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Causes
By Mayo Clinic staff
Peptic ulcers occur when acid in the digestive tract eats away at the inner surface of the esophagus, stomach or small intestine. The acid can create a painful open sore that may bleed.
Your digestive tract is coated with a mucous layer that normally protects against acid. But if the amount of acid is increased or the amount of mucus is decreased, you could develop an ulcer. Causes include:
- A bacterium. A common cause of ulcers is the corkscrew-shaped bacterium Helicobacter pylori. H. pylori bacteria commonly live and multiply 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 the lining of your stomach or duodenum, producing an ulcer. It's not clear how H. pylori spreads. It may be transmitted from person to person by close contact, such as kissing. People may also contract H. pylori through food and water.
- Regular use of pain relievers. Certain over-the-counter and prescription pain medications can irritate or inflame the lining of your stomach and small intestine. These medications include aspirin, ibuprofen (Advil, Motrin, others), naproxen (Aleve, Anaprox, others), ketoprofen and others. Peptic ulcers are more common in older adults who take pain medications frequently, such as might be common in people with osteoarthritis. To help avoid digestive upset, take pain relievers with meals. If you have been diagnosed with an ulcer, make sure your doctor knows this when prescribing any pain reliever. The pain reliever acetaminophen (Tylenol, others) doesn't cause peptic ulcers.
- Other medications. Other prescription medications that can also lead to ulcers include medications used to treat osteoporosis called bisphosphonates (Actonel, Fosamax, others).
References
- Vakil N. Peptic ulcer disease. In: Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-1-4160-6189-2..X0001-7--TOP&isbn=978-1-4160-6189-2&about=true&uniqId=229935664-2192. Accessed Dec. 1, 2010.
- Chan FK, et al. Treatment of peptic ulcer disease. In: Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-1-4160-6189-2..X0001-7--TOP&isbn=978-1-4160-6189-2&about=true&uniqId=229935664-2192. Accessed Dec. 1, 2010.
- American College of Gastroenterology guidelines on the management of Helicobacter pylori infection. Bethesda, M.D.: American College of Gastroenterology. http://www.acg.gi.org/physicians/guidelines/ManagementofHpylori.pdf. Accessed Dec. 1, 2010.
- Podein R. Peptic ulcer disease. In: Rakel D. Integrative Medicine. 2nd ed. Philadelphia, Pa.: Saunders; 2007. http://www.mdconsult.com/das/book/body/202281144-2/0/1494/0.html. Accessed Dec. 1, 2010.
- H. pylori and peptic ulcers. National Institute for Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/hpylori/index.htm. Accessed Dec. 1, 2010.
- NSAIDs and peptic ulcers. National Institute for Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/nsaids/index.htm. Accessed Dec. 1, 2010.
- Picco MF (expert opinion). Mayo Clinic, Jacksonville, Fla. Dec. 8, 2010.
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