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Causes of Peptic ulcer

  • Helicobacter Pylori (H. Pylori)

Most ulcers are caused by the bacterium, Helicobacter Pylori (H. Pylori). H. Pylori is a very common infection in humans and is present in about half of all middle-aged people in the UK, although few develop ulcers. Scientists are not sure why H. Pylori does not cause ulcers in every infected person. It is probably linked to the characteristics of the infected person and the type of H. Pylori.

H. Pylori is spread through food and water. It has also been found in saliva, so may be spread through mouth to mouth contact such as kissing. Most people are infected during childhood, but the infection is becoming much rarer due to better standards of hygiene. Nearly all children in developing countries are infected with the bacterium due to unsanitary living conditions. 

H. Pylori lives in the sticky mucus that coats the lining of the stomach and duodenum. It produces an enzyme called urease, which neutralises stomach acid. This causes the stomach to produce more acid and increases the risk of irritation to the delicate stomach lining. The bacteria weaken the protective mucus, making it less able to protect the lining of the stomach and duodenum.

H. Pylori bacteria can also attach themselves to stomach cells, further weakening the stomach's defence mechanisms and causing inflammation in the affected area. Medical treatment to completely clear H. Pylori from the stomach is needed to prevent ulcers coming back.

  • Non-steroidal anti-inflammatory drugs (NSAIDs)

Drugs such as aspirin and ibuprofencan make the stomach vulnerable to the damaging effect of acid. These type of drugs are available over-the-counter and are commonly taken to treat minor aches and pains. They interfere with the stomach's ability to produce mucus, as well as affecting blood flow to the stomach and the body’s ability to repair cells.

Prescription-only NSAIDs that are used to treat arthritic conditions can also irritate the stomach lining and have a similar effect.

  • Genetic factors

Some people have a family history of peptic ulcers, which suggests that genetic factors may be involved in their development.

  • Smoking and drinking alcohol

Smoking and drinking can contribute to the development of peptic ulcers because they irritate the stomach lining and reduce mucus production.

  • Stress

Stress probably does not cause ulcers, but does worsen symptoms if an ulcer is present. Stressful situations worsen symptoms because the stomach produces more acid in response to stress.