A peptic ulcer is an erosion or sore in the lining of the stomach or intestine that occurs when the protective mucus layer wears away in certain areas, allowing damage to occur from the natural acids of the stomach.
Around 10% of people will have peptic ulcer disease (PUD) at some point in their life. The majority of peptic ulcers are caused by bacteria called Helicobacter pylori (H. pylori) or by taking aspirin* or nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen, ketoprofen, naproxen).
There are two types of peptic ulcers:
- Gastric ulcers are sores in the lining of the stomach.
- Duodenal ulcers are those in the first part of the small intestine, called the duodenum. This is an area where food is digested after passing through the stomach.
Although stress and spicy foods might make the symptoms of peptic ulcer worse, they aren't the cause of the condition as was once thought.
A bacterium called H. pylori causes the majority of ulcers. The bacteria can spread into the mucus lining that usually protects the stomach and small intestine from digestive acids, damaging it in the process. By 60 years of age, up to 50% of people are infected with this bacteria, but only 10% to 20% of these people will actually develop stomach problems.
The other major cause of PUD is the use of aspirin and other NSAIDs such as ibuprofen or naproxen. NSAIDs can penetrate the lining of the stomach and release substances that damage cells. NSAIDs also block natural chemicals called prostaglandins that can help to protect and repair those cells. People more at risk of ulcers caused by NSAIDs include those who:
- are seniors
- have a history of a peptic ulcer
- are also taking glucocorticoids (e.g., prednisone, dexamethasone)
- are taking high doses of NSAIDs or aspirin
- have several medical conditions
- are taking more than one NSAID or aspirin
Excessive alcohol use can put people at higher risk for PUD, but it isn't a true cause.