A defect in the gastric and/or duodenal mucosa with a diameter of at least 0.5cm and a depth that penetrates the muscularis mucosa. Can be acute or chronic. Can co-exist, but commonly duodenum > gastric ulcers.

• Gastric Ulcer: typically located along the lesser curvature of the stomach within the antrum or in-between the body and antrum.
• Duodenal Ulcer: typically located in the first part of the duodenum on the anterior or posterior wall.

Demographics

• Male > Female (2:1).
• 18 – 30 yrs increasing with age
• incidence decreasing in high SES countries (i.e. due to H. pylori eradication therapy), more common in low and middle SES countries.

Aetiology:

• most commonly Helicobacter pylori infection or nonsteroidal anti-inflammatory drug (NSAID) use.

  • Helicobacter pylori reside in mucous layer on surface of epithelial cells

    Helicobacter infection

• Rare causes include Zollinger-Ellison syndrome, Crohn disease and viruses.

Risk factors

• Hyperacidity
• Chronic NSAIDs/aspirin (Gastric)
• family Hx
• steroids
• smoking, Alcohol
• caffeine