Conditions InDepth: Peptic Ulcer Disease
by Rosalyn Carson-DeWitt, MD
Peptic ulcers are eroded areas in the stomach (gastric ulcers) or first part of the intestine (duodenal ulcers). Ulcers occur in areas where the lining of the stomach or intestine is worn away and irritated, causing pain, or bleeding.
Normally, a mucous coating protects the lining of the stomach and the intestine. This coating can be disrupted by a bacterial infection from Helicobacter pylori (H. pylori) or by irritating medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs). When this mucous coat is disrupted, strong digestive juices can erode the lining underneath it. This causes the ulcer.
Lifestyle factors such as diet and stress were once thought to be responsible for causing ulcers. However, now we know that the vast majority of ulcers are due to H. pylori infection or NSAID use.
In addition to creating discomfort, ulcers are serious because they can cause:
Many more people are infected with H. pylori than ever develop an ulcer. It is not known why some people infected with this kind of bacteria develop ulcers while others don’t. It is also not known how people become infected with H. pylori. It may be passed in food or water. It also seems to live in the saliva of infected people, allowing the bacteria to be passed through kissing, for example.
Meurer LN, Bower DJ. Management of Helicobacter pylori infection. Am Fam Physician. 2002;65(7):1327-36.
Peptic ulcer disease. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated May 11, 2015. Accessed January 12, 2017.
Peptic ulcer disease. Merck Manual Professional Version website. Available at:
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Updated May 2014. Accessed January 12, 2017.
Peptic ulcers (stomach ulcers). National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/peptic-ulcers-stomach-ulcers/all-content. Updated November 2014. Accessed January 12, 2017.
Last reviewed December 2016 by Daus Mahnke, MD
Last Updated: 5/20/2015
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