Peptic ulcer disease refers to painful sores or ulcers in the
lining of the stomach or the first part of the small intestine, the
Normally, a thick layer of mucus protects the stomach lining
from the effect of its digestive juices. But, many things can
reduce this protective layer, allowing for ulcers to occur.
What causes ulcers?
No single cause has been found for ulcers. However, it is now
clear that an ulcer is the end result of an imbalance between
digestive fluids (hydrochloric acid and pepsin, a digestive enzyme)
in the stomach and duodenum. Ulcers can be caused by:
- Infection with a type of bacteria called Helicobacter pylori
- Use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as
aspirin, naproxen (Aleve®, Anaprox®, Naprosyn®, and
others), ibuprofen (Motrin®, Advil®, Midol®, and
others), and many others available by prescription. Even aspirin
coated with a special substance can still cause ulcers.
- Excess acid production from Zollinger-Ellison syndrome
(gastrinoma). A gastrinoma is a tumor of the acid producing cells
of the stomach that increases acid output.
Can spicy foods cause ulcers?
Though spicy foods can make ulcers more painful, they are not
known to cause ulcers.
What symptoms should I look for?
An ulcer may or may not have symptoms. When symptoms occur, they
- A gnawing or burning pain in the middle or upper stomach
between meals or at night
- Nausea or vomiting
In severe cases symptoms can include:
- Dark or black stool (due to bleeding)
- Weight loss
- Severe pain in the mid to upper abdomen
Am I at increased risk if I take NSAIDs regularly?
The risk is dose-related (meaning the more you take, the greater
the risk) and increases with:
- Age (more likely over age 60)
- Gender (occurs more often in women than men)
- Use of corticosteroids, such as those taken for asthma or lupus
and NSAIDs together
- Length of time taking NSAIDs
- A history of ulcer disease
How serious is this condition?
Though ulcers often heal on their own, you shouldn't ignore
their warning signs. If not properly treated, ulcers can lead to
serious health problems, including:
- Perforation (a hole through the wall of the stomach)
- Gastric outlet obstruction from swelling or scarring that
blocks the passageway leading from the stomach to the small
Taking NSAIDs can cause any of the above without warning. The
risk is especially concerning for those over age 75 and for those
with a prior history of having peptic ulcer disease.