Abstract Peptic Ulcer Disease (PUD) is a common stomach condition where ulcers form in the stomach lining or the upper part of the small intestine. It is mainly caused by a bacteria called Helicobacter pylori (H-pylori). H-pylori infection and long-term use of NSAIDs can cause this condition. This detailed study looks at the causes, symptoms, risks, signs, ways to diagnose, and treatments for PUD. The sickness is characterized by symptoms like pain in the upper abdomen, pain after eating, pain at night, and feeling better after eating or taking antacids. Less common symptoms of stomach ulcers may include anaemia from bleeding in the stomach, weight loss due to loss of appetite, and vomiting from complications like pyloric stenosis. The diagnosis of stomach ulcers often requires endoscopy to directly see and take samples of ulcers to rule out cancer and confirm H. pylori infection. H-pylori infection. Advances in medical tests have made it easier to detect stomach ulcers. Treatment options include medicines like proton pump inhibitors (PPIs) and antibiotics for H. pylori. Treatment for H-pylori infection to eliminate the bacteria and lifestyle changes to prevent ulcers from coming back. Even with these improvements, there are still problems, especially with the increasing levels of bacteria that are resistant to antibiotics. Ulcers caused by H-pylori bacteria and NSAIDs need to be managed. This study shows how important it is to diagnose correctly and treat effectively to avoid problems like bleeding, perforation, and gastric outlet obstruction. Continuous research is important to tackle new problems with antibiotic resistance and to create better ways to manage Peptic Ulcer Disease. This will help lessen its impact on health and healthcare systems worldwide. 1. Introduction Peptic Ulcer Disease (PUD) is a prevalent digestive system issue marked by the formation of open sores on the inner wall of the stomach or the initial section of the small intestine (duodenum). These sores are caused by an unevenness in the aggressive elements such as stomach acid and pepsin, and the body's protective systems like the mucus and bicarbonate barrier. The main causes of PUD are the presence of Helicobacter pylori (H. pylori) infection. H. pylori bacteria) and long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs). It is believed that these factors are responsible for more than 90% of peptic ulcer disease cases worldwide, including H. pylori infection, NSAID use, and smoking. H pylori by itself causes large part (Lanas & Chan, 2017). H pylori infection weakens the protective layer of the stomach by making enzymes and toxins that cause swelling and harm, leaving the stomach lining open to acidic digestive juices (Malfertheiner, Chan, & McColl,2009). NSAIDs prevent the creation of prostaglandins, which are substances that support the protection of the stomach lining. Long-term use of these drugs can weaken the mucosal defence and raise the possibility of developing ulcers (Sung, Kuipers, & El-Serag, 2009). The occurrences decreased in numerous advanced nations because of better cleanliness, widespread use of PPIs, and effective treatment for H. pylori. H. pylori infections. However, it continues to be a major health issue in underdeveloped areas where H. The prevalence of H. pylori is high and people have limited access to healthcare (Sung, Kuipers, & El-Serag, 2009). The chances of developing peptic ulcer in a lifetime is approximately 10%, which means it is one of the most common gastrointestinal diseases globally (Lanas & Chan, 2017). Accurate identification and treatment are important for preventing problems like bleeding, puncture, and blockage in the stomach opening. Advancements in diagnostic equipment, like endoscopy and non-invasive exams for H. pylori, have improved the ability to detect and treat digestive system issues. The discovery and treatment of PUD have greatly improved thanks to the identification of H. pylori (Malfertheiner, Chan, & McColl, 2009). Despite these enhancements, the increasing usage and the expanding issue of antibiotic-resistant H. Different H. pylori types show that more research and new treatment plans are necessary to lessen the impact of the disease. For over 100 years, peptic ulcer disease was mainly treated with surgery, which led to high rates of sickness and death. The successful medical reduction of stomach acid production started with the development of histamine H2-receptor antagonists (H2RAs) in the 1970s, and this led to a significant improvement in patient outcomes. During the 1980s, voluntary surgery for peptic ulcers decreased by 85%, mostly because of the use of the H2RAs cimetidine and ranitidine. (Lanas, A., & Chan, F. K. 2017) The creation of proton-pump inhibitors (PPIs) also enhanced the ability to stop the secretion of stomach acid, and the lack of tachyphylaxis to PPI therapy ensures very high rates of healing for duodenal and gastric ulcers. (Sung, J. J., Kuipers, E. J., & El-Serag, H. B. 2009 It has been over 20 years since the arrival of the ‘H. pylori eradication’ strategy for peptic ulcer disease. After learning a great deal about the "H. pylori era," we have now peaked in our knowledge of peptic ulcer disease, its diagnosis, and its treatment. There are still three main issues that need to be resolved. We must figure out how to get rid of H-pylori (Sung, J. J., Kuipers, E. J., & El-Serag, H. B. 2009 At a time when H. pylori eradication failure rates are increasing, we need to figure out the best strategy to prevent ulcers from forming and returning in NSAID users. The appropriate course of action for non-NSAID users who do not have H. pylori must also be determined. ulcers in the stomach caused by H. pylori. The prevalence of ulcers varies around the world; gastric ulcers are more common in Asia, especially Japan, and duodenal ulcers are more common in Western countries. About one in ten Americans still have peptic ulcer disease, despite the fact that its prevalence has declined in Western nations over the past century. It is estimated that the combined direct and indirect costs of peptic ulcer disease in the United States amount to $3.4 billion annually. The impact of peptic ulcer disease on human health and health economics is expected to be a major problem in the future due to its continued prevalence, particularly among the elderly. (Sung, J. J., Kuipers, E. J., & El-Serag, H. B. (2009).