Peptic ulcer disease refers to a condition in which open sores or ulcers develop in the inside layer of the stomach, the upper portion of the small intestine (duodenum) or the esophagus (food pipe). Stress and diet are no longer believed to cause the ulcers. Between 80-90% of peptic ulcers are caused by the bacteria, Helicobacter pylori (H.pylori). Another contributing factor is the presence of high levels of certain stomach acids (pepsin and hydrochloric acid, both normally produced by our digestive system to help break down foods). Cigarette smoking, caffeine and certain genetic conditions may increase stomach acid levels. Peptic ulcers may also be caused by certain anti-inflammatory pain medications such as ibuprofen, aspirin and naproxen (Aleve). Symptoms of peptic ulcers include abdominal pain, bloating, nausea and vomiting, loss of appetite and weight, feeling tired, and dark or black stool (caused by bleeding). Peptic ulcers are diagnosed through special tests such as an upper GI or an endoscopy. H. pylori infection may be confirmed through a breath test, blood test or from a tissue sample gathered during an endoscopy. In many cases peptic ulcers will heal on their own or with over the counter medications, but they may return. Symptoms of peptic ulcers should not be ignored. Untreated ulcers may lead to more serious health problems which could be life threatening such as severe anemia (due to blood loss) or peritonitis (which occurs when the ulcer eats a hole through the stomach and allows digested food and stomach acids to enter the abdomen). Medications are available to help block the production of stomach acid and protect the stomach lining. Antibiotics can treat an H. pylori infection. Surgery may be required if medications do not work or due to certain complications. Talk with your doctor if you or your child has been diagnosed with peptic ulcer disease to decide on the best treatment plan.