Cause	Comments
Common
Helicobacter pylori infection	Gram-negative, motile spiral rod found in 48 percent of patients with peptic ulcer disease4
NSAIDs	5 to 20 percent of patients who use NSAIDs over long periods develop peptic ulcer disease
	NSAID-induced ulcers and complications are more common in older patients, patients with a history of ulcer or gastrointestinal bleeding, those who use steroids or anticoagulants, and those with major organ impairment
Other medications	Steroids, bisphosphonates, potassium chloride, chemotherapeutic agents (e.g., intravenous fluorouracil)
Rare
Acid-hypersecretory states (e.g., Zollinger- Ellison syndrome)	Multiple gastroduodenal, jejunal, or esophageal ulcers
Malignancy	Gastric cancer, lymphomas, lung cancers
Stress	After acute illness, multiorgan failure, ventilator support, extensive burns (Curling's ulcer), or head injury (Cushing's ulcer)