The incidence and mortality of peptic ulcer rose markedly during the 19th century,1 peaking in the generation born at the end of the century, and then steadily decreasing. In recent decades, the main ulcer aetiology has shifted in many countries from Helicobacter pylori to non-steroidal anti-inflammatory drugs (NSAIDs), including aspirin. Use of other drugs such as steroids, aldosterone antagonists, and selective serotonin reuptake inhibitors can contribute to gastroduodenal ulceration and its complications.2 This combination of factors explains why upper gastrointestinal bleeding remains the most common gastrointestinal emergency globally. [...]

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Journal The Lancet Gastroenterology and Hepatology
Kuipers, E.J. (2018). PPIs for prevention and treatment of peptic ulcer. The Lancet Gastroenterology and Hepatology (Vol. 3, pp. 214–215). doi:10.1016/S2468-1253(18)30047-5