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Peptic Ulcer

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What is a peptic ulcer?

Peptic ulcers are sores that develop in the lining of the esophagus, stomach, or upper section of the small intestine (duodenum). The stomach is a strong, muscular organ that grinds and crushes food, in combination with digestive juices such as hydrochloric acid, bile acids, and enzymes, including pepsin. A mucus layer coats the interior of the stomach, protecting it from the digestive juices. Prostaglandins, hormone-like substances involved in muscle contraction, also protect the lining. Any imbalance in the production of these digestive juices can damage the lining of the stomach and form an open sore called an ulcer.

There are two types of peptic ulcers: gastric ulcers (stomach ulcer) and duodenal ulcers (first segment of the intestine). Peptic ulcers are often caused by an infection with Helicobacter pylori bacteria or use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, and naproxen.

  • Infection with H. pylori is common, especially in developing countries, with up to 50% of the world's population infected. It is believed to be transmitted by eating contaminated food or drinking water or possibly through direct contact with the stool, vomit, or saliva of an infected person. For reasons that are not yet understood, H. pylori does not cause ulcers in all who are infected; however, of those who do have peptic ulcers, more than half are caused by this infection.
  • Another common cause of peptic ulcers is long-term use of NSAIDs such as aspirin, naproxen, and ibuprofen. Individuals who take NSAIDs every day or several times a week, especially if they are age 70 or older or have had a prior ulcer, are more likely to develop peptic ulcers. Women are more likely than men to develop an ulcer due to NSAIDs.
  • Rarely, peptic ulcers can be caused by the condition Zollinger-Ellison Syndrome, in which there is increased production of the hormone gastrin due to a tumor in the pancreas or small intestine.
  • Drinking alcohol in excess and smoking can make peptic ulcers worse and prevent healing.

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