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Despite long-standing beliefs linking stress to stomach ulcers, experts assert that the relationship is not straightforward.

Dr. Tonya Adams, a gastroenterologist at Gastro Health in Fairfax, Va., clarified that while critically ill patients in intensive care units can develop stress ulcers due to extreme physical stress, there is a lack of evidence supporting the notion that everyday psychological stress directly causes ulcers in general.

Peptic ulcers, which result from stomach acid eroding the gastrointestinal lining, can manifest in various forms, including gastric ulcers in the stomach lining, noted Dr. Carolyn Newberry, a gastroenterologist at NewYork-Presbyterian.

According to The New York Times, research shows that 5 to 10% of people worldwide may develop ulcers, often presenting with symptoms like upper abdominal pain, heartburn, or bleeding. In severe cases, ulcers can also lead to bleeding, characterized by dark, tar-like stools or stools tinged with bright red blood.

Dr. Neha Mathur, a gastroenterologist at Houston Methodist Hospital, suggested that stress could potentially contribute to ulcer development, citing its established link to various gastrointestinal disorders such as irritable bowel syndrome, severe acid reflux, and inflammatory bowel disease. Studies have shown conflicting results, with some suggesting a correlation between stress and ulcer development, while others do not.

The role of stress in ulcer causation remains ambiguous, as conflicting study results demonstrate. For instance, a 2015 study involving 3,400 adults in Denmark indicated that individuals reporting high stress levels had 2.2 times higher odds of developing ulcers over an 11 to 12-year period compared to those reporting low stress levels.

However, researchers noted that about one-third of this increased risk may be attributed not to direct stress effects but rather to behavioral responses to stress, such as smoking or excessive alcohol consumption, which independently elevate ulcer risk.

Conversely, a study analyzing medical records of nearly 24,000 adults in South Korea who underwent endoscopy for ulcer diagnosis found that while stress was linked to higher risks of various gastrointestinal conditions, it did not correlate specifically with ulcers.

Dr. Newberry suggested that while stress may play a role in ulcer development, individuals under stress may not necessarily develop ulcers unless other risk factors are present.

Known causes of ulcers include infection with Helicobacter pylori bacteria, chronic use of NSAIDs like ibuprofen or aspirin, smoking, excessive alcohol consumption, and rare conditions like Zollinger-Ellison syndrome, Dr. Adams stated.

Treatment depends on identifying the cause; antibiotics are prescribed for bacterial infections, while lifestyle changes and antacids help manage symptoms from other causes.

Dr. Mathur emphasized the importance of stopping or reducing NSAID use in cases involving such medications, underscoring the need for follow-up endoscopies to ensure the effectiveness of treatment.