Peptic Ulcer Disease (PUD)

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Overview

Peptic ulcer disease (PUD) is a chronic (long lasting) condition that affects the gastrointestinal (GI) tract or digestive system. PUD causes ulcers (sores or lesions) in the lining (mucosa) of the stomach or first part of the small intestine (duodenum). Peptic ulcer disease often results in burning pain in the upper center of the abdomen.

In addition to the foods that we eat, a number of other substances also come in contact with the digestive tract. Some of these substances can be harmful to the gastric (stomach) or intestinal mucosa.

Substances that can damage the lining of the stomach and duodenum include oral medications (e.g., nonsteroidal anti-inflammatory drugs [NSAIDs]), microorganisms (e.g., bacteria, parasites), and chemicals produced by the body during digestion (e.g., stomach [gastric] acid, pancreatic enzymes, bile). Digestion is the process of breaking down food into a form that can be absorbed into the bloodstream and used by the body.

Normally, a complex defense system helps to protect the lining of the digestive tract and repair damage to the gastrointestinal mucosa. This defense system includes the production of mucus and certain chemicals (e.g., bicarbonate), and blood circulation in the GI tract. Mucus coats and protects the lining of the GI tract, chemicals help neutralize stomach (gastric) acid, and blood flow helps to renew the lining of the digestive tract and repair damaged cells.

Peptic ulcer disease occurs as a result of inflammation, damage, or a structural defect in the GI tract that disrupts this defense system, allowing ulcers (sores or lesions) to develop in the stomach or duodenum.

These sores, called peptic ulcers, are larger than 5 mm in size and reach into the layer beneath the mucosa (submucosa). Peptic ulcers that form in the lining of the stomach are called gastric ulcers and those that form in the lining of the duodenum are called duodenal ulcers.

Incidence and Prevalence
Peptic ulcer disease is a relatively common condition. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), about 10% of people in the United States (25 million people) will develop peptic ulcer disease during their lifetimes (called lifetime incidence).

PUD develops about as often in women as men. Peptic ulcer disease is more common in people over the age of 50.

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