Stress shouldn’t be blamed for ulcers


By Rosanne Danielson, MD

Contributing columnist

Those who worry that increased stress in their life may lead to a stomach ulcer need to understand that this long-held notion isn’t true.

Lifestyle choices — such as the food we eat — and increased stress have long been blamed for the development of stomach ulcers, but modern medicine has proven otherwise. Stomach ulcers, also known as peptic ulcers, have two main causes: the overuse of nonsteroidal anti-inflammatory drugs (NAIDs) and an infection from the H. pylori bacteria.

Stomach ulcers are sores on the lining of a person’s stomach that can also be present in the small intestines. Symptoms of a stomach ulcer can vary, and in some cases a person may have a stomach ulcer and never know it. Those who do experience symptoms describe it as a dull or burning pain in their stomach between their breastbone and belly button. The pain is often noticed around mealtimes and can be intense enough to wake someone from their sleep. It can last a few minutes or a couple of hours.

Understanding what causes ulcers can help reduce one’s risk for developing them and also help heal existing ulcers. The National Institutes of Health (NIH) provides a closer look at the two main causes:

The overuse of NSAIDs — These common, over-the-counter medicines include aspirin, ibuprofen and naproxen and are often used to treat fever and pain. These medicines can damage the mucus that protects the lining of the stomach when used in prescription-strength dosage over a prolonged period of time.

There are other factors that can increase a person’s risk of developing a stomach ulcer from the use of NSAIDs. Females are at a higher risk, as well as people over the age of 70, those taking more than two types of NSAIDs, those who have had an ulcer before, those taking medicines such as corticosteroids and those who drink alcohol or smoke.

A H. pylori bacterial infection — Most ulcers are caused by an infection from a bacteria or germ called H. pylori. The bacteria hurts the mucus that protects the lining of the stomach and the first part of the small intestines. Stomach acid is able to damage the stomach once the lining is compromised creating ulcer sores.

About 30 to 40 percent of Americans will get a H. pylori infection. Some will develop it as a child, but not show symptoms until they are an adult. Researchers are not certain how H. pylori is spreads, but unclean food, water and eating utensils are thought to be culprits.

Stomach ulcers can often be healed by removing its cause. Reducing or eliminating the use of NSAIDs and treating the H. pylori infection are the first line of defense. Abstaining from certain foods and limiting alcohol and caffeine may also help. Eliminating tobacco use is also vital.

It’s important that anyone who suspects they are dealing with an ulcer seek a diagnosis from their physician so that its cause can be determined and treated. Sometimes surgery is a type of treatment for those who are not getting relief from any other steps. However, most patients can have relief by making simple changes to their lifestyle or faithfully completing the medication prescribed by their physician.

Rosanne Danielson, MD, is a gastroenterologist with Premier Health Specialists who practices at Premier Gastroenterology Specialists in Troy.

Rosanne Danielson, MD, is a gastroenterologist with Premier Health Specialists who practices at Premier Gastroenterology Specialists in Troy.

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