What is peptic ulcer disease?

Peptic ulcer disease is a condition in which there are painful sores or ulcers in the lining of the stomach or the first part of the small intestine (the duodenum). Normally, a thick layer of mucus protects the stomach lining from the effect of its digestive juices. But many things can reduce this protective layer, allowing for ulcers to occur.

Who is more likely to get ulcers?

You may be more likely to develop an ulcer if you:

  • Are infected with the H. pylori bacterium
  • Take NSAIDs (such as aspirin, ibuprofen, naproxen, and many others)
  • Have a family history of ulcers
  • Smoke
  • Have another illness, such as liver, kidney, or lung disease
  • Drink alcohol regularly

What causes ulcers?

No single cause has been found for ulcers. However, it is now clear that an ulcer is created by an imbalance, or unevenness, between the digestive fluids hydrochloric acid and pepsin (a digestive enzyme) in the stomach and duodenum.

Ulcers can be caused by:

  • Infection with a type of bacteria called _Helicobacter pylori (_H. pylori).\
  • Use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, naproxen (Aleve®, Anaprox®, Naprosyn®, and others), ibuprofen (Motrin®, Advil®, Midol®, and others), and many others that are available by prescription. Even aspirin that is coated with a special substance can still cause ulcers.
  • Excessive acid production from a condition called Zollinger-Ellison syndrome (gastrinoma). A gastrinoma is a tumor of the acid-producing cells of the stomach that increases acid output.

Can spicy foods cause ulcers?

Though spicy foods can make ulcers more painful, they are not known to cause ulcers.

What are the symptoms of ulcers?

An ulcer may or may not have symptoms. When symptoms occur, they include:

  • A gnawing or burning pain in the middle or upper stomach between meals or at night
  • Bloating
  • Heartburn
  • Nausea or vomiting

In severe cases, symptoms can include:

  • Dark or black stool (due to bleeding)
  • Vomiting
  • Weight loss
  • Severe pain in the mid- to upper abdomen  

Last reviewed by a Cleveland Clinic medical professional on 01/13/2016.


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