Peptic Ulcer Disease (PUD)

Causes and Risk Factors

The most common cause for peptic ulcer disease is Helicobacter pylori (pronounced HEE-li-co BACK-ter pie-LOR-ee or HELL-uh-koh-BAK-tur py-LOH-ree) infection, also called H. pylori infection. Helicobacter pylori are spiral-shaped bacteria that are found in contaminated food and water. These bacteria, which were formerly called Campylobacter pylori, spread through close contact (e.g., sharing drinking glasses and eating utensils) and poor hygiene.

H. pylori infection occurs when these bacteria attach to the lining of the stomach or small intestine, multiply, and release toxins that cause mucosal inflammation and damage. Helicobacter pylori infection can cause peptic ulcer disease, gastritis (inflammation of the stomach lining), and other complications (e.g., stomach [gastric] cancer).

Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and naproxen, also can damage the lining of the GI tract and cause peptic ulcer disease. These medications, which are used to reduce pain and inflammation, should be used only as directed. When used in combination with NSAIDs, corticosteroids (e.g., prednisone) further increase the risk for peptic ulcers.

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In most cases, peptic ulcer disease caused by Helicobacter pylori infection or nonsteroidal anti-inflammatory drugs resolves once the infection is treated or the medication is discontinued.

Serious illnesses (e.g., liver disease, chronic obstructive pulmonary disease [COPD], kidney failure) can increase the risk for developing peptic ulcer disease. Trauma resulting from physical stress (e.g., severe burns, traumatic brain injury [TBI], surgery) also can increase the risk for PUD.

Additional factors that increase the risk for peptic ulcer disease include the following:

• Age (more common in people over the age of 50)
• Alcohol use
• Family history of peptic ulcers
• Smoking

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