Table of ContentsView AllTable of ContentsCommon CausesGeneticsLifestyle Risk FactorsFrequently Asked QuestionsNext in Peptic Ulcer Disease GuideHow Peptic Ulcer Disease Is Diagnosed
Table of ContentsView All
View All
Table of Contents
Common Causes
Genetics
Lifestyle Risk Factors
Frequently Asked Questions
Next in Peptic Ulcer Disease Guide
You may be surprised to learn that infection with a bacterium calledHelicobacter pyloriand long-term use of pain relievers are causes ofpeptic ulcers. In the past, it was believed stress, diet, or having too much stomach acid (hydrochloric acidand pepsin) causedpeptic ulcers, and these inaccurate beliefs still circulate. But Drs. Barry Marshall and J. Robin Warren were awarded the 2005 Nobel Prize in Medicine for their discovery of a bacterial cause of peptic ulcer disease.
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H. Pylori Infection
HavingHelicobacter pyloribacteria growing in your stomachcan damage the mucus coating that protects the tissues lining the stomach and duodenum. This allows stomach acid to come into contact with the lining, causing inflammation and ulcers. The bacteria also stimulate gastric cells to grow in the lining of the duodenum, secreting acid and pepsin.
In the U.S., 30% to 40% of the population is infected withH. pylori, but most never develop an ulcer. The bacteria can be spread via saliva, food, water, and eating utensils. It is often acquired in childhood without any symptoms.
Causes and Risk Factors of Peptic Ulcer Disease
NSAIDs
Long-term use ofnon-steroidal anti-inflammatory drugs(NSAIDs) is another common cause of peptic ulcers, raising your risk 20 times that of non-users. These include over-the-counter products containing aspirin, ibuprofen, and naproxen sodium. Prescription NSAIDs are also used to treat several arthritic conditions.
Both havingH. pyloriinfection and taking NSAIDs at the same time can increase the risk of developing a peptic ulcer to 60 times the usual rate.
Other risk factors for NSAID-induced peptic ulcers include:
Zollinger-Ellison Syndrome
Zollinger-Ellison syndrome is a rare condition that can cause peptic ulcers. Those who have it have one or more tumors in the pancreas and duodenum that produce a large amount of gastrin hormone. This leads to large amounts of acid in the duodenum and upper intestine.
About 20% of people withpeptic ulcer diseasehave a family history of duodenal ulcers.Researchershave found some genetic basis for susceptibility toH. pyloriinfection. This genetic research is still very early, but in the future, it might show those at greater risk.
Studies show thatcigarette smokingcan increase your chance of getting an ulcer, especially if you are infected withH. pylori.Smoking also slows the healing of existing ulcers and contributes to ulcer recurrence.
While a link hasn’t been found between alcohol consumption and peptic ulcers, ulcers are more common in people who have cirrhosis of the liver, a disease often linked to heavy alcohol consumption. Drinking alcohol can increase discomfort when you have an ulcer.
Spicy foods, caffeine, and acidic juices do not cause peptic ulcers, and a bland diet is no longer recommended for people with ulcers. However, you may find there are things thataggravate your symptomsand you can choose to avoid them while your ulcer is being treated and healing.
Emotional stress is no longer thought to be a cause of ulcers, but people who are experiencing it often report increased pain of existing ulcers.
A Word From Verywell
Frequently Asked QuestionsIf you have a history of heavy drinking, you may be more likely to develop ulcers. Drinking alcohol can also cause ulcersymptomsto flare up, but researchers say that even people without ulcers can have similar symptoms if they drink excessively.It’s a common assumption, but most researchers don’t believe stress is a direct cause. Possibly, people who are stressed are more likely to learn they have ulcers because they see a doctor for issues related to stress. They may also increase their risk because of stress-related behaviors like drinking and smoking.No.Stomach cancerdoes not cause ulcers. However, the same bacteria that put you at risk for ulcers,Helicobacter pylori, may over time damage the lining of your gastrointestinal system and lead to lymphoma of the stomach.
If you have a history of heavy drinking, you may be more likely to develop ulcers. Drinking alcohol can also cause ulcersymptomsto flare up, but researchers say that even people without ulcers can have similar symptoms if they drink excessively.
It’s a common assumption, but most researchers don’t believe stress is a direct cause. Possibly, people who are stressed are more likely to learn they have ulcers because they see a doctor for issues related to stress. They may also increase their risk because of stress-related behaviors like drinking and smoking.
No.Stomach cancerdoes not cause ulcers. However, the same bacteria that put you at risk for ulcers,Helicobacter pylori, may over time damage the lining of your gastrointestinal system and lead to lymphoma of the stomach.
How Peptic Ulcer Disease Is Diagnosed
10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Testerman TL, Morris J.Beyond the stomach: an updated view of Helicobacter pylori pathogenesis, diagnosis, and treatment.World J Gastroenterol.2014;20(36):12781-808. doi:10.3748/wjg.v20.i36.12781Ramakrishnan K, Salinas RC.Peptic ulcer disease.Am Fam Physician.2007;76(7):1005-12.Epelboym I, Mazeh H.Zollinger-Ellison syndrome: classical considerations and current controversies.Oncologist. 2014;19(1):44-50. doi:10.1634/theoncologist.2013-0369Lim YJ.Genetic susceptibility of gastroduodenal disease in ethnic and regional diversity.Gut Liver.2014;8(6):575-6. doi:10.5009/gnl14313Li L, Chan R, Lu L, et al.Cigarette smoking and gastrointestinal diseases: The causal relationship and underlying molecular mechanisms (Review).International Journal of Molecular Medicine. 2014;34(2):372-380. doi:10.3892/ijmm.2014.1786Bang CS, Baik GH, Kim JH, et al.Peptic ulcer disease in liver cirrhosis and chronic hepatitis: impact of portal hypertension.Scand J Gastroenterol.2014;49(9):1051-7. doi:10.3109/00365521.2014.923501American College of Gastroenterology.Peptic Ulcer Disease.Lee SP, Sung I-K, Kim JH, Lee S-Y, Park HS, Shim CS.Risk factors for the presence of symptoms in peptic ulcer disease.Clin Endosc. 2016;50(6):578-584. doi:10.5946%2Fce.2016.129Deding U, Ejlskov L, Grabas MPK, Nielsen BJ, Torp-Pedersen C, Bøggild H.Perceived stress as a risk factor for peptic ulcers: a register-based cohort study.BMC Gastroenterology. 2016;16(1):140. doi:10.1186%2Fs12876-016-0554-9American Cancer Society.Bacteria that can lead to cancer.Additional ReadingPeptic Ulcer Disease. American College of Gastroenterology.Definition & Facts for Peptic Ulcers (Stomach Ulcers). National Institute of Diabetes and Digestive and Kidney Diseases.Lim YJ.Genetic Susceptibility of Gastroduodenal Disease in Ethnic and Regional Diversity.Gut Liver. 2014;8(6):575–576. doi:10.5009/gnl14313
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Testerman TL, Morris J.Beyond the stomach: an updated view of Helicobacter pylori pathogenesis, diagnosis, and treatment.World J Gastroenterol.2014;20(36):12781-808. doi:10.3748/wjg.v20.i36.12781Ramakrishnan K, Salinas RC.Peptic ulcer disease.Am Fam Physician.2007;76(7):1005-12.Epelboym I, Mazeh H.Zollinger-Ellison syndrome: classical considerations and current controversies.Oncologist. 2014;19(1):44-50. doi:10.1634/theoncologist.2013-0369Lim YJ.Genetic susceptibility of gastroduodenal disease in ethnic and regional diversity.Gut Liver.2014;8(6):575-6. doi:10.5009/gnl14313Li L, Chan R, Lu L, et al.Cigarette smoking and gastrointestinal diseases: The causal relationship and underlying molecular mechanisms (Review).International Journal of Molecular Medicine. 2014;34(2):372-380. doi:10.3892/ijmm.2014.1786Bang CS, Baik GH, Kim JH, et al.Peptic ulcer disease in liver cirrhosis and chronic hepatitis: impact of portal hypertension.Scand J Gastroenterol.2014;49(9):1051-7. doi:10.3109/00365521.2014.923501American College of Gastroenterology.Peptic Ulcer Disease.Lee SP, Sung I-K, Kim JH, Lee S-Y, Park HS, Shim CS.Risk factors for the presence of symptoms in peptic ulcer disease.Clin Endosc. 2016;50(6):578-584. doi:10.5946%2Fce.2016.129Deding U, Ejlskov L, Grabas MPK, Nielsen BJ, Torp-Pedersen C, Bøggild H.Perceived stress as a risk factor for peptic ulcers: a register-based cohort study.BMC Gastroenterology. 2016;16(1):140. doi:10.1186%2Fs12876-016-0554-9American Cancer Society.Bacteria that can lead to cancer.Additional ReadingPeptic Ulcer Disease. American College of Gastroenterology.Definition & Facts for Peptic Ulcers (Stomach Ulcers). National Institute of Diabetes and Digestive and Kidney Diseases.Lim YJ.Genetic Susceptibility of Gastroduodenal Disease in Ethnic and Regional Diversity.Gut Liver. 2014;8(6):575–576. doi:10.5009/gnl14313
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Testerman TL, Morris J.Beyond the stomach: an updated view of Helicobacter pylori pathogenesis, diagnosis, and treatment.World J Gastroenterol.2014;20(36):12781-808. doi:10.3748/wjg.v20.i36.12781Ramakrishnan K, Salinas RC.Peptic ulcer disease.Am Fam Physician.2007;76(7):1005-12.Epelboym I, Mazeh H.Zollinger-Ellison syndrome: classical considerations and current controversies.Oncologist. 2014;19(1):44-50. doi:10.1634/theoncologist.2013-0369Lim YJ.Genetic susceptibility of gastroduodenal disease in ethnic and regional diversity.Gut Liver.2014;8(6):575-6. doi:10.5009/gnl14313Li L, Chan R, Lu L, et al.Cigarette smoking and gastrointestinal diseases: The causal relationship and underlying molecular mechanisms (Review).International Journal of Molecular Medicine. 2014;34(2):372-380. doi:10.3892/ijmm.2014.1786Bang CS, Baik GH, Kim JH, et al.Peptic ulcer disease in liver cirrhosis and chronic hepatitis: impact of portal hypertension.Scand J Gastroenterol.2014;49(9):1051-7. doi:10.3109/00365521.2014.923501American College of Gastroenterology.Peptic Ulcer Disease.Lee SP, Sung I-K, Kim JH, Lee S-Y, Park HS, Shim CS.Risk factors for the presence of symptoms in peptic ulcer disease.Clin Endosc. 2016;50(6):578-584. doi:10.5946%2Fce.2016.129Deding U, Ejlskov L, Grabas MPK, Nielsen BJ, Torp-Pedersen C, Bøggild H.Perceived stress as a risk factor for peptic ulcers: a register-based cohort study.BMC Gastroenterology. 2016;16(1):140. doi:10.1186%2Fs12876-016-0554-9American Cancer Society.Bacteria that can lead to cancer.
Testerman TL, Morris J.Beyond the stomach: an updated view of Helicobacter pylori pathogenesis, diagnosis, and treatment.World J Gastroenterol.2014;20(36):12781-808. doi:10.3748/wjg.v20.i36.12781
Ramakrishnan K, Salinas RC.Peptic ulcer disease.Am Fam Physician.2007;76(7):1005-12.
Epelboym I, Mazeh H.Zollinger-Ellison syndrome: classical considerations and current controversies.Oncologist. 2014;19(1):44-50. doi:10.1634/theoncologist.2013-0369
Lim YJ.Genetic susceptibility of gastroduodenal disease in ethnic and regional diversity.Gut Liver.2014;8(6):575-6. doi:10.5009/gnl14313
Li L, Chan R, Lu L, et al.Cigarette smoking and gastrointestinal diseases: The causal relationship and underlying molecular mechanisms (Review).International Journal of Molecular Medicine. 2014;34(2):372-380. doi:10.3892/ijmm.2014.1786
Bang CS, Baik GH, Kim JH, et al.Peptic ulcer disease in liver cirrhosis and chronic hepatitis: impact of portal hypertension.Scand J Gastroenterol.2014;49(9):1051-7. doi:10.3109/00365521.2014.923501
American College of Gastroenterology.Peptic Ulcer Disease.
Lee SP, Sung I-K, Kim JH, Lee S-Y, Park HS, Shim CS.Risk factors for the presence of symptoms in peptic ulcer disease.Clin Endosc. 2016;50(6):578-584. doi:10.5946%2Fce.2016.129
Deding U, Ejlskov L, Grabas MPK, Nielsen BJ, Torp-Pedersen C, Bøggild H.Perceived stress as a risk factor for peptic ulcers: a register-based cohort study.BMC Gastroenterology. 2016;16(1):140. doi:10.1186%2Fs12876-016-0554-9
American Cancer Society.Bacteria that can lead to cancer.
Peptic Ulcer Disease. American College of Gastroenterology.Definition & Facts for Peptic Ulcers (Stomach Ulcers). National Institute of Diabetes and Digestive and Kidney Diseases.Lim YJ.Genetic Susceptibility of Gastroduodenal Disease in Ethnic and Regional Diversity.Gut Liver. 2014;8(6):575–576. doi:10.5009/gnl14313
Peptic Ulcer Disease. American College of Gastroenterology.
Definition & Facts for Peptic Ulcers (Stomach Ulcers). National Institute of Diabetes and Digestive and Kidney Diseases.
Lim YJ.Genetic Susceptibility of Gastroduodenal Disease in Ethnic and Regional Diversity.Gut Liver. 2014;8(6):575–576. doi:10.5009/gnl14313
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