What is a peptic ulcer?
A peptic ulcer is a hole in the lining of the stomach or duodenum, often caused by a bacterial infection of Helicobacter pylori. The stomach produces hydrochloric acid and enzymes, including pepsin, that break down and digest food. A mucus layer coats the stomach and protects it from the acid. Prostaglandins, hormone-like substances involved in muscle contraction, also aid in protecting the lining. When these defenses are not performing their job properly, acid and pepsin eat away at the lining, forming an open sore called an ulcer.
H. pylori is a urease-enzyme-producing bacterium that decreases the stomach's ability to produce mucus, making it prone to acid-damage and peptic ulcers. Infection with H. pylori is common, especially in developing countries. It is believed to be transmitted by eating food or drinking water that has been contaminated with human fecal material, or possibly through 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 nonsteroidal anti-inflammatory agents (NSAIDs) such as aspirin, naproxen, and ibuprofen. 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 exacerbate peptic ulcers and prevent healing.