In this article, you’ll learn about what causes peptic ulcer disease, how common it is, who gets peptic ulcers, and what you need to know about screening and outcome.
Overview
Peptic ulcer disease happens when the stomach and upper small intestine lining break down and painful sores called ulcers emerge. There are many reasons why someone may develop peptic ulcer disease. Surprisingly, these reasons are not about stress or diet (i.e., spicy foods). Ulcers are a common digestive disorder. In any given year, around 4 million Americans will experience an ulcer. Some 1 in 10 Americans develop an ulcer over the course of their lifetime.
About half of the world’s population is infected with a bacteria called H. pylori (often without symptoms). H. pylori is responsible for around half of all peptic ulcer disease cases worldwide. The pain associated with peptic ulcer disease often occurs within 2-3 hours after a meal.
Peptic Ulcers by Age
Stomach ulcers can happen to anyone at any age, but they are more common after the age of 60-70. Complications (such as bleeding ulcers) are said to increase with age.
Ulcers of the small intestine, though, can be found more commonly in men in the age 30-50 age group.
At any age, if you feel pain after eating (even several hours later as can be the case for ulcers in the small intestine), seek to know what’s causing the pain. Avoid assuming you can’t have an ulcer due to your age.
Peptic Ulcers by Gender
Peptic ulcers are more commonly diagnosed in women than men (except men in the 30-50 age group). There is no clear explanation for this difference observed.
Causes of Peptic Ulcers and Risk Factors
Causes and risk factors for peptic ulcers include behaviors or genetic factors that contribute to an increased or excessive production of stomach acid (also known as pepsin) or an increased susceptibility to damage from even normal levels of acid.
Risk factors for peptic ulcers include:
Over-the-counter NSAIDs or non-steroidal anti-inflammatories such as: Aspirin Naproxen (Aleve, Anaprox, and Naprosyn) Ibuprofen (Motrin, Advil, and Midol) Prescription NSAIDs (Celebrex and Cambia) Corticosteroids Smoking Coffee (with or without caffeine) Alcohol use
What are the Mortality Rates for Peptic Ulcer Disease?
The mortality rate for bleeding peptic ulcers is around 10%. This has gone fairly unchanged despite advancements in surgery for peptic ulcers, according to one literature review.
The severity of ulcers and associated features (ie., bleeding, perforation), both of which can be affected by increasing age, play a role in mortality rates.
Complications of peptic ulcer disease include:
BleedingPenetration or perforation (hole or opening)Obstruction of stomach entry and exit from swelling or scarring
Screening and Early Detection
Screening for an ulcer includes answering questions about your symptoms. It may or may not include lab tests. If your healthcare provider wants more information, they may order tests such as:
If you have been experiencing symptoms of an ulcer, such as pain after eating, or have been finding yourself taking more antacids than usual, it’s best to reach out to your healthcare provider. Ulcers are unlikely to go away on their own and require several weeks of treatment.
An endoscopy to see inside your stomachA breath test for infectionImaging tests such as X-rays or C-scans (less likely)
Early screening and eradicating an associated H. Pylori infection has been associated with improving outcome of peptic ulcer disease, chronic indigestion, and reducing risk of stomach cancer. Ulcers are not likely to resolve on their own, and they require treatments including proton pump inhibitors (PPIs) and antibiotics to eradicate Helicobacter pylori infection and lifestyle modifications such as quitting smoking.
Early screening and eradicating the infection has been associated with improving outcome of peptic ulcer disease, chronic indigestion, and reducing risk of stomach cancer.
Summary
Peptic ulcers occur when stomach acid damages the lining of the stomach or upper small intestine. The acid wears away at the lining of these organs, causing pain shortly after eating. Genetics and lifestyle factors play a role. Ulcers affect women more than men and elderly populations more than young populations. The risk of ulcer complications increases with age and includes bleeding, perforation and obstruction. Screening and early detection and treatment improve outcomes by preventing complications and mitigating the risk of associated stomach cancer.
A Word From Verywell
Ulcers are relatively common, so there’s no shame in seeking treatment. The earlier you speak with your healthcare provider about treatment options, the sooner you can recover.
