Causes of Peptic Ulcers

Updated January 17, 2018
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You don't have to be a stressed-out CEO of a large corporation to develop an ulcer. Even those spicy foods won't cause an ulcer.

In the past, it was believed stress and diet caused peptic ulcers. Later, researchers stated stomach acids (hydrochloric acid and pepsin) contributed to the majority of ulcer formation. Today, however, research shows that most ulcers develop as a result of infection with a bacterium called Helicobacter pylori.

Helicobacter pylori 

Research studies have shown that most ulcers are caused by an infection by a bacteria called Helicobacter pylori -- also referred to as H. pylori. While the other factors listed below can also cause ulcers, H. pylori are now considered the cause of most ulcers. The H. pylori bacterium is found in the stomach, and along with acid secretion, can damage the tissue of the stomach and duodenum, causing inflammation and ulcers.

Acid and Pepsin

These powerful digestive fluids are believed to contribute to the formation of ulcers. In ideal situations, the stomach can protect itself from these fluids in several ways. These are:

  • The stomach produces a lubricant-like mucus that coats the stomach and shields stomach tissues.
  • The stomach can produce a chemical called bicarbonate that neutralizes digestive fluids and breaks them down into less harmful substances.
  • Blood circulation in the lining of the stomach, as well as cell renewal and repair, help protect the stomach.

    NSAIDs

    NSAIDs are non-steroidal anti-inflammatory drugs. The most commonly known NSAIDs are aspirin, ibuprofen, and naproxen sodium. Others are prescription NSAIDs used to treat several arthritic conditions. NSAIDs can make the stomach's defense mechanisms to fail in a couple of different ways:

    • They can make the stomach vulnerable to the harmful effects of acid and pepsin by interfering with the stomach's ability to produce mucus and bicarbonate.
    • They can affect cell repair and blood flow to the stomach.

    Smoking

    Studies show that cigarette smoking can increase a person's chance of getting an ulcer. Smoking also slows the healing of existing ulcers and contributes to ulcer recurrence.

    Caffeine

    Beverages and foods that contain caffeine can stimulate acid secretion in the stomach. This can aggravate an existing ulcer, but the stimulation of stomach acid can't be attributed solely to caffeine.

    Alcohol

    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.

    Stress

    Emotional stress is no longer thought to be a cause of ulcers, but people who are experiencing emotional stress often report increased pain of existing ulcers. Physical stress, however, is different. It can increase the risk of developing ulcers, especially in the stomach. Examples of physical stress that can lead to ulcers are that suffered by people with injuries such as severe burns, and people undergoing major surgery.

    Sources:
    "Common GI Problems: Volume 1." American College of Gastroenterology. 22 Aug 2007

    "H. pylori and Peptic Ulcer." NIH Publication No. 05–4225 October 2004. National Digestive Diseases Information Clearinghouse (NDDIC). 22 Aug 2007

    "What I need to know about Peptic Ulcers." NIH Publication No. 05–5042 October 2004. National Digestive Diseases Information Clearinghouse (NDDIC). 22 Aug 2007

    William D. Chey, M.D., F.A.C.G., A.G.A.F., F.A.C.P., Benjamin C.Y. Wong, M.D., Ph.D., F.A.C.G., F.A.C.P., "American College of Gastroenterology Guideline on the Management of Helicobacter pylori Infection." doi: 10.1111/j.1572-0241.2007.01393.x. American College of Gastroenterology. 22 Aug 2007