Does Stress Cause Stomach Ulcers?

A wealth of research from over the years demonstrates a strong connection between mind and body, which is why mental health conditions can have physical manifestations. Stress, in particular, can have a variety of effects on the body over the short and long term. Below, read an overview of these impacts and learn about stomach ulcers and whether stress can cause them.

Potential health effects of chronic stress

The body automatically instigates physiological processes that go into the “fight-or-flight” response when you are stressed to prepare you to handle a threat. These processes include an increase in epinephrine and cortisol levels, which cause higher blood pressure, a faster heart rate, and more rapid breathing. If you’re highly stressed much of the time, these processes continue for longer than they’re meant to, keeping you in a constant state of high alert that can cause health problems.

According to an article by Yale Medicine, people who experience chronic stress may be at a higher risk for mental and physical health conditions such as:

• Hypertension
• Type II diabetes
• Arthritis
• Obesity
• Heart disease
• Metabolic syndrome
• Substance use disorders
• Behavioral addictions (internet, food, gambling)
• Mood disorders like depression
• Anxiety disorders

Ulcers aren’t commonly found on lists of the most common stress-related health problems, but is it possible for stress to cause them? We’ll explore research on the topic below.

What are ulcers?

An ulcer is a sore that is slow to heal or that eventually heals but returns. Ulcers can appear virtually anywhere on the skin or even inside the body, including within the gastrointestinal tract. Open sores that develop on the lining of the stomach or small intestine are referred to as stomach (peptic) or duodenal (intestinal) ulcers. They can damage the layer that safeguards your stomach from the acids inside of it, causing a significant amount of pain. Ulcers can hurt or burn when you move, or they may cause pain even when you’re sitting still. 

Can stress cause ulcers?

Can stress cause ulcers? Generally, the answer is no—not on its own. However, stress may contribute to the formation of ulcers when other risk factors are present, and it can also make them more difficult to heal. Peptic ulcers are typically caused by H. pylori bacterial infections or by taking NSAIDs (non-steroidal anti-inflammatory medications). In the past, researchers concluded that stress alone does not cause ulcers, but more recent studies suggest that there may still be a link between the two. 

Researchers have discovered that neural pathways between the brain and stomach mean that mental and emotional states can influence the gut environment. Stress experienced in the brain could potentially encourage the growth of H. pylori bacteria in the stomach—especially if an individual is already prone to an overgrowth of this ulcer-causing bacteria. In addition, stress could make people more vulnerable to developing an ulcer from other causes. Other risk factors for developing an ulcer include these conditions:

• Smoking
• Substance use
• Excessive alcohol consumption
• Excessive use of NSAIDs or aspirin 
• Hypertension
• Obesity
• Advanced age

How ulcers are diagnosed and treated

Since you can’t see any external signs of a stomach ulcer, you may meet with your doctor for a diagnosis. The doctor may ask about your symptoms, health history, and lifestyle, and they might conduct an upper endoscopy test, which involves passing a tiny camera into your digestive tract to identify possible ulcers. 

Treatment depends on the severity of your ulcers, their cause, and any concurrent medical conditions you may have or medications you take. Treatment could range from over-the-counter antacids to prescription acid blockers to antibiotics or to other prescription medications. Your doctor may also recommend avoiding or limiting activities that can worsen an ulcer, some of which include smoking, drinking alcohol, eating spicy foods, and experiencing high stress levels. Ulcers can lead to serious complications if left untreated, so meet with your doctor if you believe you may have one.

The BetterHelp platform is not intended for any information regarding which drugs, medication, or medical treatment may be appropriate for you. The content provides generalized information that is not specific to one individual. You should not take any action without consulting a qualified medical professional.

Tips for reducing stress levels

While there doesn’t appear to be a direct, causal relationship between stress and ulcers, reducing stress may help you avoid various gut issues and can help you heal existing ulcers. Pinpointing the main causes of your stress and addressing them may be the first step. However, people may be unable to change jobs, solve relationship problems, or eliminate other common sources of stress so easily. Stress-reduction and stress-management techniques like the following can be helpful in those cases.

Get physically active

Extensive research points toward the power of physical activity in reducing symptoms of mental and physical health concerns—and high stress is one of them. According to the Anxiety & Depression Association of America (ADAA), getting regular physical exercise may “decrease overall levels of tension” in addition to elevating and stabilizing mood, improving sleep quality, and boosting self-esteem. The article reports that even five minutes of aerobic exercise can “stimulate anti-anxiety effects.” For that reason, engaging in the recommended amount of exercise can help you manage stress overall, and going for a walk or a jog when you start to sense your stress levels rising may make it possible for you to stay calm.

Try meditation

Meditation is the practice of cultivating a nonjudgmental awareness of the present moment. This practice originated as an ancient spiritual and religious practice in India and is now practiced by religious and non-religious people worldwide. Research suggests that meditation can offer various mental and physical health benefits, including reducing stress. A 2021 study reports that mindfulness-based meditation may “significantly decrease stress.” There are many ways to learn how to meditate, from apps to in-person classes to free online videos.

Set healthy boundaries

Ending up in situations that aren’t comfortable for you may cause stress. Therefore, learning to set and enforce healthy boundaries can be helpful. For example, if you’re overextended and someone invites you to an event or asks for a favor that you don’t have the bandwidth for, turning them down can assist you in avoiding a spike in stress levels. Additionally, if a friend or partner wants to vent to you about a topic that’s bothering them, kindly but firmly telling them when you’re not emotionally up for listening can contribute to safeguarding your calm, too.

Speak with a therapist

Whether you’re worried about exacerbating an ulcer or contributing to other health issues, managing stress can help you improve your overall well-being. If you’re having trouble managing stress levels in your life, you may find it helpful to speak with a therapist. They can provide you with a safe, non-judgmental space where you can express and process your emotions and offer you coping techniques to better manage stress levels in your life. If a mental health condition like an anxiety disorder is causing additional challenges in this area, they can help you address those symptoms. 

Some people who experience high stress levels have busy schedules and may find it difficult to attend regular, in-person sessions with a therapist. Online therapy may represent a more convenient, available option in cases like these. With a virtual therapy platform like BetterHelp, you can get matched with a licensed therapist who you can meet with via phone, video call, or online chat to address the challenges you may be facing. In addition, you can choose a session time that fits your schedule. Research suggests that there’s no difference in effectiveness between in-person and online therapy, so you can be confident in choosing whichever option works for you.