What is peptic ulcer disease and what causes it ?

Peptic ulcer disease

Peptic ulcer disease (PUD) includes irritation, ulcer formation and scarring of the stomach or the first part of the small intestine, called the duodenum. Ulcers of the stomach are often caused by irritating medications such as aspirin or other non-steroidal anti-inflammatory drugs such as ibuprofen or naproxen. Stomach ulcers arising without provocative medications may precede stomach cancer. Ulcers of the duodenum are more common. They are not generally associated with cancer. Most duodenal ulcers have an infectious cause, contrary to earlier thoughts about the cause of these conditions.

Causes of ulcers

Several factors are known causes of PUD and GERD. Previously, most ulcers were thought to be caused by irritants to the stomach, such as stress, spicy foods, caffeine, tobacco and alcohol. Alcohol in particular is an irritant to the lining of the stomach (mucosa). All of these can cause the circular muscle at the lower end of the oesophagus to relax and allow food to reflux from the stomach back into the oesophagus. This may contribute to heartburn and GERD, but other than alcohol, they do not contribute to most ulcers.

However, recent research demonstrates that most ulcers of the duodenum are caused by an infectious agent named Helicobacter pylori or H. pylori. According to the Centres for Disease control and Prevention, 90% of duodenal (small intestine) and 80% of gastric (stomach) ulcers are caused by H. pylori. Elimination of this bacteria frequently causes quick resolution of an ulcer and minimizes the chances of recurrence. People infected with this bacterium have two to six times increased risk of stomach cancer. This discovery led to a dramatic shift in the treatment of PUD.