Health A-Z

Medical Content Created by the Faculty of the
Harvard Medical School

Peptic Ulcer

What Is It?

A peptic ulcer is a sore or hole that forms in the lining of the stomach or intestine. The word "peptic" is a general term relating to the digestive tract. An ulcer in the lining of the stomach is more specifically called a gastric ulcer. An ulcer in the first part of the small intestine (the duodenum) is called a duodenal ulcer.

The lining of the stomach is a layer of special cells and mucous. Mucous prevents the stomach and duodenum from being damaged by acid and digestive enzymes. If there is a break in the lining such as an ulcer, the tissue under the lining can be damaged by the enzymes and corrosive acid. If the ulcer is small, there may be few symptoms, and the wound can heal on its own. If the ulcer is deep, it can cause serious pain or bleeding, and rarely, corrosive acids in the digestive juices may eat completely through the stomach or duodenum wall.

Peptic ulcers are very common. It has been estimated that about 10 percent of Americans will develop an ulcer at some time in their lives. Ulcers can develop in anyone at any age, but they become more common as people age. Duodenal ulcers tend to occur at an earlier age than gastric ulcers. While ulcers used to be more common in men, recent studies show that ulcers now occur at the same rate in men and women.

The bacterium Helicobacter pylori is believed to cause between 70 percent and 90 percent of all peptic ulcers. This bacteria type causes inflammation in the stomach lining, and this probably makes the lining vulnerable. But infection is not the whole story, because only about 20 percent of people infected with H. pylori develop ulcers.

The second most common cause of ulcers is the use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Advil, Motrin and others) and naproxen (Aleve, Naprosyn). NSAIDs cause you to make less of the natural chemicals that are named prostaglandins. Prostaglandins have a variety of effects in your body. In your stomach, prostaglandins make the stomach less acidic and they stimulate mucous production. With less prostaglandin, ulcers are more likely to form. Ulcers caused by NSAIDs are particularly common in the elderly.

Several factors can increase your risk of developing a peptic ulcer. Both gastric and duodenal ulcers run in families. Smoking puts you at higher risk for an ulcer, particularly if you are infected with H. pylori. Alcohol may increase the production of acid and damage the lining of the stomach. However, contrary to popular belief, stress and spicy foods do not seem to increase the risk of ulcers.