After reinforcing teaching on peptic ulcer disease, the nurse evaluates the patient as understanding the education if the patient states which of the following is a primary cause of peptic ulcer disease?

D. Duodenal ulcers are peptic ulcers that develop in the first part of the small intestine, known as the duodenum. They are the most common type of peptic ulcer. The classic symptom of a duodenal ulcer is intermittent upper abdominal pain that occurs about 2 to 3 hours after eating, particularly meals that contain acidic or spicy foods. The pain often wakes the patient from sleep and is relieved by eating or taking antacids.
A. Decubitus ulcers, also known as pressure ulcers or bedsores, are caused by prolonged pressure on the skin, typically over bony prominences. They occur due to impaired blood flow and tissue damage, often in individuals who are bedridden or immobile.
B. Gastric ulcers are peptic ulcers that develop in the lining of the stomach. While gastric ulcers can cause upper abdominal pain, they typically occur shortly after eating or during meals, rather than 3 hours after eating or at night.
C. Esophageal ulcers are peptic ulcers that develop in the lining of the esophagus. They are relatively rare compared to gastric and duodenal ulcers. Esophageal ulcers can cause symptoms such as chest pain, difficulty swallowing, and heartburn, but they are not typically associated with the timing of symptoms described by the client.

D. The primary cause of peptic ulcer disease is infection with Helicobacter pylori (H. pylori) bacteria. H. pylori infection is associated with the majority of peptic ulcers, particularly those in the stomach. This bacterium weakens the protective mucous lining of the stomach and duodenum, allowing stomach acid to damage the underlying tissue and form ulcers.

A. Spicy foods can exacerbate symptoms in some individuals with peptic ulcer disease but they are not a primary cause of the condition. Spicy foods can irritate the lining of the stomach or duodenum, potentially worsening symptoms, but they do not directly cause ulcers.
B. Stress was once thought to be a major factor in the development of peptic ulcers, but research has shown that while stress may aggravate symptoms, it is not a primary cause of peptic ulcer disease.
C. Excessive caffeine intake was also previously believed to be a major cause of peptic ulcer disease, but this is not entirely accurate. While caffeine can stimulate gastric acid secretion, leading to increased acidity in the stomach, it is not a primary cause of peptic ulcers.