What are the most common causes of peptic ulcers?

The most common causes of peptic ulcers are infection with the H. pylori bacteria and overuse of nonsteroidal anti-inflammatory drugs (NSAIDs), including ibuprofen and several other over-the-counter medications. The H. pylori bacteria is actually considered the most common of all causes of peptic ulcers, with NSAIDs a distant second. There are also other risk factors that increase a person's chance of developing a peptic ulcer, including alcohol abuse, tobacco use, medical radiation treatments, and stress.

All causes of peptic ulcers generally work by causing the lining of the stomach to fail, allowing acid to burn through the stomach wall, leading to pain and nausea. Ulcer symptoms tend to come and go periodically, and can sometimes go away for weeks or months at a time and then return. There are several medications used to treat ulcers, and most focus on reducing the amount of stomach acid produced so the lining can heal. In some cases, patients will also take antacid medications as a way to deal with symptoms.

H. pylori bacteria cause ulcers by directly damaging the stomach lining, and NSAIDs cause ulcers by disabling some of the stomach's protective mechanisms, leading to damage to the lining. For H. pylori-based ulcers, antibiotic prescriptions can cure the bacterial infection, but they won't necessarily clear the ulcer right away. When ulcers are caused by NSAIDs, patients are generally advised to stop taking the medication until the ulcer has a chance to heal, which can take several months.

For many people, H. pylori infection does not necessarily cause an ulcer or any other serious problem. Many scientists think that certain risky behaviors that cause an increase in stomach acid, such as smoking and alcohol, might make it easier for the bacteria to cause problems. Researchers generally believe that H. pylori is contagious, but the mechanism for transmitting it from person to person is currently unknown.

Spicy food used to be considered one of the main causes of peptic ulcers, but most experts don't think so anymore. Some scientists think that spicy food may be a contributing factor in helping to aggravate an existing ulcer, which could cause a difficult episode with particularly severe symptoms. The medical community also suggests that alcohol and stress can aggravate existing ulcers in the same way. People trying to recover are often advised to avoid all potential risky behaviors that lead to overproduction of stomach acid until their ulcers can heal.

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