Peptic ulcer causes

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Peptic ulcer Microchapters


Patient Information


Historical Perspective




Differentiating Peptic Ulcer from other Diseases

Epidemiology and Demographics

Risk Factors


Natural History, Complications and Prognosis


Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Upper GI Endoscopy

X Ray




Other Imaging Findings

Other Diagnostic Studies


Medical Therapy


Endoscopic management
Surgical management

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

2017 ACG Guidelines for Peptic Ulcer Disease

Guidelines for the Indications to Test for, and to Treat, H. pylori Infection

Guidelines for First line Treatment Strategies of Peptic Ulcer Disease for Providers in North America

Guidlines for factors that predict the successful eradication when treating H. pylori infection

Guidelines to document H. pylori antimicrobial resistance in the North America

Guidelines for evaluation and testing of H. pylori antibiotic resistance

Guidelines for when to test for treatment success after H. pylori eradication therapy

Guidelines for penicillin allergy in patients with H. pylori infection

Guidelines for the salvage therapy

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to Hospitals Treating Peptic ulcer

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ;Associate Editor(s)-in-Chief: Manpreet Kaur, MD [2]


Common causes of peptic ulcer disease include Helicobacter pylori infection and NSAID use. Less common causes of peptic ulcer disease include Crohn's disease, Zollinger-Ellison syndrome, Cushing and Curling ulcers, Carcinoid tumors, and carcinoid syndrome.


Common Causes[1][2][3]

Less common causes

Rare causes of peptic ulcer disease

Genetic causes[4]

Causes by Organ System

Cardiovascular No underlying causes
Chemical / poisoning No underlying causes
Dermatologic Rosacea,Chronic idiopathic urticaria ,Psoriasis vulgaris ,Behcet's disease ,Alopecia areata,Sweet's syndrome [5]
Drug Side Effect Aceclofenac, Acemetacin, Alendronate, Artemether and lumefantrin, Aspirin, Azapropazone, Benoxaprofen, Bisphosphonates, Carbinoxamine, Celecoxib, Clopidogrel, Dexamethasone, Diclofenac, Diflunisal, Ethanol, ethanolamine oleate, Etidronic acid, Etodolac, Etoricoxib, Febuxostat, Fenbufen, Fenoprofen, Flurbiprofen, Glucocorticoids, Hydrocortisone, Ibuprofen, Indomethacin, Ketoprofen, Laxative abuse, Mefenamic acid, Meloxicam, Mepenzolate bromide, Methylprednisolone, Nabumetone, Naproxen, Naproxen and esomeprazole magnesium, Niacin, Non steroidal anti-inflammatory drugs, Oxcarbazepine, Para-amino salicylic acid, Pergolide, Phenylbutazone, Pramipexole, Piroxicam, Pramipexole, Prednisolone, Prednisone, Rofecoxib, Sertraline, Sulindac, Tacrolimus, Tenoxicam, Tiaprofenic acid, Tocilizumab, Tolazoline, Tolmetin, Trimetrexate
Ear Nose Throat No underlying causes
Endocrine Cushing syndrome, Multiple endocrine neoplasia type 1, Zollinger-Ellison syndrome, primary hyperparathyroidism
Environmental No underlying causes
Gastroenterologic Crohn disease, Cushing ulcers, Dieulafoy's lesion, Duodenal ulcer, Eosinophilic gastroenteritis, Gastric ulcer, Oesophagitis, Zollinger-Ellison syndrome, Carcinoid tumours and carcinoid syndrome, Stomach cancer, Curling ulcers
Genetic Zollinger -Ellison syndrome associated with MEN TYPE 1 syndrome caused by mutation in MEN gene present on chromosome 11q 13
Hematologic Mastocytosis, Polycythaemia rubra vera, Primary thrombocythemia
Iatrogenic Mechanical ventilation
Infectious Disease Helicobacter pylori
Musculoskeletal / Ortho No underlying causes
Neurologic Cushing ulcers
Nutritional / Metabolic Hypercalcaemia
Obstetric/Gynecologic No underlying causes
Oncologic Carcinoid tumours and carcinoid syndrome, Stomach cancer, Zollinger-Ellison syndrome , gastrinomas
Opthalmologic No underlying causes
Overdose / Toxicity Aceclofenac, Acemetacin, Alendronate, Aspirin, Azapropazone, Benoxaprofen, Bisphosphonates, Celecoxib, Clopidogrel, Diclofenac, Diflunisal, Ethanol, Etodolac, Etoricoxib, Fenbufen, Fenoprofen, Flurbiprofen, Glucocorticoids, Ibuprofen, Indomethacin, Ketoprofen, Laxative abuse, Mefenamic acid, Meloxicam, Nabumetone, Naproxen, Non steroidal anti-inflammatory drugs, Para-amino salicylic acid, Phenylbutazone, Piroxicam, Prednisolone, Rofecoxib, Sulindac, Tacrolimus, Tenoxicam, Tiaprofenic acid, Tolazoline, Trimetrexate
Psychiatric Curling ulcers
Pulmonary Sarcoidosis
Renal / Electrolyte Hypercalcemia
Rheum / Immune / Allergy Fibromyalgia[6]
Sexual No underlying causes
Trauma Burns
Urologic No underlying causes
Dental No underlying causes
Miscellaneous Alcohol, Caffeine, Smoking

Causes in Alphabetical Order


  1. Malfertheiner P, Chan FK, McColl KE (2009). "Peptic ulcer disease". Lancet. 374 (9699): 1449–61. doi:10.1016/S0140-6736(09)60938-7. PMID 19683340.
  2. Hirschowitz BI, Lanas A (2002). "Atypical and aggressive upper gastrointestinal ulceration associated with aspirin abuse". J. Clin. Gastroenterol. 34 (5): 523–8. PMID 11960062.
  3. Dovjak P (2017). "[Duodenal ulcers, gastric ulcers and Helicobacter pylori]". Z Gerontol Geriatr (in German). 50 (2): 159–169. doi:10.1007/s00391-017-1190-x. PMID 28150170.
  4. Jensen RT, Niederle B, Mitry E, Ramage JK, Steinmuller T, Lewington V; et al. (2006). "Gastrinoma (duodenal and pancreatic)". Neuroendocrinology. 84 (3): 173–82. doi:10.1159/000098009. PMID 17312377.
  5. Kutlubay Z, Zara T, Engin B, Serdaroğlu S, Tüzün Y, Yilmaz E; et al. (2014). "Helicobacter pylori infection and skin disorders". Hong Kong Med J. 20 (4): 317–24. doi:10.12809/hkmj134174. PMID 25045884.