Prevention First


A peptic ulcer, also known as ulcus pepticum, PUD or peptic ulcer disease, is an ulcer of an area of the gastrointestinal tract that is usually acidic and thus extremely painful. As many as 80% of ulcers are associated with Helicobacter pylori, a spiral-shaped bacterium that lives in the acidic environment of the stomach.


  • A major causative factor is chronic inflammation due to bacteria. The immune system is unable to clear the infection, despite the appearance of antibodies. Thus, the bacterium can cause a chronic active gastritis.
  • Another major cause is the use of NSAIDs . The gastric mucosa protects itself from gastric acid with a layer of mucus, the secretion of which is stimulated by certain prostaglandins. Due to increased medical treatment, a greater proportion of ulcers will be due to increasing NSAID use among individuals with pain syndromes as well as the growth of aging populations that develop arthritis.

    The incidence of duodenal ulcers has dropped significantly during the last 30 years, while the incidence of gastric ulcers has shown a small increase, mainly caused by the widespread use of NSAIDs.
  • Tobacco smoking leads to atherosclerosis and vascular spasms, causing vascular insufficiency and promoting the development of ulcers through ischemia. Gastrinomas, rare gastrin-secreting tumors, also cause multiple and difficult to heal ulcers.
  • There is an association between heavy alcohol use and the development of peptic ulcer disease.

Signs and symptoms

  • Abdominal pain, classically epigastric with severity relating to mealtimes, after around 3 hours of taking a meal (duodenal ulcers are classically relieved by food, while gastric ulcers are exacerbated by it).
  • Bloating and abdominal fullness.
  • Waterbrash (rush of saliva after an episode of regurgitation to dilute the acid in esophagus).
  • Nausea and copious vomiting.
  • Loss of appetite and weight loss.
  • Hematemesis (vomiting of blood); this can occur due to bleeding directly from a gastric ulcer, or from damage to the esophagus from severe/continuing vomiting.
  • Melena (tarry, foul-smelling feces due to oxidized iron from hemoglobin).
  • Gastric or duodenal perforation, rarely, an ulcer can lead to it. This is extremely painful and requires immediate surgery.
  • A history of heartburn, gastro esophageal reflux disease (GERD) and use of certain forms of medication can raise the suspicion for peptic ulcer. Medicines associated with peptic ulcer include NSAID.

Prevention and risk

  • Sometimes there is no apparent explanation for the development of an ulcer. However, it is known that smoking, heavy alcohol intake especially spirits and certain medicines such as aspirin and anti-inflammatory drugs form ulcers.
  • If you are being treated for a peptic ulcer, your doctor will likely prescribe medicines and encourage you to try some home treatment methods. To stop symptoms and help an ulcer heal, you can:
    • Stop smoking.
    • Try nonprescription medicines that reduce acid production. Make sure you tell your doctor about any medicines you are taking.
    • Make changes to your diet, such as eating smaller, more frequent meals. These changes may improve your symptoms, but they will not help your ulcer heal.
    • Avoid drinking alcohol.