What causes ulcers?

Robynne K. Chutkan, MD
The three causes of ulcers are the following:

- Helicobacter pylori (H. pylori) is a bacteria that was first described in the 1980s and is transmitted through food and water or person to person. Although roughly half the world's population is infected with H. pylori and infection increases your chances for developing ulcers, only about 20% of those infected have any symptoms. Still, if you are diagnosed with an ulcer, finding out if you have H. pylori and treating it if you do is an important part of making sure your ulcer heals and doesn't come back.

- Common pain relievers containing ibuprofen or aspirin are frequent causes of inflammation and ulcers, particularly in older people who may be using them regularly for arthritis. Taking them with meals or switching to acetaminophen when appropriate may be helpful steps to avoid developing an ulcer. If you have been diagnosed with an ulcer, particularly a bleeding ulcer, you need to be careful about taking ibuprofen or aspirin in the future.

- Excessive alcohol and caffeine can also lead to ulcers, particularly in smokers. Your doctor may prescribe drugs that suppress acid production to heal the ulcers, but smoking cessation and avoiding or cutting back significantly on caffeine and alcohol are also an important part of treatment.

Patients frequently ask me about the role of stress in causing ulcers. A serious illness, an accident, major surgery or significant emotional stress may all be contributing factors in the development of ulcers. In fact, ulcers are a common finding in patients admitted to the intensive care unit for other serious medical conditions.
Dr. Robin Miller, MD
Internal Medicine
It's true - not getting enough sleep could give you an ulcer. In this video, Dr. Robin Miller reveals the connection between ulcers and a bad night's sleep.


Ulcers, or peptic ulcer disease, are sores that can form in the mucosal lining of the stomach, the first section of the small intestine or the esophagus. Some are caused by taking NSAIDs (non-steroidal anti-inflammatory drugs) such as aspirin, ibuprofen or naproxen for long periods of time. The majority of ulcers are caused by a spiral-shaped bacterium that makes its home in the stomach and intestine. Called Helicobacter pylori, this bacterium secretes an enzyme that protects it from stomach acid. After it burrows into the stomach lining, white blood cells have trouble fighting it. Any nutrients meant to nourish the white blood cells feed the bacteria. For most people, H. pylori doesn't cause any discernable problems, but a constant infection without treatment leads to ulcers. Treatment involves two weeks of antibiotics, plus both a proton pump inhibitor to lower stomach acid (a good example is Prilosec) and another medication to coat the stomach lining (for instance, Pepto-Bismol). You might need a few different antibiotics to clear up the infection.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.