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Peptic ulcer disease (PUD) is a break in the inner lining of the stomach, the first part of the small intestine, or sometimes the lower oesophagus. An ulcer in the stomach is called a gastric ulcer, while one in the first part of the intestines is a duodenal ulcer. he most common symptoms of a duodenal ulcer are waking at night with upper abdominal pain and upper abdominal pain that improves with eating. Other symptoms include belching, vomiting, weight loss, or poor appetite. About a third of older people have no symptoms. Complications may include bleeding, perforation, and blockage of the stomach. Bleeding occurs in as many as 15% of cases.
Common causes include the bacteria Helicobacter pylori and nonsteroidal antiinflammatory drugs (NSAIDs). Other, less common causes include tobacco smoking, stress due to serious illness, Behcet disease, ZollingerEllison syndrome, Crohn disease, and liver cirrhosis. Older people are more sensitive to the ulcercausing effects of NSAIDs

A dull or burning pain in your stomach is the most common symptom of a peptic ulcer. You may feel the pain anywhere between your belly button and breastbone. The pain most often
1. happens when your stomach is empty—such as between meals or during the night
2. stops briefly if you eat or if you take antacids
3. lasts for minutes to hours
4. comes and goes for several days, weeks, or months
Less common symptoms may include
1. bloating
2. burping
3. feeling sick to your stomach
4. poor appetite
5. vomiting
6. weight loss

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