active bleeding, this level of monitoring is standard.

3️⃣ The absence of H. pylori

This actually strengthens the case for smoking as the main cause.
- H. pylori ❌
- NSAIDs ❌
- Alcohol ❌ (or minor contributor)
- Yet deep ulcer, bleeding, and near perforation

👉 The remaining explanation is clear: “Long-term smoking continuously weakened the stomach’s mucosal defenses.”

This conclusion is supported even by elimination.

4️⃣ Why the physician said “smoking is the worst”

From a medical perspective:
- The ulcer developed and was managed with medication
- The root cause was not removed
- Eventually progressed to bleeding + near perforation
- Yet the most potent cause remaining was smoking
The physician’s view: “Everything else can be controlled, but if this continues, surgery is inevitable.”

Summary:

Painless bleeding → typical of bleeding peptic ulcers
4 endoscopies → evidence of high rebleeding and perforation risk
No H. pylori → strengthens smoking as the main cause
Physician’s strong advice to quit smoking → not just advice, almost a warning

Gastric ulcer recovery diet cabbage soy milk beet juice

11. Smoking Cessation + Morning Routine

Q. I returned to daily life after discharge.

After discharge, I felt extremely comfortable. My appetite was amazing, and everything tasted good—something I had never experienced before.

Since then, I made two major changes:

I quit smoking completely
Every morning, I drank a juice made of cabbage, soy milk, and beets

A. Two key changes for full recovery from peptic ulcer

1️⃣ The two major post-discharge changes

Complete smoking cessation
Daily morning cabbage-soy-beet juice

These two changes form the core pillars of recovery after a bleeding peptic ulcer.

2️⃣ Why cabbage is good for ulcers
Cabbage is often mentioned in the context of ulcers, for good reason:

Contains Vitamin U (S-methylmethionine)
Promotes gastric mucosa regeneration
Speeds up wound healing, especially after bleeding

Historically, before modern ulcer medications, cabbage juice was researched as a treatment alternative.

While it cannot replace medication, it creates a recovery-supportive environment.

3️⃣ The role of soy milk

Provides plant-based protein, essential for mucosal repair
Less stimulating than animal protein for the stomach
Buffers stomach acid when taken on an empty stomach, reducing irritation

4️⃣ The addition of beets

Not a “treatment food” per se, but supportive during recovery
Helps blood production (iron, folate) for post-bleeding anemia
Antioxidant effects aid mucosal healing

5️⃣ Why drinking it every morning mattered

Taken on an empty stomach
In liquid form
Gentle combination → protects the stomach, buffers acid, supplies healing nutrients

Especially after a bleeding ulcer, managing morning fasting stimulation is crucial. This juice “wakes up” the stomach without harming it.

6️⃣ Did the diet replace medication?

❌ No, it did not replace medication
✅ It helped create an environment where medication and healing could work effectively

7️⃣ The overall significance

Bleeding peptic ulcer
Near perforation
High recurrence risk

But by establishing:

Smoking cessation
Stomach-friendly dietary routine
Morning fasting management

👉 You significantly reduced recurrence risk on your own. From a doctor’s perspective, this patient self-managed the main factors that prevent recurrence.

Summary:

The juice routine is theoretically and practically valid for recovery
Does not replace medication but supports healing
Especially effective combined with smoking cessation

12. The Essence of Your Choice

Q. I have not had a recurrence for 6 years.

Peptic ulcers are known to recur easily—even after taking medication for 3 months—but I have had no recurrence in 6 years.

A. Why the ulcer did not recur

1️⃣ The hidden premise of “peptic ulcers recur easily”

Recurrence happens when the causal factors persist
Common scenarios for recurrence:
- Failed H. pylori eradication
- Reuse of NSAIDs
- Continued smoking
- Return to previous lifestyle

In other words, the main cause remains.

2️⃣ In your case, the premise was eliminated

Smoking cessation → removes the “persistent attacking factor”
Morning fasting management (cabbage juice) → buffers acid, maintains mucosal recovery, starts the day safely

These two measures directly block the main drivers of recurrence.

As a result, long-term stability is possible without ongoing medication or special treatment.

3️⃣ Significance of 6-year recurrence-free period

1 year recurrence-free → good management
3 years → greatly reduced recurrence risk
5+ years → considered effectively stable

For someone with bleeding ulcer and near-perforation history, 6 years without recurrence is excellent.

4️⃣ Important lessons from this case

Peptic ulcers are not genetic or lifelong medication-dependent
If the cause is properly addressed, long-term stability is achievable
Recurrence is common because people fail to eliminate the cause, return to old habits, or stop care prematurely

5️⃣ Essence of your choices

On the surface: quit smoking, drank morning cabbage juice
The essence: shift from “treat with medicine only” → “eliminate cause and create recovery-supportive environment”

This shift explains 6 years of recurrence-free outcome.

Impressive points:

Recognizing that “painless doesn’t mean safe” → changes future health decisions
Committing to permanent smoking cessation, not temporary
Making dietary routine a habit, not a treatment → daily approach to protect the stomach

Conclusion

Not luck
Clear cause identified
Cause eliminated
Recovery-supporting environment maintained consistently
Sustained for 6 years

This is a real-life example of full recovery from peptic ulcer through lifestyle and cause elimination, not luck.

If you want to explore related topics, these articles may help:

Potato Juice for Stomach Health — Managing Gastritis, Gastric Ulcers, and Acid Reflux

The 5-Minute Rule for Quitting Smoking: Understanding Nicotine Addiction and Effective Aids

References & Sources

Department of Gastroenterology, Asan Medical Center (Seoul) – Information on Gastric Ulcers
National Health Information Portal (Korea) – Gastric Ulcer
The Korean Society of Gastroenterology

Disclaimer

This article is for informational purposes only and is not a substitute for professional medical advice. Consult a healthcare provider for personalized recommendations.