Building Your Foundation: Understanding Peptic Ulcer Disease

At a Glance

Peptic ulcer disease is an open sore in the stomach or duodenum, commonly linked to H. pylori infection or NSAID pain relievers. Symptoms can include upper-abdominal pain, nausea, bloating, and early fullness, and endoscopy can confirm the diagnosis.

Being diagnosed with Peptic Ulcer Disease (PUD) can feel overwhelming, but it is a very common and manageable condition. At its simplest, PUD means that an open sore—an ulcer—has developed on the lining of your digestive tract ^[1]. While the term “ulcer” can sound alarming, modern medicine has made PUD highly treatable, and most people experience significant relief once they begin the correct therapy ^[2]^[3].

What is Peptic Ulcer Disease?

Peptic ulcers occur when the protective layer of mucus that lines your digestive system is weakened, allowing stomach acid to damage the sensitive tissue underneath ^[1]. There are two main types of peptic ulcers, named for where they are found:

Gastric Ulcers: These are located in the stomach ^[4].
Duodenal Ulcers: These are located in the duodenum, which is the very first part of the small intestine ^[4].

PUD is a widespread condition globally ^[5]. The exact prevalence varies by region, age, and background, but the important thing to know is that your care team sees and treats this condition frequently ^[6]^[7].

Comparing Gastric and Duodenal Ulcers

While both types of ulcers are caused by similar factors—most often a bacterial infection called H. pylori or the use of certain pain medications—they can behave differently ^[8]^[9].

Feature	Gastric Ulcer (Stomach)	Duodenal Ulcer (Small Intestine)
Common Cause	Often linked to NSAIDs (like ibuprofen) or H. pylori ^[10].	More frequently linked to H. pylori infection ^[10].
Demographics	Often seen in older adults ^[10].	More common in men and slightly younger populations ^[7].
Cancer Risk	A history of gastric ulcers is associated with a slightly higher risk of gastric cancer. A biopsy is usually taken to ensure the ulcer is benign ^[11].	Duodenal ulcers are almost never associated with an increased risk of cancer ^[11].
Follow-up	Doctors often recommend a follow-up endoscopy (a procedure using a small camera) to ensure the ulcer has healed completely ^[12].	Follow-up endoscopy is less common unless symptoms persist or complications occurred ^[13].

How You Might Feel

The symptoms of PUD are often grouped under the term dyspepsia, which is the medical word for indigestion or “upset stomach” ^[1]. You might experience:

Epigastric pain: A burning or gnawing pain in the upper middle part of your belly ^[1].
Bloating and fullness: Feeling “stuffed” or swollen shortly after eating ^[14].
Nausea: A feeling of sickness in the stomach, sometimes accompanied by vomiting ^[14].
Early satiety: Feeling full much sooner than usual when eating a meal ^[1].

It is important to know that symptoms alone cannot tell a doctor exactly where an ulcer is located, or even guarantee an ulcer is present. A definitive diagnosis is often made through an upper gastrointestinal endoscopy, which allows your doctor to see the ulcer directly ^[15]^[2].

Understanding the Emotional Impact

A diagnosis of PUD can be stressful, and it is normal to feel anxious about what it means for your long-term health. Some patients worry about the risk of bleeding or the possibility of cancer ^[3]. Because the symptoms can affect your sleep, your ability to enjoy food, and your overall energy levels, PUD can temporarily lower your quality of life ^[1]^[16].

The good news is that when the cause is addressed—such as treating an H. pylori infection or adjusting your medications with your doctor’s guidance—the healing rate is very high ^[2]. For example, successfully clearing an H. pylori infection substantially reduces the chance of the ulcer ever coming back ^[2]. Education and a clear treatment plan are often the best tools for reducing the anxiety that comes with a new diagnosis ^[17]. Your care team is there to help you navigate this process and get you back to feeling your best.

Common questions in this guide

What is peptic ulcer disease, and where does it occur?

Peptic ulcer disease means an open sore has formed in the lining of the stomach or the duodenum, the first part of the small intestine. A stomach ulcer is called a gastric ulcer, while an ulcer in the duodenum is called a duodenal ulcer.

What usually causes a peptic ulcer?

The most common causes discussed are H. pylori infection and use of NSAID pain relievers such as ibuprofen, naproxen, or aspirin. These factors can weaken the protective lining so stomach acid can injure the tissue.

What symptoms can an ulcer cause?

Symptoms may include burning or gnawing pain in the upper middle abdomen, indigestion, bloating, feeling full, nausea, vomiting, or becoming full quickly. Symptoms alone cannot confirm an ulcer or show whether it is in the stomach or duodenum.

How do doctors confirm peptic ulcer disease?

An upper gastrointestinal endoscopy lets a clinician see the ulcer directly and is often used to make a definite diagnosis. A gastric ulcer is commonly biopsied to check that it is benign, and testing may also assess whether H. pylori is present.

Does having a peptic ulcer mean I have cancer?

A peptic ulcer is not the same as cancer. Gastric ulcers have a slightly higher association with gastric cancer, so doctors usually take a biopsy and may repeat endoscopy; duodenal ulcers are almost never linked to an increased cancer risk.

Will I need another endoscopy after an ulcer is found?

Not always. Doctors often recommend repeat endoscopy for a gastric ulcer to confirm healing, whereas follow-up endoscopy is less common for a duodenal ulcer unless symptoms continue or complications occurred.

Can a peptic ulcer heal, and can treatment prevent it from returning?

Healing rates are very high when the cause is treated. Clearing an H. pylori infection substantially lowers the chance of the ulcer returning, and medication changes may be needed when pain relievers contributed.

Curated prompts to bring to your next appointment.

1.Is my ulcer located in the stomach (gastric) or the first part of the small intestine (duodenal)?
2.Do I need a follow-up endoscopy to ensure the ulcer has completely healed, and if so, when?
3.Was I tested for H. pylori, and if the result was positive, how will we confirm it is gone after treatment?
4.Are any of my current medications, including over-the-counter pain relievers, contributing to this ulcer?
5.Given the location and size of my ulcer, what is my specific risk for complications like bleeding?

Tap a prompt to share your answer — we'll use it plus this page's context to start a tailored conversation.

References (17)

1
Diagnosis and Treatment of Peptic Ulcer Disease.
Kavitt RT, Lipowska AM, Anyane-Yeboa A, Gralnek IM
The American journal of medicine 2019; (132(4)):447-456 doi:10.1016/j.amjmed.2018.12.009.
PMID: 30611829
2
Peptic Ulcer Disease: A Review.
Vakil N
JAMA 2024; (332(21)):1832-1842 doi:10.1001/jama.2024.19094.
PMID: 39466269
3
Efficacy of emotion regulation training on pain intensity and life quality in patients with peptic ulcer disease (PUD).
Eftekhari A, Masjedi Arani A, Bakhtiari M, et al.
Gastroenterology and hepatology from bed to bench 2023; (16(4)):394-400 doi:10.22037/ghfbb.v16i4.2694.
PMID: 38313358
4
Evidence-based clinical practice guidelines for peptic ulcer disease 2020.
Kamada T, Satoh K, Itoh T, et al.
Journal of gastroenterology 2021; (56(4)):303-322 doi:10.1007/s00535-021-01769-0.
PMID: 33620586
5
Peptic ulcer disease.
Almadi MA, Lu Y, Alali AA, Barkun AN
Lancet (London, England) 2024; (404(10447)):68-81 doi:10.1016/S0140-6736(24)00155-7.
PMID: 38885678
6
Low Prevalence of Helicobacter pylori-Positive Peptic Ulcers in Private Outpatient Endoscopy Centers in the United States.
Sonnenberg A, Turner KO, Genta RM
The American journal of gastroenterology 2020; (115(2)):244-250 doi:10.14309/ajg.0000000000000517.
PMID: 31972622
7
Prevalence of common upper gastrointestinal diseases in Chinese adults aged 18-64 years.
Yang H, Zhang M, Li H, et al.
Science bulletin 2024; (69(24)):3889-3898 doi:10.1016/j.scib.2024.07.048.
PMID: 39562185
8
Eradication therapy for peptic ulcer disease in Helicobacter pylori-positive people.
Ford AC, Gurusamy KS, Delaney B, et al.
The Cochrane database of systematic reviews 2016; (4()):CD003840 doi:10.1002/14651858.CD003840.pub5.
PMID: 27092708
9
A systematic approach for the diagnosis and treatment of idiopathic peptic ulcers.
Chung CS, Chiang TH, Lee YC
The Korean journal of internal medicine 2015; (30(5)):559-70 doi:10.3904/kjim.2015.30.5.559.
PMID: 26354049
10
Time trends in the prevalence of Helicobacter pylori infection in patients with peptic ulcer disease: a single-center retrospective study in Shanghai.
Zhang W, Liang X, Chen X, et al.
The Journal of international medical research 2021; (49(10)):3000605211051167 doi:10.1177/03000605211051167.
PMID: 34686094
11
The Association between Peptic Ulcer Disease and Gastric Cancer: Results from the Stomach Cancer Pooling (StoP) Project Consortium.
Paragomi P, Dabo B, Pelucchi C, et al.
Cancers 2022; (14(19)) doi:10.3390/cancers14194905.
PMID: 36230828
12
[Non-Helicobacter pylori, Non-nonsteroidal Anti-inflammatory Drug Peptic Ulcer Disease].
Chang YW
The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi 2016; (67(6)):313-7 doi:10.4166/kjg.2016.67.6.313.
PMID: 27312831
13
Perforated and bleeding peptic ulcer: WSES guidelines.
Tarasconi A, Coccolini F, Biffl WL, et al.
World journal of emergency surgery : WJES 2020; (15()):3 doi:10.1186/s13017-019-0283-9.
PMID: 31921329
14
Profile of peptic ulcer disease and its risk factors in Arar, Northern Saudi Arabia.
Albaqawi ASB, El-Fetoh NMA, Alanazi RFA, et al.
Electronic physician 2017; (9(11)):5740-5745 doi:10.19082/5740.
PMID: 29403613
15
[Peptic ulcer].
Laucirica I, García Iglesias P, Calvet X
Medicina clinica 2023; (161(6)):260-266 doi:10.1016/j.medcli.2023.05.008.
PMID: 37365037
16
Measurement properties of a patient-reported outcome scale for peptic ulcer: a validation study using classical test theory and generalizability theory.
Xu F, Luo N, Fu T, et al.
Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 2026; (35(10)).
PMID: 42667501
17
Analyzing the Comprehension and Awareness of Peptic Ulcer Disease and Its Risk Factors among the Jazan Population, Saudi Arabia.
Someili A, Safhi AM, Alharbi AI, et al.
Annals of African medicine 2026; (25(3)):531-537 doi:10.4103/aam.aam_146_25.
PMID: 40831430

This page explains peptic ulcer disease for education and does not replace medical advice. A clinician should interpret your symptoms, H. pylori results, endoscopy findings, and need for follow-up.

Get notified when new evidence is published on peptic ulcer disease.

We monitor PubMed for new peer-reviewed studies on this topic and email a short summary when something meaningful changes.

Guide Contents