Common Causes & Risk Factors Of Peptic Ulcer Disease

The most common cause of a peptic ulcer is an infection with a bacterium known as Heliobacter pylori (H. pylori). This is the only known bacteria that can survive inside the stomach and it thrives in the digestive tract. Over a period of years, it causes sores or ulcers on the upper area of the small intestine and the lining of the stomach. H. pylori uses flagella to burrow into the stomach's lining until it reaches the less acidic epithelial cells. As the infection grows, H. pylori damages the stomach lining by producing ammonia that's toxic to epithelial cells and causing inflammation.

About two-thirds of individuals in the world have H. pylori, but it doesn't cause ulcers in most patients. The link between H. pylori and peptic ulcers wasn't discovered until 1982. Before this, it was generally believed no germ could survive the harsh and acidic environment of the stomach. After failing to colonize H. pylori in animals, Dr. Marshall made the unusual and dramatic step of drinking a vial of H. pylori and turning himself into a guinea pig. A week later, he developed stomach symptoms that developed into acute peptic ulcers to prove the link between the two.

Serious Illnesses

A few serious illnesses are linked to the development of peptic ulcer disease. One of the most common is stomach cancer. There is evidence that chronic H. pylori infection can lead to stomach cancer in about one to two percent of patients. An ulcer is essentially a sore on the protective lining of the stomach. This eventually causes erosion of the digestive system due to stomach acid. Bacteria can infect this open sore and lead to DNA mutations and damage to the stomach lining. Long-term inflammation can also increase the risk of stomach cancer.

Crohn's disease is also linked to stomach ulcers, but the use of NSAIDs to treat the condition may also be to blame, as when they are taken at high doses or for a long time, they can contribute to damage to the stomach lining.

Family Medical History

Research has shown peptic ulcer disease tends to run in families, and it even occurs more often in individuals who have type O blood. Some individuals are simply more likely to develop an ulcer when infected with H. pylori than others due to unknown genetic factors. Among individuals who are genetically disposed to ulcers, an infection of H. pylori not treated can cause an ulcer or potentially stomach cancer although ulcers also develop in patients with no known family medical history of the disorder.

Prolonged And Untreated Stress

Prolonged and untreated stress can affect the production of stomach acid. In some cases, this can be enough to cause an ulcer, but an ulcer usually requires the presence of H. pylori. There is evidence stress plays a role in digestive health as the brain and gut appear to communicate on many levels. Mental stress may aggravate an ulcer and worsen the condition. This may be the result of stress causing the esophagus to spasm, which increases the amount of acid in the stomach and causing indigestion.

Spicy Foods

It was long believed spicy foods could cause peptic ulcers by literally burning the lining of the stomach. A growing body of research shows spicy food won't cause an ulcer, but it will make the condition worse. This is why patients with peptic ulcer disease experience burning stomach pain after consuming spicy food. If you do have an ulcer, it's generally a good idea to avoid hot foods like hot peppers, curry, and salsa if you experience discomfort. There is some research, however, that capsaicin, which makes peppers hot, can stimulate stomach secretions that may prevent and help heal stomach ulcers.

Medications

Certain medications can also cause peptic ulcer disease to develop, especially if a patient frequently uses acetylsalicylic acid, ibuprofen, naproxen sodium, ketoprofen, and other nonsteroidal anti-inflammatory medications. However, they do not include acetaminophen. The risk for this type of behavior increases significantly in women over the age of sixty, making them some of the most susceptible individuals to developing peptic ulcer disease. Older individuals who also take anti-inflammatory medications for osteoarthritis are also highly likely to develop this condition as well.

Nonsteroidal anti-inflammatory medications can irritate or inflame the lining of the stomach as well as the small intestine, possibly leading to peptic ulcer disease. Other medications, especially when combined with nonsteroidal anti-inflammatory medications, can increase the risk of developing ulcers. These medications include steroids, anticoagulants, selective serotonin reuptake inhibitors (SSRIs), alendronate, and risedronate.

Radiation Therapy

Radiation therapy can cause peptic ulcers to form depending on where in the body the radiation is targeted. For instance, patients with gastric lymphoma, specifically in stages one and two, often receive radiation after a round of chemotherapy, as an effective form of treatment for destroying the cancerous cells. As with any cancer treatment, there are a few risks, such as gastric bleeding and perforation, or ulcers that eat through the wall of the stomach lining and small intestine.

Radiation therapy that is done to the upper abdomen can also irritate the esophagus and stomach, while radiation to the lower abdomen is more likely to irritate the small and large intestines and further cause digestive issues. One of the main side effects a patient can experience while receiving radiation in the abdomen area is peptic ulcers, as well as stomach ulcers.

Smoking

We’ve all heard how cigarette smoke can contribute to a number of diseases, from aggravating symptoms to being the root cause for a specific condition to form. Cigarette smoking is a significant risk factor for gastrointestinal disorders to develop, such as peptic ulcers. Researchers have found that smoking is positively associated with the pathogenesis of peptic ulcers and also delays the ulcer from healing properly. Studies have further shown that cigarette smoking and its active ingredients cause mucosal cell death, restricts cell renewal within the digestive tract, decreases blood flow in the gastrointestinal mucosa and can interfere with the mucosal immune system, which can lead to the development of peptic ulcers.

Complications

Besides the risks and causes of peptic ulcer disease, there are various complications that this disease can cause, including internal bleeding, infection, and obstruction. Internal bleeding is when the body slowly begins to lose blood that can lead to anemia or severe blood loss, which might require a blood transfusion and hospitalization. When a patient is suffering from severe blood loss, they may have bloody or black vomit or stools.

Infection is another complication often associated with peptic ulcer disease. Unfortunately, peptic ulcers can perforate, or eat a hole through the wall of the stomach or small intestine, resulting in the risk of the patient developing a serious infection in the abdominal cavity. Obstruction is another common complication, as peptic ulcers can block the passage of food through the digestive tract, causing the patient to become full easily, to vomit and lose weight through swelling from inflammation or scarring.

Prevention Tips

One of the easiest ways an individual can prevent a peptic ulcer from developing is by protecting themselves from infections, especially from H. pylori, the main bacteria that causes it, from spreading, as it is believed to be transmitted through people, food, and water. Preventative measures to protect oneself from this harmful bacteria is the frequent washing of the hands with soap and water, and eating properly cooked foods. Another preventative tip is for individuals to be cautious when consuming pain relievers, such as taking the medication with meals, taking the lowest dose recommended by a physician, and avoiding alcohol when taking the medication to reduce the risk of an upset stomach.