Sorry something went wrong with your subscription Please, try again in a couple of minutes Retry. Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Show references Kellerman RD, et al. Gastritis and peptic ulcer disease. In: Conn's Current Therapy Elsevier; Accessed July 8, Peptic ulcer disease. American College of Gastroenterology. Peptic ulcers stomach ulcers. Feldman M, et al. Saunders Elsevier; Nehra AK, et al.
Proton pump inhibitors: Review of emerging concerns. Mayo Clinic Proceedings. Peptic ulcer disease adult. Mayo Clinic; Peptic ulcers.
Natural Medicines. Accessed July 21, Brown AY. In the healthy control group, 9. In the present study, we found that active-stage ulcers triggered more symptoms than healing-stage ulcers, and the presence of active-stage ulcers was an independent risk factor for the presence of symptoms in PUD. Gastroduodenal symptoms can develop more often in the active stage of ulcers, because the gastric mucosa is damaged to the highest extent in this stage. In addition, ulcer location and number were not related to symptoms.
It is speculated that patients with healing-stage ulcers show symptoms less frequently, even if they have several peptic ulcers. In this study, heavy drinking was the most powerful risk factor for the presence of symptoms in patients with PUD. Excessive alcohol consumption by patients with PUD may be related to gastroduodenal symptoms.
However, heavy drinking can induce symptoms, with or without PUD [ 14 ]. In our study, heavy drinking was related to gastroduodenal symptoms not only in subjects with PUD but also in healthy individuals. Therefore, further studies will be required to determine whether heavy drinking is responsible for the development of symptoms in PUD.
According to the current study, the use of NSAIDs was related to gastroduodenal symptoms in the healthy control group as well. In the present study, H. However, the absence of chronic atrophic gastritis was associated with asymptomatic PUD.
This result suggests that ulcer-related symptoms may be reduced in patients with advanced stages of H. As the infection persists over a long period, atrophic changes of the gastric and duodenal mucosa become more severe [ 17 ]. However, chronic inflammation of the mucosa may desensitize patients to the mucosal damage and reduce their symptoms [ 18 ].
This inverse relationship between gastroduodenal symptoms and chronic atrophic gastritis was also observed in the healthy control group Supplementary Table 1. Old age and smoking are well-known risk factors for PUD; these were also found to be risk factors for PUD in the present study, regardless of the presence of symptoms [ 19 ].
Previous studies revealed that female sex is a common predisposing factor for symptoms of functional GI disorders [ 20 - 22 ]. Because men are less sensitive to GI symptoms, ulcer-related symptoms may be less obvious in men than in women. Despite our important findings, the present study has some limitations. First, it was nearly impossible to determine the causal relationship between gastroduodenal symptoms and PUD. In this study, 9. Although individuals diagnosed with functional dyspepsia were excluded from the study based on survey responses, some subjects included in the study may have had functional GI disorders.
Similarly, some symptoms may have been triggered by minor injury to the gastroduodenal wall. In other words, symptoms of some subjects with symptomatic PUD may not be caused by the peptic ulcers. Second, some values were missing in our data, which included the smoking history of 1, subjects, the alcohol-consumption history of subjects, and the BMI of 23 subjects; additionally, the serum PG of 7, subjects was not measured.
Finally, the relationship between atrophic change of the gastric mucosa and upper GI symptoms remains a highly contentious issue [ 18 , 23 , 24 ]. In the present study, atrophic gastritis diagnosed by endoscopy was inversely related to symptoms. However, PG assay results did not show any relationship to symptoms. In conclusion, in Korea, a country in which H. Heavy drinking and active-stage ulcers were independent risk factors for the presence of gastroduodenal symptoms in patients with PUD.
Active-stage ulcers may trigger more symptoms than healing-stage ulcers, regardless of their location and number. Conflicts of Interest: The authors have no financial conflicts of interest.
Supplementary Table 1. National Center for Biotechnology Information , U. Journal List Clin Endosc v. NSAIDs are medicines widely used to treat pain, a high temperature fever and inflammation swelling. Many people take NSAIDs without having any side effects, but there's always a risk the medication could cause problems, such as stomach ulcers, particularly if taken for a long time or at high doses.
You may be advised not to use NSAIDs if you currently have a stomach ulcer or if you have had one in the past. Paracetamol can often be used as an alternative painkiller, as it's generally considered safer. Develop and improve products. List of Partners vendors. You may be surprised to learn that infection with a bacterium called Helicobacter pylori and long-term use of pain relievers are causes of peptic ulcers.
In the past, it was believed stress, diet, or having too much stomach acid hydrochloric acid and pepsin caused peptic ulcers , and these inaccurate beliefs still circulate. But Drs. Barry Marshall and J. Robin Warren were awarded the Nobel Prize in Medicine for their discovery of a bacterial cause of peptic ulcer disease. Having this bacteria growing in your stomach can damage the mucus coating that protects the tissues lining the stomach and duodenum.
This allows stomach acid to come into contact with the lining, causing inflammation and ulcers. The bacteria also stimulate gastric cells to grow in the lining of the duodenum, secreting acid and pepsin. In the U. The bacteria can be spread via saliva, food, water, and eating utensils. It is often acquired in childhood without any symptoms.
Long-term use of non-steroidal anti-inflammatory drugs NSAIDs is another common cause of peptic ulcers, raising your risk 20 times that of non-users.
These include over-the-counter products containing aspirin, ibuprofen, and naproxen sodium. NSAIDs can make the stomach's defense mechanisms fail in a couple of different ways.
They can make the stomach vulnerable to the harmful effects of acid and pepsin by interfering with the stomach's ability to produce mucus and bicarbonate. This natural bicarbonate normally neutralizes digestive fluids and breaks them down into less harmful substances.
They can also affect cell repair by inhibiting the COX-1 receptors and blood flow to the stomach, which normally help protect it. Both having H. Zollinger-Ellison syndrome is a rare condition that can cause peptic ulcers.
Those who have it have one or more tumors in the pancreas and duodenum that produce a large amount of gastrin hormone. This leads to large amounts of acid in the duodenum and upper intestine. Researchers have found some genetic basis for susceptibility to H. Studies show that cigarette smoking can increase your chance of getting an ulcer, especially if you are infected with H.
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