Firstmed Blog

There are two main causes of peptic ulcer disease (PUD): Helicobacter pylori bacteria and the use of aspirin (ASA) and other no steroidal anti-inflammatory drugs (NSAIDs).

Helicobacter pylori (H. pylori) bacteria are responsible for the most of ulcers (about 80-85% of duodenal ulcers and 60-80% of gastric ulcers). The bacteria can expend into the protective mucus lining of the stomach and small intestine, causing damage. Not all people infected with these bacteria will actually develop ulcers.

Smoking also contributes to PUD, poor ulcer healing, and ulcer complications such as bleeding. It is not known exactly how this happens, but smoking is believed to block prostaglandins that can help repair damaged cells in the protective mucus layer. It may also make it easier for H. pylori to cause PUD. Excessive use of alcohol can put people at higher risk for PUD.

Use of aspirin (ASA) and other no steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen can cause PUD. NSAIDs block natural chemicals called prostaglandins that can help repair damaged cells in the protective mucus layer. This makes the mucus layer weaker and less able to protect the delicate stomach and intestine lining. Using ASA and NSAIDs regularly for a long time such as for arthritis pain increases the risk of developing PUD. Since NSAIDs are painkillers, they can mask the discomfort of ulcers.

Some people have certain risk factors that make them more vulnerable to peptic ulcers caused by NSAIDs. If you are taking an NSAID and have one of these risk factors, your doctor may prescribe a stomach protective drug or an acid-suppressing drug. These risk factors are:

- Being older than 50 years
- A history of previous ulcers
- Using high doses of NSAIDs or multiple NSAIDs
- Using corticosteroids
- Blood clotting disorders
- Chronic health problems with major organs
- Heavy cigarette smoking
- H. pylori infection
- Poor general health