Can stress cause stomach ulcers? Get the facts from a gastroenterologist

Digestive

by Muhannad Al Hanayneh, MD

Oct 10, 2023

If you’re one of the 4 million Americans who has experienced a stomach ulcer, you know how painful and disruptive they can be to your daily life. Many people believe that stress causes their ulcers, but this isn’t the case.

So what does cause ulcers and how can they be treated? And when should you speak to your primary care provider about digestive issues?

Common causes of stomach ulcers

The term “ulcer” is used to describe an interruption or break in any lining of the body. Stomach ulcers fall under the umbrella of gastrointestinal ulcers, which can be found in the esophagus, the stomach, the small intestine and the colon.

One of the most common reasons for stomach ulcers is over-the-counter medications called non-steroidal anti-inflammatory medications (NSAIDs) such as ibuprofen and naproxen. You may think these medications are safe to take every day, but they can have serious side effects, including ulcers. That’s why healthcare providers recommend that they shouldn’t be taken for longer than two weeks.

Another common cause of ulcers is infection by a bacterium called H. pylori. It can damage the protective lining of the stomach, allowing stomach acid to create an ulcer. It’s difficult to prevent infections by H. pylori, which is believed to spread through person-to-person contact or contaminated food and water. But while many people have H. pylori in their bodies, multiple studies have found that only about 10-15% will develop ulcers.

Don't ignore the symptoms

So is there a link between stress and ulcers? It’s widely known that stress can take a toll on our bodies. But ultimately, stress and long-term anxiety cannot cause stomach ulcers. However, they can impact your body’s healing process. Chronic stress can weaken your immune system and slows down your ability to fight infections and illnesses and could make you more prone to developing an ulcer.

Another common misconception about stomach ulcers is that if left alone, they will heal by themselves. However, the symptoms of stomach ulcers can be severe and shouldn’t be ignored or left untreated.

See your doctor if you have:

  • Nagging stomach pain that doesn’t resolve itself
  • Pain that increases after eating
  • Black-colored stool, which could be a sign of bleeding from the stomach

Ulcers often get progressively worse and can even cause internal bleeding, leading to anemia, vomiting blood or blood in the stool.

Your doctor will diagnose an ulcer by doing an upper endoscopy, which uses a thin, flexible tube with a light and a camera at its tip (called an endoscope) to examine your internal organs while you are asleep.

During the procedure, your doctor will look at the inner lining of the stomach to see the size and shape of the ulcer and take biopsies to look for bacteria or cancerous cells.

Early intervention matters

If ulcers are left untreated, they can continue to damage your stomach and cause a perforation (or hole) in the lining.

Ulcers are usually just found in the innermost layer of the gastrointestinal system, which we call the mucosa. However, when it starts eroding deeper, it can create a hole in the entire wall of the stomach. This will need emergency surgery to fix.

Most often, stomach ulcers can be cured with medications. Lifestyle and behavior also impact the treatment options and recovery time for ulcers. For example, smoking can delay the healing process as the toxic fumes from cigarettes travel down to the stomach, aggravating the ulcer.

However, there are rarer causes of stomach ulcers that can lead to reoccurring problems. This can occur, for example, if your stomach produces too much acid or if you’re living with a chronic digestive condition like Crohn’s disease. But for the most common types of ulcers, adjusting your lifestyle and treating the infection will heal them.

If you are living with persistent stomach pain or have noticed irregular bleeding, consult a healthcare professional for proper diagnosis and management. Early intervention can help prevent complications and get you back on track to healthy living.

Concerned about your risk for ulcers and other digestive disorders? Take our assessment or book an appointment with a gastroenterologist near you.

About the Author

Dr. Al Hanayneh is a gastroenterologist on the medical staff at Baylor Scott & White Specialty Clinic – Marble Falls. Previously, he was an assistant professor at the University of Texas Branch in Galveston, teaching fellows, residents and students. 

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