Hello
A peptic ulcer will give you pain in you burning pain in your abdomen (actually anywhere from your navel up to your breastbone). Your symptoms would be worse on an empty stomach and would most likely be worse during the night.
The only true way to know is to have an upper endoscopy where the Dr insert a flexible tube with a light and camera on the end so they can visualize the esophagus, and stomach.
Other causes for upper abdominal pain could also be caused from things like gallbladder disease, liver conditions, H. Pylori infection, Pancreatitis, and Gastritis.
I would say if you have not had any success with the Prilosec, Tums, and the acid reducer, it might be time to see a Gastroenterologist for the tests.
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Yes, the pain is not always constant. The pain getting worse at night (midnight) is certainly consistant with an ulcer (given that fact that you are sleeping at night and not working 3rd shift or anything like that) because your stomach is typically empty. The higher the acid contents, the more pain (empty stomach-more acid).
If you do not want to go the hospital, you can go to a walk-in clinic and be seen if you do not have a regular Dr. They will be happy to run some test for you and then refer you out if they feel like you need to be referred out.
As far as going to the hospital goes....let pain be your guide (if you are wondering about needing to go tonight). Also, if any blood is seen in your stool or vomiting blood, then yes, you should not delay, but as of tonight, as long as you are feeling ok, you could go the urgent care clinic or your regular Dr tomorrow and be seen.
Just make sure when they ask you if you are on any medications, you tell them all of the over the counter medications you have taken as this alter the test results.
Nurse
17 years exp. in all areas of nursing including emergency medicine, hospital, and private practice.