Does Stress Cause Ulcers?

Q: My family always says I’m going to give myself an ulcer if I don’t manage my stress. But is that really a thing?

Although people have long believed — and doctors used to claim — that stress can cause stomach ulcers, the relationship between the two is not straightforward, experts say.

It’s true that some critically ill patients, like those admitted to intensive care units, can develop stress ulcers, which are sores in the lining of the gastrointestinal tract that quickly arise after extreme physical stress. But “there is simply no data” confirming that everyday psychological stress can directly cause ulcers, said Dr. Tonya Adams, a gastroenterologist at Gastro Health in Fairfax, Va.

That said, it’s possible that, among people who are at high risk for developing ulcers for other reasons, such as overusing specific medications or being infected with a certain type of bacteria, stress could tip them over the edge, said Dr. Neha Mathur, a gastroenterologist at Houston Methodist Hospital.

The Complex Role of Stress

A common type of ulcer — called a peptic ulcer — forms when stomach acid erodes the protective lining of the stomach or the small intestine, causing sores to develop, said Dr. Carolyn Newberry, a gastroenterologist at NewYork-Presbyterian. Another type, known as a gastric ulcer, forms when the sores develop in the stomach lining specifically.

Researchers estimate that about 5 to 10 percent of people worldwide will develop an ulcer.

Most people with peptic ulcers do not have symptoms, Dr. Mathur said. But some can have upper abdominal pain, upset stomach, heartburn, bloating or nausea. Some ulcers also bleed, causing dark, tar-like stools or stools tinged with bright red blood.