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Researchers recognize three major causes of peptic ulcer disease: infection with Helicobacter pylori (formerly known as Campylobacter pylori), use of NSAIDs, and pathologic hypersecretory disorders such as Zollinger-Ellison syndrome. (See How peptic ulcers develop.)
How H. pylori produces an ulcer isn’t clear. Gastric acid, which was considered a primary cause, now appears mainly to contribute to the consequences of infection. Ongoing studies should soon unveil the full mechanism of ulcer formation.
Salicylates and other NSAIDs encourage ulcer formation by inhibiting the secretion of prostaglandins (the substances that suppress ulceration). Certain illnesses, such as pancreatitis, hepatic disease, Crohn’s disease, preexisting gastritis, and Zollinger-Ellison syndrome, are also known causes.
Besides peptic ulcer’s main causes, several predisposing factors are acknowledged. They include blood type (gastric ulcers tend to strike people with type A blood; duodenal ulcers tend to afflict people with type O blood) and other genetic factors. Exposure to irritants, such as alcohol, coffee, and tobacco, may contribute by accelerating gastric acid emptying and promoting mucosal breakdown. Ulceration occurs when the acid secretion exceeds the buffering factors. Physical trauma, emotional stress, and normal aging are additional predisposing conditions.
In the United States, about 1.6 million people acquire peptic ulcers yearly. Males and females are affected equally, and incidence increases with age. A higher percentage of H. pylori infection occurs in people older than age 50.
Source: Professional Guide to Diseases (Eighth Edition), 2005
The term 'prevalence' of Helicobacter pylori bacteria usually refers to the estimated population of people who are managing Helicobacter pylori bacteria at any given time. The term 'incidence' of Helicobacter pylori bacteria refers to the annual diagnosis rate, or the number of new cases of Helicobacter pylori bacteria diagnosed each year. Hence, these two statistics types can differ: a short-lived disease like flu can have high annual incidence but low prevalence, but a life-long disease like diabetes has a low annual incidence but high prevalence. For more information see about prevalence and incidence statistics.
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