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Between five and 10 percent of the adult population is affected by peptic ulcer disease worldwide. Here’s everything you need to know about peptic ulcer disease.

A peptic ulcer is an erosion of the inner wall of the stomach or duodenum, the first part of the small intestine. Peptic ulcers occur when the acid inside your stomach injures its inner lining and ultimately creates a sore.

Peptic ulcer disease (PUD) is classified according to its location. Ulcers present in the stomach are called gastric ulcers and those present in the duodenum are called duodenal ulcers. An ulcer in the esophagus is called an esophageal ulcer.

Causes Of Peptic Ulcers

The stomach normally produces hydrochloric acid to kill germs and digest the food. This same acid is responsible for the injury to the stomach wall seen in peptic ulcer disease. So, what’s changed in a PUD patient that the same acid that's normally essential to normal digestion starts making a hole in the stomach wall?

The most common causes of peptic ulcers are H Pylori bacteria and overuse of non-steroidal anti-inflammatory drugs.

Helicobacter Pylori infection in the stomch is the most common cause of peptic ulcer. H Pylori bacteria are normally present in the stomach of roughly 25 percent of the population, but they do not cause ulceration in all of them. In some people, this bacterium starts an inflammation of the stomach wall (gastritis), which then causes irritation and ultimately leads to ulcer formation.

Regular use of NSAIDs like Aspirin, ibuprofen, naproxen, Meloxicam, and diclofenac is a common cause of peptic ulcers in developed countries. Frequent use of these drugs reduces the secretion of protective chemicals (prostaglandins) inside the stomach wall and makes it more susceptible to acidic damage. 

There are some other factors that increase the risk of peptic ulcer disease.

  • Smoking cigarettes or chewing tobacco.
  • Increased intake of alcohol.
  • Genetics is also a risk factor because a number of people with PUD have a close relative with the same problem.
  • Mental stress is believed to cause peptic ulcers but there is no significant evidence.
  • A rare condition called Zollinger-Ellison syndrome increases stomach acid secretion and leads to ulcers.

Symptoms Of Peptic Ulcer Disease

Upper abdominal pain is the most common symptom of peptic ulcers. This pain is caused by the ulcer's contact with acid. The pain of a gastric ulcer is aggravated during meals, while the pain of duodenal ulcer is relieved during meals. Pain is usually burning in nature and is accompanied by mild nausea.

Other symptoms of peptic ulcers include heartburn, bloating, decreased appetite and unexplained weight loss.

Peptic Ulcer Disease: Danger Signs

Most people self-treat this “burning pain” by using antacids or other medications. These do provide temporary relief but do not give a comprehensive treatment. If you have severe burning pain in your upper abdomen for a long time, you should always contact your healthcare provider for diagnosis and treatment. Call a doctor immediately if you experience the following symptoms:

  • Severe vomiting that contains blood
  • Blood in stools or black, tarry stools
  • Severe sharp pain all over the abdomen

These symptoms mean that the ulcer has started bleeding. This complication can lead to significant blood loss. The ulcer may bore a hole throughout the wall of stomach (perforation) resulting in leakage of contents and infection (peritonitis). These complications are medical emergencies and you should seek immediate medical help.

Continue reading after recommendations

  • Janet M. Torpy, MD, Writer
  • Cassio Lynm, MA, Illustrator
  • Robert M. Golub, MD, Editor
  • JAMA. 2012
  • 307(12):1329. doi:10.1001/jama.2012.184.
  • By Ed Uthman, MD. [Public domain], via Wikimedia Commons
  • By Ed Uthman, MD. [Public domain], via Wikimedia Commons
  • Photo courtesy of Yuya Tamai via Flickr:

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