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Causes of gastric and duodenal ulcers
Medical expert of the article
Last reviewed: 04.07.2025
Causes of development of gastric and duodenal ulcers
- presence of Helicobacter pylori;
- increased secretion of gastric juice and decreased activity of protective factors of the mucous membrane (mucoproteins, bicarbonates).
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Causes of ulcer formation
The destruction of a section of the mucous membrane and the formation of an ulcer occur due to an imbalance between the factors of aggression and defense.
The main factors of aggression are:
- hydrochloric acid
- pepsin is a digestive enzyme capable of digesting proteins. In addition, aggressive factors include:
- reflux of bile into the stomach (bile destroys protective mucus)
- disorder of evacuation of gastric contents into the duodenum (both delay and acceleration) due to impaired motor function of the stomach
- traumatic effect of food.
Protective factors include:
- insoluble gastric mucus
- the mucous membrane itself, which has a high capacity for restoration
- good blood supply to the mucous membrane, as well as bicarbonates produced by the pancreas.
The most important role in the development of peptic ulcer disease belongs to the microorganisms Helicobacter pylori (pyloric helicobacteria), discovered at the end of the 20th century, which reduce the protective properties of the mucous membrane and increase the aggression of gastric juice. Helicobacter pylori is detected in 90% of patients with duodenal ulcers and in 85% of patients with gastric ulcers. The opinions of practicing doctors and scientists about the role of Helicobacter pylori in the development of peptic ulcer disease are ambiguous: at present, it is generally accepted that the disease can be either associated with Helicobacter pylori or not associated (not associated) with this microorganism.
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Risk factors for gastric and duodenal ulcers
- taking NSAIDs;
- neuropsychic factor, primarily stress;
- hereditary and constitutional predisposition (in people with the first blood group - 0 (I) - the probability of developing an ulcer is 30-40% higher);
- male gender;
- the presence of bad habits (smoking, alcohol abuse, strong natural coffee);
- improper nutrition: eating dry food, hasty consumption of food, poor chewing of food, excessively coarse and spicy food, irregular meals, deficiency of proteins and vitamins in food;
- the presence of peptic ulcer disease in close relatives.
It is necessary to differentiate gastric and duodenal ulcers from symptomatic ulcers that occur within the context of gastropathy induced by NSAID use.
Risk factors for ulcer formation while taking NSAIDs
- age over 65 years;
- history of peptic ulcer disease and its complications, primarily bleeding;
- the need to use high doses of NSAIDs;
- the need for concomitant use of glucocorticoids;
- history of coronary heart disease;
- concomitant administration of anticoagulants.