Peptic and duodenal ulcers are lesions of the mucos al lining which penetrate the muscularis mucosae of the stomach or duodenum, known as gastric ulcers (GU) and duodenal ulcers (DU), respectively. Ulcers may also affect the distal oesophagus as a result of chronic gastrointestinal reflux. Duodenal ulcers are the most common. Other underlying driver
s of digestive ulceration and/or inflammation include autoimmunity, anxiety and/or stress and environmental irritants, such as cigarette smoking.

Aetiology /Major causative factors and risk factors that can contribute to the incidence of peptic or duodenal ulcers include:
• Helicobacter pylori infection
• Smoking
• Alcohol consumption
• Caffeine consumption
• Food allergy
• Antacid abuse
• NSAID use
• Stress, anxiety and other psychological factors
• Overwork syndrome
• Repressed emotions
• Inability to effectively communicate feelings – especially anger
• Age (elderly)
• Genetics or higher rate of familial H.pylori infection
• Acute stress in life-threatening and surgical emergencies can cause ulcers

Signs and Symptoms:
Common signs and symptoms of peptic ulcers include the following:
• Epigastric pain (often burning or gnawing) occurs after eating and lasts from one to three hours; relieved by milk and antacids; episodic with period s of remission.
• Duodenal ulcers are classically relieved by food, while gastric ulcers are exacerbated by it
• Nausea
• Dyspepsia, bloating, belching
• Vomiting
• Epigastric tenderness
• Increased pain, vomiting of blood, tarry or red stools, and significant weight loss are indications of perforation, gastric outlet obstruction, or haemorrhaging.