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Ulcers in the digestive system can be the result of several different factors:

Peptic ulcers are holes or breaks in the protective lining of the duodenum (the upper part of the small intestine) or the stomach -- areas that come into contact with stomach acids and enzymes. Duodenal ulcers are more common than stomach ulcers.

Comparatively rare are esophageal ulcers, which form in the esophagus (swallowing tube) -- and are often a result of exposure to medications, like certain antibiotics or anti-inflammatories, or alcohol abuse.

While excessive stomach acid secretion certainly plays a role in the development of ulcers, a relatively recent theory holds that bacterial infection is the primary cause of peptic ulcers. Indeed, research conducted since the mid-1980s has shown that the bacterium Helicobacter pylori (H. pylori) is present in more than 90% of duodenal ulcers and about 80% of stomach ulcers. However, more recent figures indicate those percentages are declining.

Other factors also seem to contribute to ulcer formation. Overuse of over-the-counter painkillers (such as aspirin, ibuprofen, and naproxen), heavy alcohol use, psychological stress, and smoking exacerbate and may promote the development of ulcers, especially in someone with H. pylori.

Other studies show that stomach ulcers are more likely to develop in older people. This may be because Arthritis is prevalent in the elderly, and alleviating arthritis pain can mean taking daily doses of aspirin or ibuprofen. Another contributing factor may be that with advancing age the pylorus (the valve between the stomach and duodoneum) relaxes and allows excess bile (a compound produced in the liver to aid in digestion) to seep up into the stomach and erode the stomach lining. Obesity can also put extra pressure on on the pylorus valve and lead to bile squeezing past the valve.

Duodenal ulcers tend to appear in people with type O blood, possibly because they do not produce the substance on the surface of blood cells that may protect the lining of the duodenum.

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