Stomach ulcers, also known as gastric ulcers, are painful sores that develop in the lining of the stomach. They are a type of peptic ulcer, which can also occur in the duodenum, the first part of the small intestine. Understanding What Causes Stomach Ulcers is crucial for prevention and effective treatment. While stomach ulcers can cause significant discomfort and pain, knowing the primary causes and risk factors can empower individuals to take proactive steps towards better digestive health.
Primary Causes of Stomach Ulcers
For a long time, stress and spicy food were wrongly considered the main culprits behind stomach ulcers. However, medical science has advanced, and we now know that the vast majority of stomach ulcers are caused by specific factors, primarily bacterial infection and the prolonged use of certain medications.
Helicobacter pylori (H. pylori) Infection
Helicobacter pylori (H. pylori) is a type of bacteria that infects the stomach. It’s one of the most common causes of stomach ulcers worldwide. It is estimated that billions of people globally are infected with H. pylori, although many may not develop ulcers. These bacteria damage the protective mucus lining of the stomach and duodenum, allowing stomach acid to reach and injure the sensitive tissues underneath. This damage can eventually lead to the formation of an ulcer.
The exact way H. pylori spreads is still under investigation, but researchers believe transmission occurs primarily through:
- Person-to-person contact: Close contact, such as through saliva, vomit, or stool of an infected person, can spread the bacteria. This can happen through kissing or sharing utensils.
- Contaminated food or water: In regions with poor sanitation, H. pylori can spread through food and water contaminated with fecal matter.
It’s important to note that while H. pylori is a major cause, not everyone infected will develop ulcers. Other factors, such as genetics and lifestyle, also play a role.
Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
Nonsteroidal anti-inflammatory drugs (NSAIDs) are a common class of pain relievers available both over-the-counter and by prescription. Common examples include aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve). While effective at reducing pain and inflammation, NSAIDs can also have a significant impact on the stomach lining.
NSAIDs work by blocking the production of prostaglandins, substances in the body that contribute to inflammation and pain. However, prostaglandins also play a crucial role in protecting the stomach lining from acid and promoting healing. By reducing prostaglandin production, NSAIDs can weaken the stomach’s defense mechanisms, making it more susceptible to damage from stomach acid and pepsin, a digestive enzyme. Over time, this can lead to ulcer formation.
The risk of developing stomach ulcers from NSAIDs increases with:
- Long-term use: The longer you take NSAIDs, the higher the risk.
- High doses: Taking higher doses of NSAIDs increases the likelihood of ulcer development.
- Specific NSAIDs: Some NSAIDs are more likely to cause ulcers than others.
- Combination of NSAIDs: Taking multiple NSAIDs simultaneously significantly elevates the risk.
- Concomitant medications: Taking NSAIDs with other medications like corticosteroids, anticoagulants, and certain antidepressants can further increase ulcer risk.
- H. pylori infection: Having an H. pylori infection while taking NSAIDs dramatically increases the risk of ulcers.
- Older age: Older adults are more susceptible to NSAID-induced ulcers.
- History of ulcers: Individuals with a prior history of peptic ulcers are at higher risk.
Less Common and Rare Causes of Stomach Ulcers
While H. pylori and NSAIDs account for the majority of stomach ulcers, other less common factors can also contribute to their development. These include:
- Zollinger-Ellison syndrome: This rare condition causes the stomach to produce excessive acid, leading to peptic ulcers. It’s caused by a tumor in the pancreas or duodenum that secretes gastrin, a hormone that stimulates acid production.
- Certain Medications: Besides NSAIDs, other medications can also increase the risk of ulcers, although less commonly. These include corticosteroids, bisphosphonates, and potassium chloride.
- Medical Conditions: Certain medical conditions can increase susceptibility to stomach ulcers, such as liver, kidney, or lung disease.
- Stress (Physiological Stress): Severe physical stress due to major surgery, burns, or critical illness can increase the risk of stress ulcers, which are a different type of ulcer that can occur in the stomach and duodenum. However, everyday emotional stress is not considered a direct cause of peptic ulcers.
- Radiation therapy: Radiation treatment to the stomach area can sometimes lead to ulcer formation.
- Idiopathic Peptic Ulcers: In rare cases, the cause of peptic ulcers cannot be identified. These are referred to as idiopathic peptic ulcers.
Risk Factors That Increase Your Susceptibility to Stomach Ulcers
Certain lifestyle and genetic factors can increase your risk of developing stomach ulcers, even if you are exposed to H. pylori or use NSAIDs. These risk factors include:
- Smoking: Smoking increases stomach acid production, reduces bicarbonate production (which neutralizes acid), and impairs ulcer healing. Smokers are more likely to develop ulcers and experience complications.
- Excessive Alcohol Consumption: While moderate alcohol intake may not directly cause ulcers, excessive and chronic alcohol consumption can irritate the stomach lining and worsen existing ulcers.
- Untreated Stress: While daily stress isn’t a direct cause, chronic and unmanaged stress can weaken the immune system and potentially make individuals more susceptible to H. pylori infection and slower ulcer healing.
- Family History: There may be a genetic predisposition to developing peptic ulcers. Having a family history of ulcers can slightly increase your risk.
- Age: While peptic ulcers can occur at any age, they are more common in older adults, particularly for NSAID-related ulcers.
Understanding the causes of stomach ulcers is the first step towards prevention and effective management. If you experience persistent stomach pain or other symptoms suggestive of an ulcer, it is crucial to consult a healthcare professional for proper diagnosis and treatment. Early intervention can help prevent complications and promote healing, leading to better long-term digestive health.
