Peptic ulcer causes

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

Overview

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.

Causes

Common Causes

• Helicobacter pylori
• NSAIDs

Less common causes

• Hormonal or mediator-induced including secondary acid hypersecretory states
  • Gastrinomas
  • Systemic mastocytosis
  • Carcinoid syndrome
  • Myeloproliferative disorder
• Antral G-cell hyperfunction
• Post-surgical antral exclusion and post gastric bypass surgery
• Cancers and lymphomas
• Cameron ulcer (gastric ulcer where a hiatus hernia passes through the diaphragmatic hiatus)
• True idiopathic ulcer

Rare causes of peptic ulcer disease

• Crohn’s disease of the stomach or duodenum
• Eosinophilic gastroduodenitis
• Systemic mastocytosis
• Radiation damage
• Viral infections (eg cytomegalovirus or herpes simplex infection, in particular in immunocompromised patients)
• Colonization of stomach with H heilmanii
• Severe systemic disease

Genetic causes

• Peptic ulcer disease caused by gastrinomas (Zollinger-Ellison syndrome) caused by a mutation in MEN gene present on chromosome 11q13

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
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
Sexual	No underlying causes
Trauma	Burns
Urologic	No underlying causes
Dental	No underlying causes
Miscellaneous	Alcohol, Caffeine, Smoking

Causes in Alphabetical Order

Aceclofenac Acemetacin Alcohol Alendronate Artemether and lumefantrin Aspirin Azapropazone Benoxaprofen Bisphosphonates Burns Caffeine Carcinoid tumours and carcinoid syndrome Celecoxib Clopidogrel Crohn disease Curling ulcers Cushing syndrome Cushing ulcers Dexamethasone Diclofenac Dieulafoy's lesion Diflunisal Duodenal ulcer Eosinophilic gastroenteritis Ethanol Etodolac Etoricoxib Fenbufen Fenoprofen Flurbiprofen Gastric ulcer Glucocorticoids Helicobacter pylori

Hypercalcaemia Ibuprofen Indomethacin Ketoprofen Laxative abuse Mastocytosis Mechanical ventilation Mefenamic acid Meloxicam Multiple endocrine neoplasia type 1 Nabumetone Naproxen Niacin Non steroidal anti-inflammatory drugs Oesophagitis Para-amino salicylic acid Pergolide Phenylbutazone Piroxicam Polycythaemia rubra vera Prednisolone Primary thrombocythemia Rofecoxib Smoking Stomach cancer Sulindac Tacrolimus Tenoxicam Tiaprofenic acid Tolazoline Trimetrexate Zollinger-Ellison syndrome