Peptic ulcer disease is the condition in which an ulceration of stomach or duodenum occurs. It can be caused by H.pylori bacterial infection (80% of the time), drug induced such as NSAIDs or steroids, smoking, alcohol intake, stress ,Cushing ulcers, Curling’s ulcer, Zollinger Elison tumors increased enzyme released , post small bowel resection (no neutralization of acid done) and abnormal gastric emptying. It presents as heartburn, dyspepsia, pain, hematemesis, melena or perforation.