What Happens

Many people who have peptic ulcers may not see a doctor when their symptoms begin. Their symptoms, such as belly pain, may come and go. Even without treatment, some ulcers will heal by themselves.

And even with treatment, ulcers sometimes come back. Certain factors such as cigarette smoking and continued use of nonsteroidal anti-inflammatory drugs (NSAIDs) increase the risk of ulcers coming back.

Sometimes ulcers can cause complications, such as bleeding, perforation, penetration, or obstruction. That's why it's important to treat an ulcer, even if you have one that isn't causing any symptoms.

Most peptic ulcers without complications heal, regardless of the cause. But an ulcer is likely to come back if you have an H. pylori infection that is not successfully treated. Recurring ulcers caused by reinfection with H. pylori are not common in the United States, except in areas that are overcrowded or have poor sanitation.

Ulcers in the stomach (gastric ulcers) often heal more slowly than ulcers in the upper small intestine (duodenal ulcers).

What Increases Your Risk

Risk factors you can control

The following things can increase your chance of getting a peptic ulcer and may slow the healing of an ulcer you already have:

• Taking nonsteroidal anti-inflammatory drugs (NSAIDs) (such as aspirin).
• Smoking.
• Drinking too much alcohol.

In the past, spicy foods, caffeine, and moderate amounts of alcohol were thought to increase ulcer risk. This is no longer believed to be true.

Risk factors you cannot control

Some things that you cannot control may increase your risk of getting an ulcer. These include:

• A Helicobacter pylori (H. pylori) infection, the most common cause of ulcers.
• Physical stress caused by a serious illness or injury (such as a major trauma, surgery, or the need to be on a ventilator to assist breathing).
• Hypersecretory condition, in which your stomach produces too much acid.
• A personal or family history of ulcers.