Stomach (Gastric) Ulcer - Causes

Authored by Dr Colin Tidy, 03 Feb 2015

Patient is a certified member of
The Information Standard

Reviewed by:
Prof Cathy Jackson, 03 Feb 2015

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Your stomach normally produces acid to help with the digestion of food and to kill germs (bacteria). This acid is corrosive, so some cells on the inside lining of the stomach and the first part of the gut (small intestine) known as the duodenum produce a natural mucous barrier. This protects the lining of the stomach and duodenum.

There is normally a balance between the amount of acid that you make and the mucous defence barrier. An ulcer may develop if there is an alteration in this balance, allowing the acid to damage the lining of the stomach or duodenum. Causes of this include the following:

Infection with Helicobacter pylori

Infection with H. pylori is the cause in about 8 in 10 cases of stomach ulcer. More than a quarter of people in the UK become infected with H. pylori at some stage in their lives. Once you are infected, unless treated, the infection usually stays for the rest of your life.

In many people, it causes no problems and a number of these bacteria just live harmlessly in the lining of the stomach and duodenum. However, in some people, this bacterium causes an inflammation of the lining of the stomach or duodenum. This causes the defence mucous barrier to be disrupted (and in some cases the amount of acid to be increased) which allows the acid to cause inflammation and ulcers.

Anti-inflammatory medicines - including aspirin

Anti-inflammatory medicines are sometimes called non-steroidal anti-inflammatory drugs (NSAIDs). There are various types and brands. For example, aspirin, ibuprofen, diclofenac, etc. Many people take an anti-inflammatory medicine for arthritis, muscular pains, etc. Aspirin is also used by many people to protect against blood clots forming. However, these medicines sometimes affect the mucous barrier of the stomach and allow acid to cause an ulcer. About 2 in 10 stomach ulcers are caused by anti-inflammatory medicines.

Other causes and factors

Other causes are rare. For example, some viral infections can cause a stomach ulcer. Crohn's disease may cause a stomach ulcer in addition to other problems of the gut.

Stomach cancer may at first look similar to an ulcer. Stomach cancer is uncommon but may need to be 'ruled out' if you are found to have a stomach ulcer.

Further reading and references

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