Which of the following is NOT a cause of peptic ulcer disease?

Peptic ulcer disease is primarily caused by factors that increase stomach acid or decrease the protective lining of the stomach and duodenum. The correct choice indicates a factor that is generally not considered a direct cause of peptic ulcers.

NSAIDs (non-steroidal anti-inflammatory drugs) and pyloric infections, particularly those caused by Helicobacter pylori, are well-established causes of peptic ulcers. NSAIDs can irritate the stomach lining and reduce the secretion of protective mucus, while H. pylori infections lead to inflammation and damage to the gastric mucosa.

Smoking is also recognized as a risk factor that can exacerbate ulcer formation, as it impairs healing and may increase gastric acid production.

Dietary changes, while they may influence overall gastrointestinal health or exacerbate symptoms for some individuals, have not been definitively shown to directly cause peptic ulcer disease. Therefore, this option is correct as it is not a recognized primary cause of ulcers, aligning with the understanding that ulcers are more closely linked to medications, infections, and lifestyle factors like smoking rather than specific dietary changes.