What Is a Peptic Ulcer?

A peptic ulcer is a type of sore or hole that forms in the lining of the stomach or intestine. The word "peptic" refers to the digestive process. An ulcer in the lining of the stomach is called a gastric ulcer. An ulcer in the upper part of the small intestine, or duodenum, is called a duodenal ulcer.

The lining of the stomach is a layer of special cells, chemicals and mucous that prevent the stomach from being damaged by its own acids and digestive enzymes. If there is a break or ulcer in the lining, the tissue under the lining can be damaged by the enzymes and corrosive acid. If the ulcer is small, there may be few symptoms, and the wound can heal on its own. If the ulcer is deep, it can cause serious pain or bleeding, and may eat completely through the stomach or duodenum wall.

Peptic ulcers are relatively common, affecting approximately 500,000 people in the United States each year. It has been estimated that about 10% of Americans will develop an ulcer at some time in their lives. Ulcers can develop in anyone at any age, but they become more common as people age. Duodenal ulcers tend to occur at an earlier age than gastric ulcers. While ulcers used to be more common in men, recent studies show that ulcers now occur at the same rate in men and women.

It's still unclear what causes ulcers, current research suggests that the bacterium Helicobacter pylori plays a major role. In fact, this bacterium is believed to cause between 70% and 90% of all peptic ulcers. But infection is not the whole story, because only about 20% of people infected with H. pylori develop ulcers. In some people, H. pylori infection somehow upsets the delicate balance between the damaging effects of gastric acids and the body's natural protection. When the lining is no longer able to protect the stomach or intestine, an ulcer develops (see How an Ulcer Starts ).

The second most common cause of ulcers is the use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Advil, Motrin and others) and naproxen (Aleve, Naprosyn). These drugs interfere with the body's methods of protecting the stomach lining from the harmful effects of acid. Ulcers caused by NSAIDs are particularly common in the elderly. Ulcers also can be caused by other drugs, such as those used to treat osteoporosis.

Several other factors can increase your risk of developing a peptic ulcer. Both gastric and duodenal ulcers seem to run in families. Cigarettes appear to interfere with the body's natural protection against ulcers, particularly in people who are infected with H. pylori. Alcohol may increase the production of acid and damage the lining of the stomach. However, contrary to popular belief, stress and spicy foods do not seem to increase the risk of ulcers.

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