A peptic ulcer is a spot where the lining of the stomach and the tissues beneath — and sometimes part of the stomach muscle itself — have been eroded, leaving an open wound inside the stomach. The surrounding tissue is usually swollen and irritated. Ulcers can occur anywhere along the gastrointestinal tract, but are most common in the stomach (gastric ulcers) and duodenum (duodenal ulcers). The symptoms of a peptic ulcer include chronic burning stomach pain that usually begins forty-five to sixty minutes after eating or at night, and that is relieved by eating, taking antacids, vomiting, or drinking a large glass of water. The pain may range from mild to severe. It may cause the individual to awaken in the middle of the night. Other possible symptoms include lower back pain, headaches, a choking sensation, itchiness, and possibly nausea and vomiting. an ulcer results when the lining of the stomach fails to provide adequate protection against the effect of digestive acids, and the acids in effect start to digest the stomach itself. an excess of stomach acid, insufficient production of protective mucus, or both may cause this. many factors affect the secretion of stomach acid. Stress and anxiety cause an increase in acid production, which is why ulcers are so closely related to stress levels. certain drugs and supplements may also increase acid production. taking aspirin and nonsteroidal anti-inflammatory drugs, especially over a long period of time, can increase stomach acidity and lead to ulcers. Steroids, such as those taken for arthritis, and even vitamin C supplements can contribute to stomach ulcers. Heavy smokers are more prone to developing ulcers, and have greater trouble getting ulcers to heal. although ulcers have long been known to be related to stress, recent evidence has also implicated a common type of bacteria, Helicobacter pylori. this organism is always found in persons who have ulcers and is seldom found in persons who do not.What are the risks? most ulcers can be cured without further complications. However, in some cases, peptic ulcers can develop potentially life-threatening complications such as penetration, perforation, bleeding, and obstruction. Penetration: an ulcer can go through the wall of the stomach or duodenum and continue into an adjacent solid organ, such as the liver or pancreas. Perforation:  ulcers on the front surface of the duodenum, or less commonly the stomach, can go through the wall, creating an opening to the free space in the abdomen. Bleeding (Hemorrhage): a common complication of ulcers even when they aren’t painful. Vomiting bright red blood or reddish brown clumps of partially digested blood that look like coffee grounds and passing black or obviously bloody stools can be symptoms of bleeding ulcers. Obstruction:  swelling of inflamed tissues around an ulcer or scarring from previous ulcer flare-ups can narrow the outlet from the stomach or narrow the duodenum. a person with this type of obstruction may vomit repeatedly.  a feeling of being unusually full after eating, bloating, and a lack of appetite are frequent symptoms of obstruction.Treatment one aspect of treating duodenal or gastric ulcers is neutralizing or decreasing stomach acidity. this process begins with eliminating possible stomach irritants, such as nonsteroidal anti-inflammatory drugs, alcohol, and nicotine. Antacids relieve symptoms, promote healing, and decrease the number of recurrences of ulcers. Antibiotics are being used when the bacterium Helicobacter pylori is the major underlying  cause of ulcers. Surgery for ulcers is seldom needed because drug therapy is so effective. Surgery is used primarily to deal with complications of a peptic ulcer such as perforation, an obstruction that fails to respond to drug therapy or that recurs, two or more major episodes of bleeding ulcers, a gastric ulcer suspected of being cancerous, or severe and frequent recurrences of peptic ulcers.Recommendations: Eat plenty of dark green leafy vegetables. do not smoke do not consume coffee (even decaffeinated) or alcohol beverages. Eat frequent small meals Avoid fried foods, tea, caffeine, salt, chocolate, strong spices, animal fats of any kind, and carbonated drinks. do not drink cow’s milk. Avoid painkillers such as aspirin. try to avoid stressful situation.