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Can stress give you a stomach ulcer?

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Stress shoulders a lot of blame for health issues like high blood pressure, fatigue and depression — and rightly so. But when it comes to causing stomach ulcers, it gets a bit of a bad rap.

The main triggers for stomach ulcers, also known as peptic ulcers or gastric ulcers, are:

H. pylori infection caused by a common gut bacteria.
Overuse of over-the-counter pain relief medication known as NSAIDs, short for nonsteroidal anti-inflammatory drugs.

Now, that doesn’t mean stress is off the hook completely. While it might not be the main culprit behind stomach ulcers, it definitely qualifies as an accomplice. Gastroenterologist Christine Lee, MD, explains.

Does stress cause ulcers?

Research shows that there’s a relationship between stress and ulcers. But does stress actually cause ulcers? That’s where things get complicated.

From numerous studies, it’s pretty clear that stress often serves as a backdrop to stomach ulcers, explains Dr. Lee. People diagnosed with this stomach condition often report high levels of stress in their daily lives.

Your body’s natural response to stress also increases stomach acid, a source of ulcers.

But people under stress tend to use more NSAIDs to address aches and pains that develop. Stressors also can prompt more alcohol and tobacco use, factors known to fuel and worsen ulcer development, Dr. Lee notes.

Stress-stoking surgeries and illness have been connected to the development of stomach ulcers, too. (Plus, let’s be honest: The burning feeling in your gut that comes from an ulcer can amp up perceived stress levels!)

So, it becomes a question of which comes first, stress or the ulcer?

“Basically, it’s a chicken-or-the-egg sort of argument,” says Dr. Lee. “There’s a lot of conflicting research and debate on the topic. Most, though, view stress as something that does not cause stomach ulcers on its own.”

So, what causes ulcers?

A lining in your stomach protects it against the caustic acids and enzymes inside of your gut. Ulcers develop when that lining breaks down and allows those internal juices to eat away at your stomach wall.

But what’s powerful enough to undermine that tough lining? Let’s look at the two main sources.

H. pylori infection

Between 50% and 75% of the world’s population has H. pylori bacteria in their belly. For most, it’s not a problem. Sometimes, though, this bacteria multiplies to the point where your immune system can’t keep it in check.

This bacteria overgrowth may eventually work around your stomach’s immune system and damage your stomach walls, leading to ulcers. About 40% of stomach ulcers are linked to H. pylori.

NSAIDs

Taking an over-the-counter (OTC) pain pill is often shrugged off as no big deal in today’s world. But here’s the thing: The medications are powerful, and sending too many pills into your belly can cause problems.

The medication can irritate your stomach lining and even block your body’s natural ability to repair the damage. About 50% of stomach ulcers are caused by NSAID overuse.

The medication can decrease the production of a hormone called prostaglandin, which can decrease the thickness of your stomach lining or impair your body’s natural ability to repair stomach lining damage.

Symptoms of a stomach ulcer

Burning discomfort and indigestion are two classic signs of a stomach ulcer. It can be described as an intense sensation that sometimes accompanies gut pain. The discomfort typically grows when you have an empty stomach.

Other common symptoms include:

A bloated stomach
Nausea or vomiting

Does a stomach ulcer go away?

Common ulcers typically heal with medication designed to reduce stomach acid and put a protective coating over the ulcer. If an H. pylori infection is involved, antibiotics may be prescribed to kill the bacteria.

You’ll need to avoid irritating the ulcer, too, which means avoiding NSAIDs, alcohol and smoking during recovery. Limiting their use afterwards could help you avoid future issues, as well.

Managing stress

While stress may not cause a stomach ulcer, it certainly doesn’t help it, says Dr. Lee. Learning how to better handle stressors in your life can help you be a healthier, happier and more productive person.