The chances of developing a stomach ulcer after gastric bypass surgery are relatively low, but it is a recognized complication. Marginal ulcers, which form where the stomach pouch connects to the small intestine, occur in about 3-15% of patients. The risk depends on factors such as smoking, the use of certain medications like NSAIDs (ibuprofen or aspirin), alcohol consumption, or the presence of an H. pylori infection. Dietary choices and stress levels can also contribute. Symptoms of an ulcer may include persistent upper abdominal pain, nausea, vomiting, or, in more severe cases, black stools or signs of anemia due to bleeding. If an ulcer develops, it is typically treated with medications such as proton pump inhibitors (PPIs), which reduce stomach acid to promote healing. If H. pylori is involved, a combination of antibiotics may also be prescribed. Additional medications like antacids or H2 blockers may help alleviate symptoms. Lifestyle adjustments play an essential role in both treatment and prevention. It is important to avoid smoking, alcohol, and NSAIDs, as these can irritate the stomach lining. Following post-surgery dietary guidelines and managing stress are also crucial to minimizing risk. In rare cases, if the ulcer causes complications like bleeding or perforation, further intervention might be required, such as endoscopy or surgery. Regular follow-ups with your bariatric surgeon are essential for early detection and management of any issues. While ulcers can occur, they are manageable with prompt treatment and appropriate care.