An esophagus ulcer is an actual hole caused by acidic digestive juices secreted by cells in the stomach. This type of problem can be caused by a number of things, including certain medications, specifically anti-inflammatory, smoking, and bacteria called H. pylorus or Helicobacter pylori. One of the challenges of this type of physical problem is that pain is not always associated. However, if the ulcer were located behind or just below the breastbone, pain would probably be intense. In addition, the individual would likely have decreased appetite, experience weight loss, and feel unwell overall.

Complications of ulcers include bleeding and perforation. Ulcers and their resulting inflammation can erode into the esophageal blood vessels and give rise to bleeding into the esophagus. Bleeding ulcers are dangerous and should be treated immediately. Prolonged or severe acid reflux (severe heartburn) causes changes in the cells that line the esophagus. These cells then become pre-cancerous, and finally cancerous. Cancer is estimated to occur in 10% of patients with acid reflux.