What is the primary risk factor for developing a duodenal ulcer?

Chronic NSAID use is recognized as the primary risk factor for developing a duodenal ulcer. Non-steroidal anti-inflammatory drugs (NSAIDs) can disrupt the protective mucosal barrier of the gastrointestinal tract by inhibiting the production of prostaglandins, which are crucial for maintaining the mucosal lining. This disruption makes the mucosa more susceptible to injury from gastric acid, thereby facilitating the development of ulcers.

While smoking is known to contribute to ulcer formation and can increase the risk of complications in individuals with existing ulcers, it does not have the same direct, well-established link to duodenal ulcers as NSAIDs. Similarly, a high-fat diet and low fiber intake have been studied in relation to gastrointestinal health but are not considered primary risk factors for duodenal ulcers specifically. Chronic NSAID use stands out as the most significant risk in the context of the diseases affecting the duodenum.