Peptic Ulcer Risk Factors

[Clara Zellinger]

Apeptic ulcer is a sore on the lining of your stomach, small intestine or esophagus. A peptic ulcer in the stomach is called a gastric ulcer. A duodenal ulcer is a peptic ulcer that develops in the first part of the small intestine (duodenum). An esophageal ulcer occurs in the lower part of your esophagus.

The most common causes of peptic ulcers are infection with the bacterium Helicobacter pylori (H. pylori) and long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve). Stress and spicy foods do not cause peptic ulcers. However, they can make your symptoms worse.

The most common peptic ulcer symptom is burning stomach pain. Stomach acid makes the pain worse, as does having an empty stomach. The pain can often be relieved by eating certain foods that buffer stomach acid or by taking an acid-reducing medication, but then it may come back. The pain may be worse between meals and at night.

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A bacterium. Helicobacter pylori bacteria commonly live in the mucous layer that covers and protects tissues that line the stomach and small intestine. Often, the H. pylori bacterium causes no problems, but it can cause inflammation of the stomach's inner layer, producing an ulcer.

Use caution with pain relievers. If you regularly use pain relievers that increase your risk of peptic ulcer, take steps to reduce your risk of stomach problems. For instance, take your medication with meals.

Work with your doctor to find the lowest dose possible that still gives you pain relief. Avoid drinking alcohol when taking your medication, since the two can combine to increase your risk of stomach upset.

If you need an NSAID, you may need to also take additional medications such as an antacid, a proton pump inhibitor, an acid blocker or cytoprotective agent. A class of NSAIDs called COX-2 inhibitors may be less likely to cause peptic ulcers, but may increase the risk of heart attack.

Stomach ulcers, also known as peptic ulcers, are open sores in the lining of your stomach or the upper part of your small intestine. The ulcer forms when stomach acid eats away at the mucus that protects the lining of your digestive tract.

About 1 in 10 Americans experience the burning, gnawing abdominal pain of a peptic ulcer at some point in life. Duodenal ulcers are more common than stomach ulcers. Esophageal ulcers are more rare and are often a result of certain medications, such as some antibiotics and anti-inflammatories, or alcohol abuse.

Until the mid-1980s, the conventional wisdom was that ulcers form as a result of stress, being prone to excessive stomach acid secretion because of genetics, and poor lifestyle habits (including overindulging in rich and fatty foods, alcohol, caffeine, and tobacco). It was believed that such factors could lead to a buildup of stomach acids that could erode the protective lining of the stomach, duodenum, or esophagus.

While too much stomach acid secretion certainly plays a role in the development of ulcers, a relatively recent theory holds that bacterial infection is the primary cause of peptic ulcers. Research since the mid-1980s has shown that the bacterium Helicobacter pylori (H. pylori) is present in more than 90% of duodenal ulcers and about 80% of stomach ulcers. However, more recent figures indicate those percentages are declining.

Ulcers can also erode the blood vessel wall in your stomach or small intestine, and eat a hole through the lining, leading to infection. Or they can cause swelling, which may block food from moving from your stomach into your small intestine.

Be careful when you take pain relievers such as aspirin, ibuprofen, and naproxen sodium. Some people who have arthritis or other conditions that cause chronic pain take NSAIDs for weeks or months at a time to ease pain and swelling. These medicines can affect the mucus that protects your stomach against acid and make you more likely to have peptic ulcers.

Abdominal pain is the most common symptom of a peptic ulcer. The pain may be dull or burning and may come and go over time. For some people, the pain may occur when the stomach is empty or at night, and it may go away for a short time after they eat. For other people, eating may make the pain worse.

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Jacquelyn has been a writer and research analyst in the health and pharmaceutical space since she graduated with a degree in biology from Cornell University. A native of Long Island, NY, she moved to San Francisco after college, and then took a brief hiatus to travel the world. In 2015, Jacquelyn relocated from sunny California to even sunnier Gainesville, FL, where she owns 7 acres and more than 100 fruit trees. She loves chocolate, pizza, hiking, yoga, soccer, and Brazilian capoeira. Connect with her on LinkedIn.

Rashida Ruwa, RN is a freelance health and wellness writer who also holds a higher diploma in psychiatric nursing. She loves to write about health and wellness because through her articles she wants people to feel understood and supported. In her current work at a correctional facility, her main focus is on providing sustained direct support and care to offenders with mental health conditions toward recovery during their time in the criminal justice system.

Duodenal ulcers are a type of peptic ulcer. This means that they happen when the layer of mucus that lines your duodenum is damaged or penetrated by infectious substances or other materials that can damage this lining.

Duodenal ulcer pain feels like a burning or gnawing feeling in the stomach area between your chest and belly button. This pain may feel like it never goes away and may feel more painful at night or a few hours after a meal.

An untreated duodenal ulcer may go away on its own if an H. pylori infection is reduced or if NSAID use decreases. But in many cases, an untreated ulcer can wear away at the lining of the duodenum and weaken it, increasing the risk of infectious material leaking into your abdomen.

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A large number of studies revealed various risk factors for PUD, but no studies revealed an association between the number of household members and PUD or sex difference in this association. We hypothesized that women would be more likely to have PUD than men as the number of household members increased because women are more involved and exposed to more stressors in family affairs. Several risk factors, such as cigarette smoking, alcohol intake, obesity, and age, remain controversial. The present study focused on the association of PUD with the number of household members among various socioeconomic risk factors other than H. pylori infection in a Korean population. Notably, the findings revealed strong positive and negative associations between PUD and the number of household members according to sex.

Table 1 indicates the sex differences between men and women and general characteristics of the PUD and non-PUD groups. Participant characteristics according to categories of the number of household members are indicated in Table 2 for men and Table 3 for women. A significant relationship between PUD and the number of household members was revealed for men. Age, SBP, location, education level, stress, current drinking, and smoking were also significantly associated with the number of household members. Men with 2 household members (7.14%) were more likely to have PUD and high SBP, to be less educated, and older than men in other household sizes. For women, PUD, age, SBP, location, education level, stress, current drinking and smoking had a statistically significant relationship to the number of household members. Women living alone (8.73%) were more likely to have PUD and high SBP, to be less educated, and older than women in other household sizes.

Several studies suggested that alcohol intake was a risk factor for PUD30,33,34 or the occurrence of PUD31,32, but other studies argued that alcohol intake was not associated with PUD22,27,29,35,36,37. Kato et al.27 reported that alcohol intake was not a risk factor for gastric or duodenal ulcers in Hawaii. Chou36 suggested that moderate alcohol intake minimally increased the odds of PUD in a large U.S. population study. Johnsen et al.22 argued that alcohol and coffee intake were not associated with PUD in a 7-year follow-up study in Norway. Levenstein16 argued that these controversial results may be due to the total amount of alcohol intake and indicated that moderate intake seemed to strengthen gastroduodenal mucosa, but heavy alcohol intake may cause PUD due to the direct mucosal and acid secretion stimulation. Liu et al.48 argued that moderate alcohol intake was related to a reduction of H. pylori infection. Our findings are consistent with the results of previous studies30,33,34 and indicated that alcohol drinking was highly associated with PUD in men and women in crude analyses and that this risk factor showed significant differences according to the number of household members.

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