A peptic ulcer, commonly called an “ulcer,” is a sore in the stomach caused by acid. Although many people believe that stress causes peptic ulcers, research has shown this is not the case. But there’s a catch: if you already have an ulcer, high stress levels can make it worse.

The American College of Gastroenterology states that peptic ulcers are actually caused by two things: bacteria and some medicines.

Helicobacter pylori infection: This bacteria, also called H. pylori, is the most common cause of peptic ulcers. Scientists aren’t sure why some people get infected with this bacteria, but genetics may be partly to blame. If you have symptoms of a peptic ulcer, your doctor may test you for this bacteria. If your test is positive, the infection can be treated with antibiotics and medicines that reduce stomach acid. Once the infection has been treated, your ulcer should go away. If you are prescribed antibiotics, be sure to take the entire course as instructed by your doctor.

Medicines: Long-term use of NSAIDs (non-steroidal anti-inflammatory drugs) can cause peptic ulcers in some people. NSAIDs include pain relievers like aspirin, ibuprofen, and naproxen. Taking these occasionally will not cause an ulcer, but if you take them for a long time or at high doses, you increase your risk.

Know the symptoms

Peptic ulcers often cause burning pain in the stomach or abdominal area. The pain may be worse when you lie down at night or when your stomach is empty. If you have symptoms of an ulcer, your doctor may refer you to a specialist to get further tests done. Proper diagnosis and treatment can usually cure an ulcer.

If you are taking NSAID medicines and are diagnosed with an ulcer, your doctor may talk with you about finding another treatment.

If you have an ulcer, you do not have to follow a bland diet. Spicy or rich foods do not make an ulcer worse. Following a healthy diet, however, can improve your health and will help your ulcer heal as quickly as possible after treatment. Visit choosemyplate.gov for the current Dietary Guidelines for Americans.