Narrative reviewindependent cross-checkabstract checked I-SOD-110 standard review
Ulcers are mainly caused by H. pylori and painkillers
Peptic ulcer disease.
Overview
Lanas A, Chan FKL. Lancet 2017 · PMID 28242110 · DOI 10.1016/S0140-6736(16)32404-7
A Lancet review describes Helicobacter pylori infection and anti-inflammatory painkillers as the central causes of stomach and duodenal ulcers.
Does the study support the specific claim? No · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Review causes and treatment of peptic ulcers.
- How was the study done?
Expert narrative review.
- How many people, animals or samples were studied?
Not applicable.
- What was actually found?
Ulcers are mainly linked to H. pylori and NSAIDs.
- How large was the observed effect?
Not applicable.
- What do the results mean in everyday life?
People with ulcer symptoms need testing for H. pylori and a review of painkiller use, not only a drink ban.
- What are the study's limitations?
Narrative review.
- What does it say about Elawady's specific claim?
Contradicts the claim that cola is a main cause of ulcers.
- Do the results apply to Germany and Europe?
Applicable.
- What can explicitly not be concluded from this study?
Does not test soft drinks directly.
Scientific in-depth review
1. Full reference
- Authors
- Lanas A, Chan FKL
- Journal
- Lancet
- Year
- 2017
- Identifier
- PMID 28242110 DOI 10.1016/S0140-6736(16)32404-7
- Verification
- verified – PubMed efetch 2026-10-26 + Crossref 2026-10-26
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
Not stated in abstract record
2. Research question
What are the causes, management and challenges of peptic ulcer disease?
3. Study design and population
- Study design
- Narrative review – Lancet Seminar (narrative review)
- Population
Not applicable
- Country
International
- Period
2017
- Sample size
Not applicable
- Inclusion and exclusion criteria
Not applicable
4. Methods and endpoints
- Exposure / intervention
Helicobacter pylori infection; NSAIDs/antithrombotics
- Comparator
Not applicable
- Endpoints
Peptic ulcer disease and complications
- Statistical methods
Not applicable
5. Actual results
- Results
The declining prevalence of H. pylori infection and use of potent anti-secretory drugs have made peptic ulcer disease less prevalent; management focuses on H. pylori therapy and on ulcers associated with anti-inflammatory analgesics and antithrombotic agents; ulcers not associated with H. pylori or NSAIDs are described as a separate, increasingly challenging group.
- Absolute risks
not applicable
- Authors' conclusion
Overview of pathogenesis and management; H. pylori and NSAIDs are the central aetiological factors addressed.
6. Strengths
- Authoritative Lancet seminar
7. Weaknesses
- Narrative; abstract only reviewed
- Does not address soft drinks explicitly
8. Risk of bias
- Orienting tool
- none applicable
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- not assessable
- Rationale
Narrative review.
9. Assessment of the statistical interpretation
Not applicable.
10. Relevance to the specific claim
Contradicts the claim that soft drinks (Pepsi) are among the main causes of gastritis and ulcers: the established main causes are H. pylori infection and NSAIDs.
11. Independent contrary findings
No study linking soft drinks to peptic ulcer was found in searches (see the project's research log).
12. Transferability to Germany and Europe
Applicable; H. pylori prevalence is higher in Egypt than in Northern Europe, which strengthens the point for Egypt.
13. Overall methodological judgement
Supports the established aetiology of ulcers; no role for soft drinks is described.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | not assessable |
| Precision of results | not applicable |
| Directness | indirect |
| Reproducibility | replicated |
| Consistency with the overall evidence | consistent |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
None for the claim.
15. Linked fact checks
- Soft drinks wreck digestion, trigger reflux and heartburn, disturb the stomach's acidity, and (Pepsi) are among the main causes of gastritis and ulcers. – Studies contradicting or limiting the claim