Peptic ulcer disease occurs when acid and pepsin in the stomach and duodenum damage the protective mucosal layer of the gastrointestinal tract, resulting in sores or ulcers. It is caused by an imbalance between acid secretion and mucosal defenses. Factors like smoking, alcohol, NSAIDs, and H. pylori infection can exacerbate peptic ulcers. Patients experience epigastric pain that may radiate to the back and is relieved by eating. Treatment involves eradicating H. pylori with antibiotic therapy, reducing acid with PPIs or H2 blockers, lifestyle changes, and sometimes surgery for complications like bleeding or perforation.