What is a stomach or duodenal ulcer?

About one in 10 Americans develops at least one ulcer during his or her lifetime.

An ulcer is an open sore, or lesion, usually found on the skin or mucous membrane areas of the body.

  • An ulcer in the lining of the stomach or duodenum is referred to as a peptic ulcer.

  • When the ulcer is in the stomach, it is called a gastric ulcer.

  • When the ulcer is in the duodenum, it is called a duodenal ulcer.

What causes gastric and duodenal ulcers?

In the past, it was believed lifestyle factors such as stress and diet caused ulcers. Later, researchers determined that stomach acids-- hydrochloric acid and pepsin--contributed to ulcer formation.

Today, research shows that most ulcers (80 percent of gastric ulcers and 90 percent of duodenal ulcers) develop as a result of infection with a bacterium called Helicobacter pylori (H. pylori).

It is believed that, although all three of these factors--lifestyle, acid and pepsin, and H. pylori--play a role in ulcer development, H. pylori is considered to be the primary cause, in most cases.

Factors in the development of peptic ulcers

Factors suspected of playing a role in the development of stomach or duodenal ulcers include:

  • Helicobacter pylori

    Research shows that most ulcers develop as a result of infection from the bacterium Helicobacter pylori (H. pylori). The bacterium produces substances that weaken the stomach's protective mucus and make it more susceptible to the damaging effects of acid and pepsin.

  • Smoking

    Studies show smoking increases the chances of developing an ulcer, slows the healing process of existing ulcers, and contributes to ulcers recurring.

  • Caffeine

    Caffeine seems to stimulate acid secretion in the stomach, which can aggravate the pain of an existing ulcer. However, the stimulation of stomach acid cannot be attributed solely to caffeine.

  • Alcohol

    Although no proven link has 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, however, people with ulcers often report that emotional stress increases ulcer pain.

  • Physical stress

    Physical stress may increase the risk of developing ulcers, particularly in the stomach. For example, people with injuries, such as severe burns, and people undergoing major surgery often require treatment to prevent ulcers and ulcer-related complications, such as bleeding.

  • Acid and pepsin

    It is believed the stomach's inability to defend itself against the powerful digestive fluids, hydrochloric acid and pepsin, contributes to ulcer formation.

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)

    These drugs (such as aspirin, ibuprofen, and naproxen sodium) make the stomach vulnerable to the harmful effects of acid and pepsin. They are present in many nonprescription medications used to treat fever, headaches, and minor aches and pains.

What are the symptoms of gastric and duodenal ulcers?

The following are the most common symptoms of ulcers. However, each individual may experience symptoms differently.

Although ulcers do not always cause symptoms, the most common ulcer symptom is a gnawing or burning pain in the abdomen between the breastbone and the navel. The pain often occurs between meals and in the early hours of the morning. It may last from a few minutes to a few hours. Less common ulcer symptoms may include:

The symptoms of stomach and duodenal ulcers may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.

What are some complications from ulcers?

People with ulcers may experience serious complications if they do not seek appropriate treatment. The most common problems include the following:

  • Bleeding

    As an ulcer eats into the muscles of the stomach or duodenal wall, blood vessels may become damaged, causing bleeding.

  • Perforation

    Sometimes, an ulcer eats a hole in the wall of the stomach or duodenum, and bacteria and partially digested food can spill through the opening into the sterile abdominal cavity (known as the peritoneum) and cause peritonitis, severe inflammation of the abdominal cavity and wall.

  • Narrowing and obstruction

    Ulcers located at the end of the stomach, where the duodenum is attached, can cause swelling and scarring, which can narrow or close the intestinal opening. This obstruction can prevent food from leaving the stomach and entering the small intestine, resulting in vomiting the contents of the stomach.


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