The stomach is the organ of the digestive system in which food travels from the esophagus and is further broken down before its nutrients are absorbed in the small intestine. It produces acid and various enzymes that break down food into simple substances. The inside wall of the stomach is protected from the acid and enzymes by a mucous lining. Ulcers are caused when there is an imbalance between the digestive juices produced by the stomach and the various factors that protect the lining of the stomach. Symptoms of ulcers may include bleeding. On rare occasions, an ulcer may completely erode the stomach wall. A major cause of stomach ulcers is the bacteria called Helicobacter pylori. Treatment regimens for ulcers caused this bacterium usually include medications to suppress the stomach acid as well as antibiotics to eradicate the infection.

What is a stomach ulcer?

Stomach ulcers are painful sores that can be found in the stomach lining or small intestine. Stomach ulcers are the most visible sign of peptic ulcer disease. They occur when the thick layer of mucus that protects your stomach from digestive juices is reduced, thus enabling the digestive acids to eat away at the lining tissues of the stomach. Stomach ulcers are easily cured, but they can become severe without proper treatment.
What causes stomach ulcers?
Stomach ulcers aren’t necessarily caused by one single factor. The decrease in the stomach’s mucus lining that leads to an ulcer is usually caused by one of the following:

an infection with the bacterium Helicobacter pylori (H. pylori)
long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen
excess acid (hyperacidity) in the stomach, which may be related to genetics, lifestyle (stress, smoking), and certain foods
Zollinger-Ellison syndrome, a rare disease that makes the body produce excess stomach acid
Certain factors and behaviors can put you at higher risk for developing stomach ulcers:

smoking
frequent use of steroids (such as those for treating asthma)
hypercalcemia (overproduction of calcium)
family history of stomach ulcers
being over 50 years old
excessive consumption of alcohol
Peptic ulcer disease (PUD), also known as a peptic ulcer or stomach ulcer, is a break in the lining of the stomach, first part of the small intestine, or occasionally the lower esophagus. An ulcer in the stomach is known as a gastric ulcer while that in the first part of the intestines is known as a duodenal ulcer. The most common symptoms are waking at night with upper abdominal pain or upper abdominal pain that improves with eating. The pain is often described as a burning or dull ache. Other symptoms include belching, vomiting, weight loss, or poor appetite. About a third of older people have no symptoms. Complications may include bleeding, perforation, and blockage of the stomach. Bleeding occurs in as many as 15% of people.

Common causes include the bacteria Helicobacter pylori and non-steroidal anti-inflammatory drugs (NSAIDs). Other less common causes include tobacco smoking, stress due to serious illness, Behcet disease, Zollinger-Ellison syndrome, Crohn disease and liver cirrhosis, among others. Older people are more sensitive to the ulcer causing effects of NSAIDs. The diagnosis is typically suspected due to the presenting symptoms with confirmation by either endoscopy or barium swallow. H. pylori can be diagnosed by testing the blood for antibodies, a urea breath test, testing the stool for signs of the bacteria, or a biopsy of the stomach. Other conditions that produce similar symptoms include stomach cancer, coronary heart disease, and inflammation of the stomach lining or gallbladder.

Diet does not play an important role in either causing or preventing ulcers. Treatment includes stopping smoking, stopping NSAIDs, stopping alcohol, and medications to decrease stomach acid. The medication used to decrease acid is usually either a proton pump inhibitor (PPI) or an H2 blocker with four weeks of treatment initially recommended. Ulcers due to H. pylori are treated with a combination of medications such as amoxicillin, clarithromycin, and a PPI. Antibiotic resistance is increasing and thus treatment may not always be effective. Bleeding ulcers may be treated by endoscopy, with open surgery typically only used in cases in which it is not successful.