Peptic ulcer

From MayoClinic.com

Causes

Although stress and spicy foods were once thought to be the main causes of peptic ulcers, doctors now know that many ulcers are caused by the corkscrew-shaped bacterium Helicobacter pylori (H. pylori). This bacterium was discovered in the early 1980s in biopsy specimens of people who had ulcers and persistent stomach inflammation (gastritis).

H. pylori lives and multiplies within the mucous layer that covers and protects tissues that line the stomach and small intestine. Often, H. pylori causes no problems. But sometimes it can disrupt the mucous layer and inflame and erode digestive tissues, producing an ulcer. Approximately one in six people infected with H. pylori get an ulcer. One reason may be that these people already have damage to the lining of the stomach or small intestine, making it easier for bacteria to invade and inflame tissues.

H. pylori is a common gastrointestinal infection around the world. In developing countries, it's even more common. Although it's not clear exactly how H. pylori spreads, it appears to be transmitted from person to person by close contact.

H. pylori is the most common, but not the only, cause of peptic ulcers. H. pylori accounts for about half of all peptic ulcers. Besides H. pylori, other causes of peptic ulcers, or factors that may aggravate them, include:

• Regular use of pain relievers. Nonsteroidal anti-inflammatory drugs (NSAIDs) can irritate or inflame the lining of your stomach and small intestine. The medications are available both by prescription and over-the-counter. Nonprescription NSAIDs include aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve) and ketoprofen (Orudis KT). To help avoid digestive upset, take NSAIDs with meals.

• About 20 percent of people who regularly take NSAIDs develop ulcers. The drugs inhibit production of an enzyme (cyclooxygenase) that produces prostaglandins. These hormone-like substances help protect your stomach lining from chemical and physical injury. Without this protection, stomach acid can erode the lining, causing bleeding and ulcers.

• It's uncertain, but seems possible, that regular use of NSAIDs may also increase the risk of ulcers in people infected with H. pylori.

• Smoking. Nicotine in tobacco increases the volume and concentration of stomach acid, increasing your risk of an ulcer. Smoking also may slow healing during ulcer treatment.

• Excessive alcohol consumption. Alcohol can irritate and erode the mucous lining of your stomach and intestines, causing inflammation and bleeding. It's uncertain, however, whether this alone can progress into an ulcer or whether other contributing factors must be present, such as H. pylori bacteria or ulcer-causing medications such as NSAIDs.

• Stress. Although stress isn't a cause of peptic ulcers, it's a contributing factor. Stress may aggravate symptoms of peptic ulcers and, in some cases, delay healing. You may undergo stress for a number of reasons — an emotionally disturbing circumstance or event, surgery, or a physical trauma, such as a burn or other severe injury.

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