Natural Health Research

Naturopathic Medicine
Health Quizzes

Peptic Ulcer


Peptic ulcer disease is a chronic ulcer in the lining of the gastrointestinal tract. There are several locations: duodenal, gastric, esophageal, and ectopic.

Duodenal ulcers are located in the duodenal bulb. Multiple ulcers, and if distal to the bulb raise the possibility of Zollinger-Ellison syndrome. Duodenal ulcers are 4 times more common than gastric ulcers.

Gastric ulcers are most commonly located along the lesser curvature of the antrum near the incisura and in the pre-pyloric area. Gastric ulcers are 3-4 times as common as duodenal ulcers among NSAID users.

A peptic ulcer in the distal esophagus may be part of Barrett's epithelial change due to chronic reflux of gastroduodenal contents.

Ectopic gastric mucosal ulceration may develop in patients with Meckel's diverticula or other sites of ectopic gastric mucosa.


The cause of of duodenal and gastric ulcers is multifactorial. H. pylori gastritis is present in >90% of duodenal and >75% of gastric ulcers (H. pylori appears to be a requisite factor). An imbalance between aggressive factors (e.g., gastric acid, pepsin, bile salts, pancreatic enzymes) and defensive factors maintaining mucosal integrity (e.g., mucus, bicarbonate, blood flow, prostaglandins, growth factors, cell turnover) may allow H. pylori to grow. Ulcerogenic drugs (e.g., NSAID's) harm the gastric mucosa. Zollinger-Ellison syndrome causes excessive gastric acid secretion which damages gastric mucosa.

Peptic ulcers are strongly associated with cigarette smoking (more than 1/2 pack/day). Other risk factors include: drugs (e.g., NSAID use), family history of ulcer, and Zollinger-Ellison syndrome (gastrinoma). It is possibly associated with: Corticosteroids (high dose and/or prolonged therapy); blood group O; HLA-B12, B5, Bw35 phenotypes; stress; lower socioeconomic status; and manual labor. It is poorly or not associated with dietary spices, alcohol, caffeine, and acetaminophen.




Fantastic new books!

CAM Therapies has studies on natural therapies for over 100 diseases.

CAM Labs lists lab tests for 100 diseases.

Nutritional Genetics is a fantastic resource.



Information on this site is provided for informational purposes only and is not meant to substitute for the advice provided by your own physician or other medical professional. You should not use the information contained herein for diagnosing or treating a health problem or disease, or prescribing any medication. If you have or suspect that you have a medical problem, promptly contact your health care provider. Information and statements on this site have not been evaluated by the Food and Drug Administration.